Ask most parents what they would do if someone harmed their child, and you’ll likely get a spirited answer like, “Who am I fighting today?”

When we imagine the types of danger our children will face in the world, we may picture ourselves in heroic roles, even using our bodies as a shield or confronting the big bully.

But when parents discover that their child is harming themselves, it can evoke a deep sense of helplessness, fear, guilt, and even disbelief. 

In this context, we can’t be shields and there’s no one to fight — and it can be confusing to know how to intervene when there’s nowhere to point the finger, except maybe at our child or at ourselves.

We recently shared about why teens self-harm and some of the misconceptions about these behaviors. 

This week, we’re discussing the key warning signs that a teen might be engaging in self-harm, and how parents can intervene with compassion and care.

Is your child struggling? You aren’t alone.

As a team of adolescent behavioral health experts, we don’t just write blog posts — we support teens and their families in building brighter, healthier futures through our day programs and outpatient services. 

If your teen is struggling with self-harm, depression, anxiety, or other behavioral issues, we’re here for you. 

Call our admissions team at 1-877-349-6720 to learn more about how we can help.

1. Your teen has new and unexplained wounds, like cuts, bruises, marks, or burns.

Self-harm in teens can range from burning oneself, skin-picking, hair pulling, hitting oneself, intentionally and abrasively scrubbing skin, choking oneself, swallowing objects or harmful substances, and even embedding objects under the skin. 

If you notice any unusual marks or wounds on your teen, it’s crucial not to ignore them. 

It starts by asking thoughtful, open-ended questions so that your teen knows you are a nonjudgmental and supportive person to talk to if they’re struggling with self-harm (or even an abusive relationship, which is another reason why a teen might have unexplained wounds).

In the last section of this article, we’ll discuss in more detail how to intervene and have an open conversation about self-harm, including when you notice marks or wounds.

While sometimes there will be visible marks when a teen self-harms, it’s also possible that any wounds your teen has are hidden from you, or that they’re engaging in a form of self-harm that isn’t visible at all. 

Therefore, it’s best not to assume that this will always be evident in every instance of self-harm, or to wait until you’ve seen the wounds before intervening.

2. Your teen seems protective over their body — i.e. hiding or concealing it, or being more reactive to being touched.

This is another common sign that a teen might be engaging in self-harm, as it could suggest they have wounds, injuries, or scars that they don’t want to have discovered, or that they’re in physical pain.

This can look like:

• Wearing long sleeves or long pants, even when it’s hot outside
• Wearing a scarf to cover their neck, especially when it’s not an item they would usually wear
• Always keeping skin covered, even at home, like suddenly wearing long sleeves and pants as pajamas, regardless of the season
• Refusing to change clothes in front of others (like in a public changeroom), especially if they were comfortable doing so previously
• Turning down invitations to swim (or otherwise wearing a bathing suit), especially if those are activities they once enjoyed
• Wincing, flinching, or seeming pained when touched
• Getting angry or upset if you attempt to touch them, especially in ways they used to find comforting

It’s very important to note here that while the above examples are concerning and warrant a conversation, they don’t guarantee that a teen is engaging in self-harm.

These signs might also point to a recent assault, a teen who is increasingly uncomfortable in their own body, a teen who may want to experiment with modesty as a form of self-expression or as a spiritual practice, a teen who is sexually active and may have marks from a recent encounter, or a teen who may just have different boundaries than they previously did around their own body.

Regardless of concerns, a parent should never force a teen to undress or endure unwanted touch, which could be experienced as a violation or even as traumatic for them.

3. Your teen requests unusual items (especially sharp objects and/or wound care supplies), and/or you keep finding those items in strange places.

While some teens will find ways to access the objects that they use for self-harm, and the supplies they use to treat their own wounds, on their own, not all of them will. 

The list of items that a teen might use related to self-harm could be endless, but parents should be especially mindful of sharp items like razors, pencil sharpeners, safety pins, letter openers, scissors, and needles, as well as wound care supplies like bandaids, gauze, antibacterial ointments.

Parents should also be mindful of where they’re finding these items in the home, or if these types of items tend to go missing.

Some related red flags for parents may include:

• Finding “deconstructed” sharps, like the cutting blade removed from a pencil sharpener or safety shaving razor
• Finding related items in unusual places, like a blade hidden underneath the soap tray in the shower, or a lighter or kitchen scissors in your teen’s closet
• Finding that related items have repeatedly gone missing, like your sewing needles missing from the sewing kit, the kitchen scissors or even knives keep disappearing, the scrapbook scissors no longer with your other supplies, shaving razors disappearing from the bathroom, or your lighter removed from your purse
• Finding wound care supplies or a first aid kit in your teen’s bedroom, rather than a common space available to all during an emergency
• Finding any of these items buried or hidden in a waste bin, especially if bloodied
• Your teen requesting these types of items when you go shopping, especially if they seem defensive or uncomfortable when you inquire about their purpose

We know it can be tempting for parents to turn into detectives, and to start rifling through their teen’s bedroom or every waste bin in the home. 

However, when teens are fearful of being found out, violating their privacy can actually teach them to become more vigilant, and therefore more skilled in hiding their self-harm behaviors, making it more difficult to intervene.

In the last section of this article, we’ll discuss safer ways to intervene that are less likely to make a teen feel surveilled or defensive.

4. Your teen has increasingly less regard for their physical safety, and/or seems to be punishing their body.

While this isn’t true for every teen who engages in self-harm, self-harm does make teens more vulnerable to suicidality, including passive suicidality. 

You might think of this as moving through the world with a death wish, having a profound disregard or apathy for their physical safety or well-being. This can also show up in the form of self-loathing, or feeling deserving in some way of any harm that happens to them.

Some examples of how this apathy may show up:

• Not wearing a seatbelt when they’re in a car or a helmet when biking
• Refusing to wear a coat outside on a cold winter day
• Stepping out into traffic without seeming to look or pay attention to oncoming traffic
• An uptick in risk taking behaviors generally, like binge drinking, driving recklessly, or extreme sports
• Exercising excessively, even when they’re eating very little to fuel that activity
• Refusing to see a doctor or receive medical attention in situations where it’s warranted
• Expressing disdain or minimizing concerns when presented with potential consequences of these behaviors

If a teen appears to have little regard for their safety or well-being, whether or not self-harm is taking place, this kind of apathy should be taken seriously, as it could be indicative of an underlying mental health struggle.

5. Your teen has been isolating themselves more, especially in unusual places like bathrooms or closets, and/or frequently keeps doors locked.

Because self-harm is often a behavior teens are trying to hide from others (or at least feel conflicted about being seen engaging in), you may notice your teen spending more time alone in locations where they are less likely to be intruded upon, like in a bathroom, a closet, a basement, or even a garage.

Your teen might also insist on locking doors behind them more often than they used to, or spending more time in rooms that have a door that locks (especially if they didn’t spend as much time in those spaces before).

Some related red flags may include:

• Needing to self-isolate in unusual or private locations when emotionally distressed (like hiding in a closet or bathroom after an argument), especially if this is a new behavior
• Changing into different clothes after retreating, like changing into long pants without explanation when they wore shorts the entire day
• Becoming panicked, frantic, or infuriated when they don’t have access to private locations during times of stress or upset, or if they’re interrupted while retreating, especially if this is unusual for them
• Refusing to participate in social outings they would normally enjoy in order to access time alone, like the family going out to a favorite restaurant or turning down an activity on vacation that they were previously looking forward to

It’s crucial to remember that it’s developmentally appropriate for teens to want more privacy as they get older, and for them to want to be left alone if they’re dealing with difficult emotions. There could also be alternative and reasonable explanations for all of the red flags listed above.

This list isn’t designed to provoke more anxiety on the part of parents, but rather, to be curious about what is typical for your teen, and to notice and be curious if something has changed.

The concern isn’t necessarily that they wish to spend time alone, but rather, if they’ve recently become more secretive about their behaviors, more isolated from supportive individuals, or otherwise insistent on being alone while they’re highly distressed, especially if this is different from how they previously behaved.

An autistic teen who has always decompressed in their closet for sensory deprivation purposes, for example, isn’t the type of red flag we would be discussing here.

But a teen who is usually emotionally open when upset, who now locks themselves in the bathroom every time they get into an argument with someone, might need some extra support to ensure that this isn’t an escalation of a new or harmful behavior.

Feeling overwhelmed? We understand.

At Evolve, we’ve provided countless families with the holistic and compassionate guidance needed to support their teens struggling with depression, self-harm, anxiety, substance use, and more. 

A resilient, hopeful, and happy future is possible for your teen. If you don’t know where to begin, our admissions team is here to help you take the next step. 

Call Now: 1-877-349-6720