Understanding Teen Self-Harm: A Guide for Parents

Picture a high school classroom filled with bright, energetic students. Beneath their cheerful exterior, however, nearly one-fifth of them harbor a dark secret: inflicting deliberate harm on themselves. Their pain may be invisible to the casual observer, concealed beneath a carefully crafted façade, but it’s there nonetheless.

For a parent, discovering that their child is one of those struggling teens is heart-wrenching. Understanding and identifying the signs of self-abuse is the first step toward getting teens the support they need.

Why do teens self-harm?

Self-harm, or nonsuicidal self-injury (NSSI), is the act of deliberately inflicting physical harm on oneself without intending to commit suicide. It’s a desperate attempt to release emotional pain when other coping mechanisms fail.

So, why do teenagers cut themselves? Such self-harm triggers endorphins, the brain’s natural painkillers, providing temporary relief from psychological distress. Because the relief is short-lived, however, it can lead to a dangerous cycle of repeated self-injury.

Mental health issues like depression and anxiety can amplify feelings of worthlessness and hopelessness, putting teens at greater risk of self-abuse. It’s no secret that feeling isolated and alone takes a toll on mental health, especially among adolescents. It can be heartbreaking for them to feel like they don’t belong or aren’t getting support from friends. Such loneliness and isolation increase the likelihood that they will turn to self-harm as a way to cope with their pain, express emotions that are difficult to verbalize, or counteract feelings of numbness and disconnection.

When bullying inflicts deep emotional scars, some teens resort to self-harm to escape the pain. Struggling with low self-esteem, they may lack healthy strategies for coping with emotional distress, such as seeking counseling or going for a run. For such teens, self-harm is a way to simultaneously release emotional pain and punish themselves.

Why don’t they seek help from someone they trust? Many teens fear being judged, labeled “crazy,” or rejected by their peers. This fear is especially pronounced in environments where seeking mental health treatment is considered a sign of weakness. As a result, teens may feel more comfortable self-harming than risking vulnerability and openness with a trusted adult or mental health professional.

Because many teens feel powerless, they may also use self-harm as a way to reassert control when things feel chaotic or uncertain. Inflicting physical pain helps them manage inner turmoil and generates a predictable outcome in an unpredictable world.

Family life plays a significant role in a teenager’s development, and sometimes things at home aren’t so great. Frequent conflict, abuse, or neglect can cause a teen to feel intense psychological pain, prompting them to self-harm as a way to deal with the distress. School can likewise be a significant source of stress, creating pressure to get good grades, compete with classmates, and live up to others’ expectations. When the burden becomes too great, teens may turn to self-harm as a way to release the pressure.

What is considered self-harm in teens?

The following are some common self-harm behaviors in teens.

Head banging
Cutting
Picking at scabs
Pulling hair
Excessive scratching
Burning
Punching themselves in the head
Inserting objects into bodily orifices
Drinking toxic substances, such as ammonia
Purposefully breaking bones

Recognizing the signs of teen self-harm

If you’re concerned your teen might be self-harming, know the signs so you can assess their condition and get them the help they need. Here’s what to look for:

Physical signs

Physical indicators are often the most noticeable signs of self-harm. Look for unexplained cuts, bruises, burns, or other injuries. Such marks are typically found on the arms, legs, or stomach—areas easily hidden by clothing.

Behavioral signs

While physical signs are often the clearest evidence of self-harm, it’s equally important to pay close attention to your teen’s behavior. A sudden change can mean something is amiss. Here are some key behaviors to watch for:

Increased isolation: If your child spends an unusual amount of time alone in their room, avoiding interactions with family and friends, it could be an attempt to hide self-inflicted injuries. It could also indicate depression or anxiety—conditions that increase the risk of self-harm.

Avoidance of social activities: A sudden reluctance to participate in activities that expose skin, such as swimming or sports, could mean your teen is trying to conceal self-inflicted injuries.
Hiding sharp objects: Have you found razors, knives, scissors, or other sharp objects in your teen’s room or among their belongings? This is a red flag that warrants further investigation.

While these behaviors don’t necessarily indicate self-harm, if you notice several together or a significant change in your teen’s usual patterns, seek professional help as soon as possible.

Emotional signs

Studies have found a significant correlation between depression and self-harming behaviors in adolescents. Watch for the following common symptoms of depression to ensure early intervention and support:

Persistent sadness or low mood: Has your teen experienced a significant and persistent shift in mood characterized by sadness, tearfulness, and/or a loss of interest in activities they once found enjoyable?
Changes in sleep patterns: Is your child sleeping too much or too little?
Changes in eating patterns: Is your teen eating significantly less or more than usual? Are they skipping meals or binge eating?
Difficulty concentrating: Is your teen having trouble focusing on schoolwork, making decisions, or remembering things?
Feelings of worthlessness or guilt: Does your teen frequently express feelings of self-loathing, shame, or inadequacy?
Loss of energy and motivation: Is your child experiencing a significant drop in energy levels? Do they seem unmotivated or lethargic?
Social withdrawal: Is your teen isolating from friends and family, preferring to spend time alone?
Physical aches and pains: Is your teen suffering from aches and pains with no apparent cause? Depression can manifest physically as headaches, stomachaches, or other unexplained pains.

What to do if your child is self-harming

Conversations about self-harm are difficult and may feel awkward, painful, and scary. However, staying silent only reinforces isolation, which is the last thing your struggling teen needs.

If you think your teen might be self-harming, address it as soon as possible. Find a quiet moment to talk privately, and be open and honest about your concerns. Avoid accusatory language and jumping to conclusions. Instead, ask open-ended questions like, “I’ve noticed some things that worry me. Can we talk about what you’re going through?” Reassure your child that you’re not angry but concerned about their well-being.

If you find sharp objects like razors or knives hidden in your teen’s room or backpack, it’s normal to feel alarmed. But it’s essential to approach the situation calmly. Take a moment to gather your thoughts and then initiate a nonconfrontational conversation, explaining that you’re worried about their safety and well-being. Gently inquire about the reasons they have these items and whether they’re engaging in or considering self-harm.

The importance of support on the recovery journey

Teens struggling with self-harm tend to withdraw from others due to the shame they feel, which increases their isolation and loneliness and hinders recovery. Building a support network of friends, family, and mental health professionals is thus crucial.

While parents are an indispensable part of a teen’s support network, it’s important that teens also connect with others who have firsthand experience with self-harm. Peer support groups, whether in-person or online, provide such opportunities. In these groups, teens can connect with others who understand what they’re going through, which helps them gain the confidence and support they need to break the cycle of self-harm.

Many community resources are available to support teens struggling with this problem. Youth centers, crisis hotlines, and mental health clinics typically offer a range of services, including therapy. Online counseling for teens is another highly effective option.

How to stop self-harming: Seeking professional help

If your teen admits to self-harming or if your concerns persist despite their denial, it’s essential to seek professional help. Mental health professionals like therapists, counselors, and psychiatrists can assess and treat this issue. They offer a supportive environment for your teen to explore their emotions, develop healthy coping strategies, and address underlying issues that are contributing to the problem.

Treatment options

Treatment for teens who self-harm typically addresses both the behaviors and their underlying emotional causes. Fortunately, several evidence-based treatments can equip young people with the tools to manage emotions and overcome self-harming urges.

Cognitive behavioral therapy (CBT) teaches teens to identify negative thought patterns and beliefs that can lead to self-harm and gives them practical skills to challenge such thoughts and replace them with healthier alternatives, reducing their urge to self-harm.
Dialectical behavior therapy (DBT) is a therapeutic approach specifically designed to help individuals manage intense emotions and impulsive behaviors. It teaches teens to regulate emotions, tolerate distress, and communicate needs effectively, which can significantly reduce self-harming behaviors.
Medication may be recommended for teens struggling with self-harm who also have a diagnosed mental health condition. It can help stabilize mood, reduce anxiety, and improve overall well-being, thus increasing the effectiveness of talk therapy.

Some of these treatment options are available through online teen therapy.

The importance of early intervention

It’s important to be compassionate and understanding when helping someone who self-harms. Shaming or judging will only make things worse.

Professional help is crucial—therapists and counselors are trained to help individuals understand the root causes of their pain and develop healthier coping mechanisms—but we all play important roles. Parents, teachers, friends, and community members can help by being observant and noticing changes in behavior. Unexplained injuries, withdrawal from social activities, or sudden mood swings can all be signs that a teen is struggling. If a teen you know is showing signs that concern you, don’t hesitate to reach out. Let them know you care and that you’re there for them.

Early intervention is critical. The sooner you get assistance for a self-harming teen, the better their chances of recovery.