What is Self-Harm?
Self-harm is when an individual intentionally hurts or injures themselves, often as a way to manage distressing emotions and internal pain. People often self-harm to escape feelings or negative emotions that they struggle to verbalize, turning emotional pain into physical pain. Teens who self-harm are not always suicidal, but they are at higher risk of attempting suicide if they do not receive treatment [1].
Cutting is one of the most visible forms of self-harm, which is why scars may draw attention first. However, teens may harm themselves in many different ways, including:
- Pricking skin with sharp objects
- Scratching the skin repeatedly or breaking the skin with fingernails
- Picking at wounds or scabs to prevent healing
- Burning the skin with heat or chemicals
- Biting the skin
- Hitting themselves or banging their head or body against objects
- Pulling out hair from the scalp, eyebrows, or body
- Inserting objects into the body
Why Do Teens Self-Harm?
Self-harm behaviors in teens are often a sign that something deeper is going on under the surface, and they are unable to cope with negative feelings. For many teens, physical pain can be easier than feeling emotionally out of control.
Other reasons teens might self-harm include to [2]:
- Reduce or release distressing emotions such as sadness, internal pain, anger, or low self-esteem
- Relieve tension or pressure, reduce feelings of panic or anxiety, and feel calmer
- Use physical pain to distract from emotional pain (e.g, trauma, bullying)
- Gain a sense of control over problems
- Relieve feelings of numbness or stop “zoning out.”
Although self-harm often brings relief to teens in the moment, the feelings eventually build up again, along with the urge to self-harm. This can create a cycle that is hard to break without adult intervention, causing many teens to feel ashamed, confused, and scared about their actions.
Signs of Self-Harm in Youth
Teens who self-harm are often not open about it due to shame, fear of getting into trouble, or the inability to express what’s happening in their internal world.
Even if your teen is not talking about self-harming or showing visible injuries or open wounds, other signs to watch out for include:
- Unexplained cuts, bruises, or burns
- Going to great lengths to cover their body (wearing a hoodie and long sleeves in the heat, avoiding swimming, or changing around others)
- Bloody tissues or paper towels in their room or trash can
- Low mood, isolation, and withdrawal from friends and family
- Expressing feelings of hopelessness, failure, or blaming themselves for negative outcomes
Recognizing Self-Harm Scars in Youth
Self-harm scars can look different depending on the method used, how long ago the injury occurred, and how an individual’s body heals. They are often in areas that are easy to hide, such as the wrists, thighs, stomach, or upper arms.
Scars may appear as straight, parallel lines, clusters of marks, or repeated patterns that look similar in size and spacing. Older scars may fade over time, while newer ones may appear pink, red, or raised as they heal [3].
Recognizing possible self-harm scars is not about making assumptions or accusations. It is about noticing patterns and using them as an opportunity to check in and actively listen so you can provide support.
When Should You Seek Immediate Help For Self-Harm in Teens?
Fresh wounds, scabs, or injuries that appear to be healing repeatedly can be signs of ongoing self-harm rather than past behavior. An increase in frequency, severity, or secrecy around injuries, clothing, or isolation is also a concern.
If scars are accompanied by noticeable changes in mood, sleep, appetite, academic performance, or social withdrawal, this combination can be a sign of emotional distress that requires prompt intervention. Seek immediate professional help or emergency support if you notice any of the following red flags:
- Recent or open fresh cuts, burns, or other wounds
- Statements about wanting to die, disappear, or not exist
- Joking or casual language about suicide or self-harm
- Giving away possessions or saying goodbye
- Accessing or stockpiling items used for self-harming
- Expressing hopelessness, shame, or feeling like a burden
If your teen expresses suicidal thoughts or you believe they may be in immediate danger, contact emergency services or a crisis line, or go to the nearest emergency room.
How Is Self-Harm Treated in Teens?
Treatment for self-harm in teens focuses on addressing the underlying emotional distress rather than simply stopping the behavior itself. Evidence-based approaches such as Cognitive Behavioral Therapy (CBT) and Dialectical Behavior Therapy (DBT) are commonly used to help teens build skills to challenge negative thoughts, regulate emotions, and manage and tolerate distress.
If self-harm is due to anxiety, depression, or other mental health conditions, treatment may also include medication. Family support and collaboration are also essential, and parents may be included in therapy sessions to improve communication, reduce conflict, and create a supportive home environment.
In cases such as when a teen is at high risk of suicide or unable to stay safe, a higher level of care, such as partial hospitalization or inpatient treatment, may be recommended.
Safe and Supervised Self-Harm Treatment for Teens in Texas
Clearfork Academy is a network of behavioral health facilities in Texas committed to helping teens recover from substance abuse disorders and co-occurring mental health challenges.
Our specialized programs address self-harm by looking at the underlying issues beneath the surface, such as emotional distress, depression, and lack of support in the home. Our team is committed to helping teens find a healthier, happier life beyond the grips of self-harm.
Contact our admission team today to see how we can support your teen.
Sources
[1] SAMHSA. What Is Self-Harm?
[2] McKean, A. 2024. When Children and Teens Self-Harm.
[3] Anderson, W. et al. (2018). Deliberate self-harm scars: Review of the current literature. JPRAS open, 16, 109–116.
Mike Carter, LCDC
Alumni Relations Manager
Mike grew up on a dairy farm in Parker County, Texas. At the age of 59, he went back to college and graduated 41 years after his first graduation from Weatherford College. God placed on his heart at that time the passion to begin to help others as they walked from addictions, alcoholism, and abuse of substances. He is a Licensed Chemical Dependency Counselor and in the past few years he has worn many hats, from intake and assessment, group counseling, individual and family counseling, intensive outpatient and now he is working with clients, therapist, and families on discharge planning and aftercare. He also coordinates our Alumni Outreach Program.
