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Recognizing Signs: Is Your Teen Struggling with Self-Harm?

Non-suicidal self-injury (NSSI), also known as self-harm, a concerning behavior often found in teenagers, refers to the intentional infliction of injury upon oneself. This alarming act is usually a manifestation of emotional distress and mental health struggles. 

In teens, self-harm is often a secretive way of coping with overwhelming feelings, such as anxiety, depression, or trauma. It’s a physical expression of internal turmoil and a cry for help, making it crucial for parents, educators, and peers to recognize the signs. 

Understanding self-harm in teens is the first step toward providing the necessary support and intervention for their well-being and recovery.

A young lady suffering from depression and is using self-harm as a coping mechanism.

What Is  Self-Harm in Teens?

Self-harm, also known as self-injury, is the deliberate act of causing physical harm to one’s body as a way to cope with emotional pain, intense anger, or frustration. In teenagers, this behavior is often a reflection of deep psychological distress and is not typically intended as a suicidal act. 

Rather, self-harm is a harmful method to:

  • Express feelings that are hard to verbalize
  • Manage overwhelming emotions
  • Cry for help 

It’s a sign that a teen is struggling to cope with something in their life and needs support. This behavior can have serious implications for a teen’s mental health, including the risk of escalating self-injury, developing chronic mental health issues, or even accidental life-threatening injuries.

Forms of Self-Harm Among Teens

Teens may resort to various forms of self-harm, each with its unique dangers and indicators. Common methods include:

  • Cutting: The most recognized form, where teens use sharp objects to make cuts or scratches on their body, often on the wrists, arms, legs, or torso.
  • Burning: Some teens inflict burns on themselves using matches, cigarettes, or hot objects.
  • Hitting or Punching: This includes banging or punching walls or oneself to the point of causing bruises or injuries.
  • Excessive Scratching: This leads to skin breaking and bleeding, often done to the point of severe wounds.
  • Hair Pulling: Known as trichotillomania, it involves pulling out one’s hair, leading to noticeable hair loss.
  • Interfering with Wound Healing: Deliberately preventing cuts or other injuries from healing.
  • Bone Breaking: In extreme cases, some teens may attempt to break their bones.

These methods are often hidden under clothing or explained away as accidents, making it imperative for those close to teens to be vigilant and empathetic in recognizing these signs of distress.

Why Do Teens Do It?

Self-harm in teens is a complex issue rooted in emotional coping, control, and expression. Often, it serves as a misguided method for handling intense emotions. 


For many teens, the physical act of harming themselves can momentarily provide relief from emotional distress. This can include feelings of sadness, loneliness, anxiety, or anger. The act of self-injury might momentarily distract them from emotional pain or help them feel a sense of release.


Self-harm can be a way for teens to exert control in their lives. Adolescence is a period filled with changes and uncertainties. For some teens, their lives may feel chaotic or beyond their control. Self-harm can emerge as a way to exert some form of control over their bodies when they can’t control other aspects of their lives.


Self-harm often acts as a form of expression. Teens struggling with deep emotional pain might find it difficult to express their feelings verbally. For them, self-injury becomes a physical representation of their inner turmoil. It’s a silent scream for help, a tangible manifestation of psychological pain that they cannot otherwise communicate. 

Understanding these underlying reasons is key to addressing the issue and providing the right support and intervention.

Is Self-Harm a Mental Illness?

Non-Suicidal Self-Injury (NSSI) refers to the deliberate, self-inflicted damage to one’s body tissue without suicidal intent. While NSSI itself is not classified as a mental illness, it is a serious behavioral issue that often indicates underlying mental health challenges. In the mental health field, NSSI is recognized as a symptom or manifestation of deeper psychological distress.

Self-harm is frequently associated with mental health disorders such as depression, anxiety disorders, borderline personality disorder, and post-traumatic stress disorder (PTSD). It’s often a physical response to the intense and overwhelming emotions that accompany these conditions. 

For instance, individuals with depression may turn to self-harm as a coping mechanism for their deep-seated sadness and hopelessness. Similarly, those with borderline personality disorder might engage in self-injury as an expression of their extreme emotional swings and identity confusion.

Furthermore, self-harm can be linked to experiences of trauma, abuse, or major life stressors. In such cases, the act of self-injuring can be a way to externalize internal pain or regain a sense of control over one’s emotions or life circumstances. 

It’s crucial to recognize self-harm as a signal that a teen may need professional help to address underlying mental health issues. Understanding and addressing these root causes is essential for effective treatment and recovery.

Self-Harm Symptoms

Identifying self-harm in teens requires vigilance to both visible signs and behavioral indicators, as many adolescents go to great lengths to hide their self-injurious actions.

Visible Signs

  • Unexplained Wounds or Scars: Frequent cuts, bruises, burns, or scratches that cannot be adequately explained, often found on wrists, arms, thighs, or stomach.
  • Wearing Inappropriate Clothing: Consistently wearing long sleeves or pants, even in hot weather, to hide scars or fresh injuries.
  • Frequent “Accidents”: Regularly attributing injuries to accidents, which may not align with the nature of the wounds.
  • Sharp Objects: Finding razors, knives, or other sharp objects among personal belongings, often hidden or in unusual places.
  • Covering Up: Excessive use of wristbands, makeup, or bandages to conceal injuries.

Behavioral Indicators

  • Isolation: Withdrawing from friends, family, and activities they once enjoyed.
  • Mood Swings: Exhibiting sudden or unexplained changes in mood, including expressions of hopelessness or worthlessness.
  • Impulsivity: Engaging in impulsive or reckless behavior, showing a lack of concern for their well-being.
  • Changes in Eating or Sleeping Habits: Showing signs of disturbed sleep patterns or changes in appetite, which can indicate emotional distress.
  • Decline in School Performance: A noticeable drop in grades or loss of interest in schoolwork and extracurricular activities.
  • Substance Abuse: Using drugs or alcohol as a coping mechanism can sometimes accompany self-harming behaviors.

Recognizing these symptoms is the first step in providing the necessary support and intervention. It’s important to approach the situation with empathy and understanding and to seek professional help. Early identification and intervention can significantly improve outcomes for teens struggling with self-harm.

The Influence of Social Media

Social media has a profound impact on teen behavior and mental health, influencing self-harm in several ways. Cyberbullying is a significant factor, where negative online interactions can deeply affect a teen’s self-esteem and mental well-being. Teens who are victims of cyberbullying often experience feelings of isolation, depression, and anxiety, which can lead to self-harming behaviors as a coping mechanism.

Additionally, the world of social media is rife with comparison. Teens are constantly bombarded with images and stories that portray unrealistic standards of beauty, success, and happiness. This relentless comparison can lead to feelings of inadequacy and low self-esteem, driving some teens towards self-harm as a way to cope with these negative feelings.

Moreover, the portrayal of self-harm in the media can have a significant impact. Social media platforms and certain websites may inadvertently glamorize or trivialize self-harm, influencing teens’ perceptions and actions. 

Exposure to graphic content related to self-injury can normalize the behavior or present it as a viable option for dealing with emotional pain. This dangerous portrayal necessitates a responsible media approach and increased parental and educational awareness to mitigate the potential negative influences of social media on teens’ mental health and behaviors.

The Escalation of Teen Self-Harm: A Dangerous Progression

Recent years have witnessed a concerning increase in self-harm among teenagers. Studies and surveys consistently show a rise in cases, indicating that this is a growing issue in youth mental health. 

One study (Klonsky et al) reported lifetime rates among adolescents are about 15% to 20%, and onset typically occurs around age 13 or 14. Klonsky further reported that approximately 34% of the adolescents studied were engaged in some form of NSSI at some point in their lives, with 16% of the overall sample reporting evidence of repetitive NSSI in the past 6 months.

Reports from healthcare providers and school counselors have noted a significant uptick in self-injury behaviors among adolescents. This trend is alarming, considering the potential for these behaviors to escalate.

Self-harm often starts as a coping mechanism for dealing with emotional pain, stress, or trauma. Initially, the injuries might be minor, but over time, there is a significant risk of escalation. As teens become more accustomed to self-harm as a method of coping, they may start inflicting more severe injuries. This escalation can stem from a need for a more intense sensation to achieve the same level of emotional relief or from a deepening of the underlying psychological issues.

Furthermore, while self-harm is not inherently a suicidal act, the behavior significantly increases the risk of suicidal tendencies. The psychological distress that leads to self-harm can also lead to suicidal thoughts and actions. 

In some cases, what starts as self-harm can evolve into attempts to take one’s own life, especially if the underlying issues are not addressed. It’s crucial for parents, educators, and healthcare professionals to be aware of this potential for escalation and to intervene early. Providing appropriate mental health support and resources is essential in reversing this dangerous progression and helping teens find healthier ways to cope with their emotions.

If your teen is suffering from mental health issues; call us, we can help.

Tips for Parents When Addressing Self-Harm

Addressing self-harm in teens is a delicate matter, requiring sensitivity, understanding, and patience. Here are some strategies for parents:

Starting the Conversation

  • Choose the Right Time and Place: Initiate the conversation in a private, quiet setting where your teen feels comfortable and safe.
  • Be Calm and Non-judgmental: Approach the subject with calmness and compassion, avoiding any expressions of anger or disappointment.
  • Express Concern, Not Blame: Let them know you are worried about their well-being and are there to support them, not to blame or punish them.
  • Listen More Than You Speak: Encourage them to share their feelings and listen attentively. Validate their emotions and avoid minimizing their struggles.

Support Strategies

  • Educate Yourself: Understand the complexities of self-harm to better empathize with their situation.
  • Maintain Open Communication: Keep the lines of communication open. Regular check-ins can foster trust and provide ongoing support.
  • Create a Safe Environment: Remove potential tools for self-harm from the home and encourage healthy outlets for emotions.
  • Involve Them in Activities: Encourage participation in activities that promote well-being, like exercise, arts, or social events.

Finding Professional Help

  • Seek a Mental Health Professional: Look for therapists or counselors who specialize in adolescent mental health and self-harm.
  • Prepare for the First Visit: Talk to your teen about what to expect and reassure them that seeking help is a positive step.
  • Be Involved in the Treatment Process: Attend sessions if appropriate, and work with the therapist to understand how you can support your teen’s recovery.
  • Be Patient with the Process: Recovery takes time. Recognize small victories and stay committed to the journey.

Dealing with a teen who self-harms can be challenging, but with the right approach and professional support, parents can play a crucial role in their child’s path to recovery.

What to Do in an Emergency

Immediate Actions

  • Assess the Severity: Quickly determine the severity of the injury. If it’s life-threatening or requires medical attention, call 911 emergency services immediately.
  • Stay Calm and Supportive: Keep calm to help stabilize the situation. Offer comfort and assurance to the teen.
  • Administer Basic First Aid: If the injury is not life-threatening, gently clean the wound and apply basic first aid. Avoid showing distress or disgust.
  • Ensure Immediate Safety: Remove any objects that could be used for further self-harm.
  • Do Not Leave Them Alone: Stay with the teen until professional help arrives or the immediate crisis is resolved.
  • Contact a Mental Health Professional: As soon as the immediate physical danger is addressed, seek help from a mental health professional.

Safety Planning

  • Remove Harmful Objects: Secure or remove items that could be used for self-harm from the home.
  • Develop a Safety Plan: Collaborate with your teen and a mental health professional to create a safety plan for handling future urges to self-harm. This can include identifying triggers, coping strategies, and emergency contacts.
  • Regular Check-Ins: Establish regular times to check in with your teen about their feelings and well-being.
  • Educate Family Members: Ensure all family members understand the seriousness of self-harm and know how to respond appropriately in an emergency.
  • Create a Supportive Environment: Foster an environment of open communication and non-judgment, encouraging the teen to share their feelings.
  • Emergency Contacts List: Keep a list of emergency contacts, including healthcare providers and crisis hotlines, readily accessible.
  • Monitor Mental Health: Pay close attention to your teen’s mental health and seek ongoing professional support.

In emergencies involving self-harm, quick and compassionate action is crucial. Long-term, proactive safety planning and creating a supportive environment are essential for preventing future incidents and promoting healing and recovery.

Clearfork Academy is a Christ-centered treatment facility that focuses on treating teenagers who are struggling with issues such as trauma and substance abuse. Our NSSI treatment focuses on healing your teen’s body, mind, and spirit so that they have the best chance of a happy and healthy future.

Our lead therapist is in session with boys and girls from our IOP location.


Klonsky ED, Victor SE, Saffer BY. 2014.  Nonsuicidal self-injury: what we know, and what we need to know. Can J Psychiatry. 2014;59(11):565–8.

Peterson, J. et al. 2008. Nonsuicidal Self-injury in Adolescents. Psychiatry (Edgmont). 2008 Nov; 5(11): 20–26. Published online 2008 NovSchwarz., J. 2006. 2006. Self-inflicted Injury Can Escalate, Study Shows. University of Washington.

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