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Signs Your Teen Is Self-Harming

Unexplained injuries, mood changes and sudden isolation may be signs your child needs help

Teen sitting in window well staring out the window

Growing up brings challenges, especially during those awkward teenage years. Kids often go through an intense range of emotions as they desperately try to find their place in a complicated world.

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The journey can be an excruciatingly painful one. It can get so bad that some teens try to dull the pain by inflicting a different kind of hurt — a physical hurt — upon themselves.

This self-harm can be done in many different ways, including cutting, scratching or burning. It’s far more common than you might expect, too: Studies show that nearly 1 in 5 teens have self-injured.

So, why does this happen and what can you do to help a teen showing the scars of psychological distress? Let’s look for answers with psychologist Kristen Eastman, PsyD, and psychiatrist Zeyd Khan, MD.

Signs of self-harming

Self-harm can come in many different forms, but many of these actions share a common connection: They leave visible marks. Common self-harming behaviors that create wounds include:

  • Cutting or piercing skin with sharp objects.
  • Scratching, picking, rubbing or biting skin until it’s damaged.
  • Burning or branding skin with flames or red-hot items.
  • Hitting oneself.
  • Striking solid objects (such as a wall) and causing injury.

But seeing those signs of self-harm (nonsuicidal self-injury, or NSSI) isn’t always easy. “Kids are smart — and they know how to hide things,” says Dr. Khan. “They’ll take steps to conceal what they’re doing.”

They can do that by:

  • Controlling the placement of injuries. “Teens may attempt to cut in places that are less likely to be seen, like their inner thighs or stomach,” he says.
  • Covering injured areas. Wearing long-sleeved shirts or pants even on hot days may be an attempt to conceal visible cuts. An armful of bracelets also may be used to cover wounds.
  • Using an unusual amount of bandages or first-aid supplies for “accidental” injuries.

Other signs of self-harming could include:

Mood changes

Stress, anxiety and depression can all lead to self-harming behaviors with the right mix of factors. “These conditions may cause teens to feel out of control and at a loss with how to cope with their emotions,” notes Dr. Eastman. “Watch for emotional or behavioral changes.”

A trigger event

Self-harm sometimes begins after an adverse experience or event, says Dr. Khan. These could include:

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Fascination with self-harm

Pay attention if your teen takes an interest in self-harm. That can include reading or watching videos about the behavior online or suddenly befriending others who engage in forms of self-injury, shares Dr. Eastman.

Isolation

If your teen shuts themselves off from family and friends and begins spending more time alone than seems typical, the withdrawal could indicate depression and, in turn, signal a move toward self-harm.

Look for patterns of signs

Every individual sign noted here doesn’t always point to self-harm. Daily life for teens comes with ups and downs, as well as occasional mood changes, recognizes Dr. Eastman. Kids may have issues with friends from time to time, too, and they certainly stress over classes and tests.

But keep an eye out for a “constellation” of signs: “If you see a combination of these warning signs, particularly if they’re out of character for your teen, you should check in with them, keep a close eye and monitor,” she states.

Why teens self-harm

Self-harm is often a misguided way of trying to cope with intense emotions.

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“Those who self-harm often view it as a form of release or a distraction from emotional pain,” explains Dr. Eastman. “Some may feel emotionally numb and view self-harm as the only way they can feel anything.”

NSSI also may be a form of communication — a cry for help in the hope that others will see their pain through the injuries and respond.

It has long been estimated that about 20% of teens self-harm. But self-injury rates increased during the COVID-19 pandemic, and there’s some evidence the number may now be closer to 25%, according to Dr. Khan.

Can self-harm indicate increased suicide risk?

Dr. Khan says that self-injury is one of the strongest predictors of a future suicide attempt. Researchers say that 70% of those with a history of self-harming attempt suicide at least once; 55% make multiple attempts.

“Some have this escalating course of action because things are kept secret and they’re on their own,” he continues. “Because of that, they struggle to slow down or stop self-harming, which is more likely to lead down the road of suicidal thoughts.”

Learn more about teen suicide warning signs.

How to help teens who self-harm

If you suspect that your teen is self-harming, or if they tell you that they are, it’s important not to react with anger or criticism. Validate their emotions and let them know you understand they’re feeling overwhelmed.

What your teen needs most at this moment are listening ears and compassion. “Be curious, not judgmental,” advises Dr. Khan. “Ask questions and try to listen more than you speak to find out what is happening.”

But make it clear that there are better ways to deal with their problems — and you’ll work with them to figure it out. Take steps to minimize access to sharp objects they may be using to self-harm, too, suggests Dr. Eastman.

If your child is self-harming, know that having a trusted, caring adult at their side is important for them to work through their emotions.

“Try your best to be that person,” encourages Dr. Khan.

Getting professional help

It’s also important to quickly connect a child who is self-harming to a mental health professional. (If your child is having suicidal thoughts, head to an emergency room.)

Look for a mental health professional who has experience treating adolescents who self-harm. If you’re not sure where to start, talk to your pediatrician first. They can work with you to take the next step.

Other resources include the:

“It’s distressing to learn that your child has been self-harming,” Dr. Eastman empathizes. “But with your support and a professional’s help, your teen can learn healthier ways of coping with tough emotions.”

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Health Library
Self-Harm (Nonsuicidal Self-Injury Disorder)

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