Few things trigger a more immediate panic reaction in parents than finding out that a child is engaging in self-harm. Unfortunately, it’s fairly common, and the reaction of the parent plays an important role in helping teens in the recovery process.

Cutting into the skin is the most widely known form of self-harm. Teens do this using their fingernails, razor blades, knives, or even pen caps. Self-harm can also come in the form of burns, skin picking, hair pulling, or even hitting oneself.

Kids with anxiety, depression, eating disorders, borderline personality disorder, and posttraumatic stress disorder are all at risk for self-harm, but so are kids with a history of trauma, neglect, or abuse.

Other potential risks for self-harm include the following:

  • Low self-esteem
  • Feeling rejected or lonely
  • Feeling unsafe at school or at home
  • Perfectionism
  • Frequent conflicts with friends or family
  • Impulsive behavior
  • A tendency to take unhealthy risks (behaviors that could result in physical harm)

How do I know if my teen is engaging in self-harm?

Teens who self-harm tend be skilled at hiding their behavior from their parents, friends, and other adults in their lives. While some parents might notice scars or marks on a teen’s arms, torso, or legs, many of the red flags for self-harm tend to be subtle.

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If you suspect that your teen might be susceptible to self-harm, be on the lookout for these signs:

  • Suspicious looking scars
  • Wounds that don’t heal or get worse over time
  • Isolation
  • Talking about self-injury (they might mention peers who engage in self-harm)
  • Collecting sharp items
  • Secretive behavior
  • Wearing long sleeves and/or long pants in hot weather
  • Avoiding social activities
  • Wearing a lot of bandages
  • Avoiding sports or other activities where they might have to change clothes in front of others

What triggers self-harm behavior in teens?

An important part of helping teens recover from self-harm is understanding why they do it in the first place. There isn’t a simple answer to this question but, in general, some teens use self-harm to relieve tension by stimulating endorphins while others use self-harm to feel physical pain instead of emotional numbness. Stress and pressure, anxiety, and depression are all associated with self-harm in adolescence.

Other feelings that trigger the impulse to engage in self-harm can include:

  • Anger
  • Sadness
  • Rejection by peers or adults
  • Loneliness
  • Irritability
  • Social issues
  • Family discord
  • Social media use, including videos and photos that show other kids cutting to cope with emotional pain

Your Reaction Matters

It’s perfectly natural to feel worried, overwhelmed, or even angry if you discover that your teen is using self-harm to cope with emotions. You might feel the urge to say something like, “How could you do this to yourself?” or “Stop doing this right now!” It’s important to remember that most teens who engage in self-harm are just as afraid of their behavior as you are. Many feel guilt, shame, and deep remorse after they self-harm.

It’s important to remain calm and engage in open and honest communication without judgment. Snap criticisms and overreactions will likely result in your teen shutting down and isolating. Instead, ask open-ended questions about how your teen is feeling and what contributes to the behavior and be sure to let your teen know that you are there to listen.

Get Help

If your teen is engaging in self-harm, he or she needs professional help. Though self-harm is generally not considered suicidal in nature, there is an elevated risk of suicidal behavior for teens who self-harm.

If there is an underlying mental health disorder, such as anxiety or depression, medication might be prescribed. A good first step is to get a comprehensive evaluation by an adolescent psychiatrist who specializes in anxiety and depressive disorders. If your teen’s self-harm behavior is elevated and potentially life-threatening, hospitalization might be necessary.

Psychotherapy helps teens work through the triggers that contribute to negative thought patterns and learn positive coping skills to use instead of engaging in self-harm behaviors. Seek an evaluation from a licensed mental health practitioner who treats adolescents and has experience helping teens who engage in self-harm. Treatment options can include:

  • Family therapy to explore triggers in the home and how parents and teens can improve communication patterns and help develop better coping skills for dealing with the stress at home.
  • Cognitive Behavioral Therapy (CBT) to challenge negative and distressing thoughts, recognize the pattern of negative thinking, and learn replacement strategies.
  • Dialectical Behavior Therapy (DBT) to learn how to tolerate uncomfortable emotions, to learn to regulate feelings of anxiety, rejection, anger, and fear, and to learn positive coping skills.

Provide Emotional Support

Teens need unconditional support as they learn to replace maladaptive coping strategies with adaptive ones and work through their emotional pain. Breaking the cycle is not easy, and teens need empathy and compassion during the recovery process.

  • Make time to connect with your teen 1 on 1
  • If your teen keeps a busy, high-pressure schedule, find ways to slow down and decrease commitments
  • Encourage your teen to connect with positive, supportive friends
  • Practice relaxing activities together (going for a walk, journaling, drawing, using a mindfulness app)
  • Exercise together
  • Help your teen create a list of people to call or text when feeling overwhelmed
  • Acknowledge your teen’s pain and validate your teen’s emotions
  • Be patient—it will take time to break the cycle
  • Reach out to the school counselor to assist with accommodations in school

With early identification, professional support, and supportive home and school environments, teens can learn to use positive strategies to cope with complex negative emotions and work through their triggers.

Last Updated: Sep 24, 2018