Everyone experiences stress, anxiety, and low moods at times. But stress and emotional shifts can feel different for different people, particularly for teens navigating the murky waters of adolescence. While some teens might feel jumpy or afraid when they’re under stress, others might feel elevated frustration and anger, overwhelming sadness, or fear and anxiety. Some teens turn to self-harm to cope with these complicated emotions.

From 2009 to 2015, emergency rooms in America saw a sharp rise in treatment of girls and young women between the ages of 10 and 24 who intentionally injured themselves. JAMA reports that within that hike of 8.4 percent of ER visits over six years, among girls between the ages of 10 and 14, rates of ER visits for self-harm surged 18.8 percent yearly between 2009 and 2015.

What is Self-Harm or Cutting?

Self-harm or cutting means hurting yourself on purpose. Cutting into the skin is the most widely known form of self-harm, but burning the skin, picking at wounds to prevent healing, picking at skin, biting or scratching at the skin, ingesting poison or pills without intent to die by suicide, and pulling out hair are all methods of self-harm.

Self-harm is a sign of emotional distress. Teens engage in self-harm to relieve feelings of stress, anxiety, or emotional pain. Self-harm can relieve tension momentarily, which gives teens the false belief that this maladaptive coping strategy actually works. The physical pain they inflict numbs the emotional pain they experience, and they feel like this potentially dangerous practice is helpful. In reality, it’s a temporary escape that can result in a lifetime of maladaptive coping if they don’t learn how to manage their emotional pain.

Teens who self-harm are either looking to release tension or looking to feel something. Some might use it to distract themselves, to avoid processing their emotions, to get attention from adults or peers, or to punish themselves. Though teens who engage in this behavior often describe a temporary feeling of relief, it can also result in an overwhelming feeling of shame.

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Why Do Teens Cut?

Self-harm is not a mental disorder, but it is associated with depression, anxiety, eating disorders, borderline personality disorder, and posttraumatic stress disorder. It also indicates a lack of effective coping skills. Other risk factors include a history of trauma, neglect, or abuse.

Self-harm might begin with feelings of anger, frustration, or emotional pain. In some cases, the self-injury stimulates the body’s pain-killing hormones and provides a temporary feeling of uplifted mood. In other cases, teens might turn to cutting to feel pain in an effort to get away from a feeling of emotional numbness.

Following cutting, teens can experience feelings of shame and guilt. This perpetuates the cycle of overwhelming emotions followed by negative coping strategies. It can become a dangerous cycle that is difficult to break.

Self-harm is not the same as suicidal behavior, but there is an elevated risk of suicidal behavior for teens who self-harm.

Does Social Media Trigger Self-Harm?

Despite efforts by social media sites to curb posting images, videos, and other disturbing content that promotes or normalizes self-harms, and clear guidelines (if you read the guidelines), images and content continue to emerge. If you search for #cutting on Instagram, for example, a pop-up window appears on your screen to warn you about content within the hashtag ask if you need help. This is a step in the right direction. The problem, however, is that it’s easy to decline the offer and proceed to the potentially triggering content.

Teens sometimes turn to social media to find support, but they also turn to social media to validate or normalize their self-harm. There are hashtags specifically created to help people who self-harm support one another in making positive choices when they feel the urge, but there are also hashtags that show some fairly disturbing content. Given that teens are savvy social media users, they also create new hashtags to get around banned hashtags or hashtags that are watched by social media sites. While #selfharm might be on the radar of social media sites, #selfharmmmm might not.

It’s difficult to draw a direct link between social media use and exacerbated self-harm behaviors among teens without sufficient data, but self-harm hashtags and communities online certainly can normalize the behavior.

How to Help a Teen Who Self-Harms

Teens who self-harm are depressed or overwhelmed by anxiety, stress, or pressure. They also tend to be skilled at hiding their pain from friends, parents, teachers, and coaches. They can post anonymously online to find support and a community. If they find a recovery community, they can share their experiences through journaling, messaging, or even art. This can be helpful for teens. If, on the other hand, they stumble upon on a community that supports the self-harm behavior, it can result in teens feeling helpless and continuing the behavior.

Teens who self-harm need treatment. The first step is to seek a referral for a psychiatrist or psychotherapist who specializes in adolescents and self-harm. Depending on the underlying triggers and emotions beneath the self-harm behaviors, there are different types of therapeutic interventions:

• Psychodynamic therapy helps people explore past experiences and emotions
• Cognitive behavioral therapy focuses on recognizing negative thought patterns and learning positive alternatives
• Dialectical behavior therapy can help teens learn positive coping strategies
If there is an underlying anxiety or depressive disorder, medication might be prescribed. Group work can be beneficial in helping teens connect with other teens and support one another through the recovery process.

If symptoms are severe or potentially dangerous, hospitalization might be necessary.

If you are concerned that your teen is engaging in self-harm it is important to remain calm and talk about the behavior with your teen without judgment. It’s essential that you seek treatment right away. With proper supports in place, teens can learn positive coping strategies to target overwhelming emotions and learn to manage their emotions in an adaptive way as they grow.

Last Updated: Nov 19, 2018