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Adolescent Self-Injury: An Overview

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT

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In honor of Adolescent Self-Injury Awareness Month, which occurs annually during the month of March, we’re helping raise awareness about this important topic by posting useful information here on our blog, on our Facebook page, and on our Twitter account.

This post offers a brief history of Adolescent Self-Injury Awareness Day and Month, then moves on to define self-injury, present the latest statistics, discuss risk factors, and offer practical tips and advice for parents or teens dealing with self-injury and related issues.

First, the history.

Adolescent Self-Injury Awareness Day

Wedge Black, the founder and chair of LifeSIGNS, a UK-based website dedicated to raising awareness on the topic, writes that Self-Injury Awareness Day “probably started in America about 18 or 19 years ago.” He continues: “How ever it started, it’s a grassroots global movement – nobody owns the day, nobody needs permission to get involved…Each individual does what they feel comfortable doing – talking about the issues and helping people see that it’s OK to talk about self-injury and emotional health.”

As for the history, that’s it. We’re not trying to be glib – that’s the extent of the available information. You can find mention of the day and month on Wikipedia, listed on sites like timeanddate, Awareness Days, last year’s Psychology Today Awareness Calendar, and on websites associated with various treatment centers. But if you dig deeper – and we assure you we did – there’s not more to find. While we typically prefer to offer links to peer reviewed journal articles or established sites like The Centers for Disease Control (CDC), The National Alliance on Mental Illness (NAMI), or the Substance Abuse and Mental Health Services Administration (SAMHSA), there’s next to nothing there. Have a look and you’ll find broken links and defunct webinar registration pages.

Which tells us we’re on the right track. We need to increase our efforts to raise awareness about this topic, because we meet teens every day who struggle with self-harming behaviors. They need us – and our society in general – to understand what they’re going through, so we can give them the help they need without fear of negative stigma or judgment. Increased general knowledge and awareness will increase the likelihood they’ll come out from behind closed doors, speak up, and ask for support.

With all that said, we’ll move on to the actual subject.

What is Self-Harming Behavior?

NAMI provides a short answer: self-harm or self-injury means hurting yourself on purpose. The American Psychological Association (APA) offers a more complete definition:

“The condition – clinically known as non-suicidal self-injury or NSSI — is characterized by deliberate self-inflicted harm that isn’t intended to be suicidal. People who self-harm may carve or cut their skin, burn themselves, bang or punch objects or themselves, embed objects under their skin, or engage in myriad other behaviors that are intended to cause themselves pain but not end their lives.”

It’s important to understand that this type of self-harm is not usually done with the intent to die. However, it’s critical to understand that self-harming behaviors such as cutting are indicators of significant emotional pain and powerful signals that teens who engage in these behaviors need professional help sooner rather than later. They’re dealing with emotions they can’t handle and develop self-harming behaviors as coping mechanisms to process those emotions. We advise parents to take self-harming behaviors as seriously as they take suicidal ideation or suicide attempts.

Self-Harm: The Latest Statistics

A report published last July in the American Journal of Public Health and summarized by Psychology Today revealed a set of disturbing statistics. In a sample set of over 60,000 teens, here’s what researchers found:

  • Over 17% said they’d engaged in self-harming behavior
  • Roughly 11% of males said they’d engaged in self-harming behavior
  • Around 24% of females said they’d engaged in self-harming behavior

We want parents and teenagers reading this article to take three things away from these statistics. First, self-harming behaviors are more common than most people think. Second, teenage girls tend to engage in this behavior more often than boys. Third, if your teenager – or you – engage(s) in self-harming behavior, you are not alone. There are people out there who understand what you’re going through and can help. This also goes for teens out there with friends who self-harm: you may not know how to handle it, but there are people who do. You can help your friends get the help they need.

Risk Factors for Self-Harm

Issues and events that can lead to self-harm include, but are not limited to:

  • Emotional, behavioral, or psychiatric disorders. Depression and substance use disorders are most often connected to self-harming behaviors.
  • Personal history of self-harm
  • Previous suicide attempts
  • Personal history of suicidal ideation
  • History of trauma
  • Feeling overwhelmed
  • Experiencing loss in productivity or confidence
  • Family history of psychiatric disorders, self-harm, or suicidal behavior
  • Peers engaging in self harm
  • Loss of close family members or friends, especially if it the loss is due to suicide
  • Major conflict with close family members or friends
  • Experiencing bullying, either online or in real life
  • Struggles with identity issues

Do not ignore talk about self-harming behaviors. Teens with friends who talk about or engage in self-harm should encourage them to get help. Parents who hear teens talk about self-harm should take it seriously. Take it seriously even if you’re sure they’re just being dramatic. The slightest chance you could be wrong is not worth the risk of minimizing anything remotely approaching talk of self-harm. If you’re a teen who self-harms, please talk to a friend, a teacher, or school therapist about what’s going on. If you don’t have anyone to talk to, scroll down to the list of resources below, and call, chat, or text someone.

What You Can Do: Practical Steps

If you’re a parent who discovers your teenager engages in self-harming behaviors or a teenager who learns a friend is cutting, branding, or biting, you’re probably in a state of shock. It’s not an easy thing to understand, but once the initial emotions fade, there are things you can do to help. Here’s a short list of practical steps:

  1. Talk to them.

Be patient, open, and calm. Do not judge, scold, or lecture. They’ll probably be embarrassed and try to downplay the behavior.

  1. Get an evaluation.

Parents should make an appointment with a psychiatrist or therapist who specializes in children and adolescents. A professional evaluation will help determine if your teen has an underlying psychiatric disorder that’s contributing to the behavior. A qualified psychiatrist or therapist can also recommend the best course of treatment, depending on the outcome of the evaluation. Teens should advise friends to seek support. Suggest a school guidance counselor or their parents. Or urge them to call an anonymous mental health support hotline as soon as possible. We advise taking any talk of self-harm, or self-harm itself, very seriously. If you’re a teen who self-harms, please find someone to talk to about it.

  1. Get treatment.

The type of treatment recommended will be contingent on whether your teen, your friend, or you have/has an underlying mental health disorder. Outpatient therapy, intensive outpatient therapy, or residential treatment programs may be potential avenues for healing. Again, if you’re a teen with a friend who self-harms or even talks about self-harm, we don’t think you should let it pass. Try your best to get them to talk to someone – sooner rather than later.

How to Find Help

As a parent or the friend of a teenager who self-harms, the chances are you don’t have the expertise to handle the emotional issues that lead to self-harming behavior. In some cases, the underlying mental health problems can be severe: bipolar disorder, depression, anxiety, PTSD, substance abuse, or defiance disorders can all contribute. Your job is to love child or support your friend. Serious, dangerous behaviors like self-harm and their root causes need to be addressed by qualified professionals. Finally, if you’re a teen who engages in self-harming behavior, please find someone to talk to. Read through the list below and call/chat/text one of the support lines. The people on the other end will offer support, suggest steps to take, or just listen if that’s what you need right now.

Here’s a list of resources anyone – parent, teen, friend, other relative or concerned party – can use right now to start the healing process:

  • Parents can find a qualified professional with this psychiatrist finder provided by the American Academy of Child and Adolescent Psychiatry.
  • Teens or friends of teens who need help can call or text the following numbers:
    • National Suicide Prevention Lifeline (24/7/365): 1-800-273-8255
    • The Trevor Project Phone (24/7/365): 1-866-488-7386
      • Trevor Project Text (7 days/wk, 6am-am ET, 3am-10pm PT): Text START to 678678
      • Trevor Project Chat: CLICK HERE
    • Teen Crisis Text Line (24/7/365): Text CONNECT to 741741
    • The Youth Yellow Pages TEEN LINE (6pm-10pm PT) 310-855-4673
      • Youth Yellow Pages TEXT: Text TEEN to 839863

Our Behavioral Health Content Team

We are an expert team of behavioral health professionals who are united in our commitment to adolescent recovery and well-being.

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