With self-harm awareness month fast approaching, it’s a timely opportunity for parents to become more informed about what self-harm in teens actually looks like, and how to respond to it.

While there are some challenges that we expect to face when we become parents — things like sleepless nights, grocery store tantrums, first days of school, and scraped knees — there are other struggles that we never imagined for our children, and may have even hoped would never come to pass.

As experts in adolescent mental health, we can confidently say that rarely (if ever) have we encountered parents who were prepared when they found out that their teen was engaging in self-harm. In fact, most parents expressed shock, confusion, and disbelief before anything else.

In the US, anywhere from 12-37% of adolescents have reported engaging in some form of self-injury. (The actual number is difficult to accurately estimate, because many who self-injure never seek out medical care.)

To put that into perspective, with the average classroom size in the United States being about 20 students, that means anywhere from 2-7 students in any given classroom would have engaged in self-injury at some point in their teen years.

Despite self-harm not being especially rare, it’s not something most parents are educated about. This article will act as an introductory guide for parents who wish to learn more, and may even be concerned about a teen in their own life.

What is Self-Harm?

Self-harm — often referred to as self-injury or nonsuicidal self-injury (NSSI) — is when someone inflicts deliberate pain and physical trauma onto one’s own body. 

Self-harm would not include such acts taken with the intention of ending their life (this would be considered a suicide attempt), and does not include acts that are aligned with any accepted cultural or spiritual practices (like body piercings or tattoos) unless they’re undertaken with the express purpose of harming oneself.

While cutting is one of the more widely recognized forms of self-injury, it isn’t the only one. Experts suggest there are over 16 observed forms of self-injury, and there could very well be more.

Different forms of self-harm include:

• Burning oneself
• Skin-picking
• Punching objects or oneself
• Banging oneself against something
• Scrubbing one’s skin abrasively
• Self-strangulation (choking oneself)
• Embedding objects under the skin
• Swallowing objects or harmful substances

Some signs your teen may be engaging in self-harm include:

• Unexplained wounds (cuts, bruises, burns)
• Suddenly covering parts of the body that weren’t usually hidden (arms, legs)
• Wearing seasonally inappropriate attire (i.e., a sweatshirt on a hot summer day)
• Sharp objects frequently changing location, or found hidden in rooms they don’t seem to belong in (like a shaving razor in a nightstand)
• Wound care supplies (gauze, bandages) repeatedly found in waste bins
• Requesting or ordering wound care supplies/a first aid kit
• Locking oneself in a bathroom, bedroom, or even closet when distressed (like after an argument)

Self-harm does involve injury to the body, but it’s important to remember that not all forms are immediately visible to others. 

Many teens will go to great lengths to hide their behaviors, including injuring parts of the body that are more difficult to see, and sometimes engaging in forms of self-harm that are less likely to leave any lasting marks.

Why Do Teens Engage in Self-Harm?

There are many reasons why a teen might engage in self-harm:

• To redirect emotional pain by focusing on a physical sensation instead
• To “punish” themselves, often rooted in a hatred or disdain for oneself
• To communicate their internal suffering by making it “real” or tangible
• To feel “alive” — so, to shift out of a state of numbness and dissociation
• To release endorphins and trigger euphoric feelings
• To self-soothe by rehearsing caretaking behaviors (so, to create wounds they then have to tend to)

Ultimately, teens do not engage in self-harm for no reason at all. 

Often a combination of emotional dysregulation (which could be due to an underlying condition like depression, anxiety, PTSD, or BPD), unmet support needs, and in some cases, a triggering environment (like a high conflict household, a terminally ill parent, bullying at school, or a traumatic event or loss) will lead a teen to engage in self-injury to cope.

Common Myths About Self-Harm in Teens

Despite broader awareness of self-harm in young people, many harmful myths still persist.

What Parents Should Do If Their Teen May Be Self-Harming

While parents may feel reluctant to directly discuss self-harm with their teen, it’s crucial to provide a safe and validating environment for teens to be honest about their emotional struggles.

As is true of many sensitive topics, if teens don’t hear about it from you, they’ll learn about it somewhere else.

That said, even if a teen denies engaging in self-harm, if you have reason to believe your teen is struggling, it’s best not to delay getting them support.

It’s important to remember, too, that self-harm is always a mental health concern. 

This is true regardless of how superficial any wounds appear to be, or any assumed reason for why the teen is engaging in self-injury. Your teen needs competent care to ensure that the behavior doesn’t escalate, and that any underlying struggles are addressed and supported.

As parents, we know how to clean up a scraped knee. But if our child then tried to stand up and couldn’t walk on it, we’d want someone with the right tools to take a look and make sure something isn’t broken in ways that we can’t mend.

Self-injury, no matter what form or how frequent, requires a different set of tools. 

It doesn’t mean you’re a bad parent if your child is struggling in ways you don’t understand or aren’t sure how to “fix.” This is exactly what therapists and other mental health providers are trained to do.

At Evolve, we specialize in adolescent behavioral health — because we know that when teens are given the right support, they become thriving adults.

We offer comprehensive, holistic care to teens with various struggles, including depression and anxiety, as well as providing education and support for their families.

Learn more about our approach, and the many types of support we offer families.