It's not unusual for adolescents to feel sad, anxious, confused, or distressed. When negative emotions become overwhelming, youth ages 12 to 14 may start using self-injury as a way to cope with stress in their lives.
More adolescent females engage in harming themselves than males. No single cause can be attributed to this behavior. Teens from all cultural and socioeconomic levels participate in self-harming practices that are not always suicidal.
What are common methods of self-harm?
Seeking quick relief from emotional distress, some adolescents resort to cutting and burning, the most common methods of self-harm. Adolescents may also ingest toxic substances or experience pain by biting or hitting themselves. Adopting a relatively new and nonphysical way to hurt themselves, some youth turn to digital self-harm, also called self-cyberbullying.
What triggers self-harm?
Many adolescents struggle with extreme levels of stress in school, at home, and in peer relationships. Self-harm shouldn't be attributed automatically to attention-seeking behavior. Adolescents may harm themselves to signal their distress but generally use self-injury to regulate themselves emotionally, distract themselves from emotional pain, and punish or disfigure themselves.
- School settings: Teenagers who are overscheduled or lack healthy sleeping habits may become frustrated when they can't keep up with assignments and extracurricular activities.
- At home: Self-harming teenagers may act out because they feel emotionally disconnected from or invalidated by parents and other family members.
- Social media outlets: Adolescents may feel dejected and lonely when they compare themselves with peers who seem more popular; experience body, fat, or slut shaming; or view idealized images of other people.
Adolescents may gravitate toward self-harming habits to experience the "endorphin effect," which induces a numbing or pleasurable sensation. This reaction provides fast-acting relief from emotional distress and other stressors that cause unpleasant thoughts and feelings. This reaction is short-lived and can be followed by feelings of shame or disappointment.
What are some signs of self-harming behavior in adolescents?
Some common indicators of self-harm include the following:
- Having cuts, scratches, bruises, or burn marks that they refuse to explain to physicians, teachers, or parents.
- Hiding knives, razor blades, box cutters, and other sharp objects in their bedrooms or backpacks.
- Retreating to their bedroom or bathroom in reaction to negative expressions from schoolmates, family members, or online activities.
- Wearing clothes to cover up injuries or refusing to participate in activities that could reveal wounds.
- Displaying worsening symptoms of depression or anxiety.
What treatments are recommended?
A teen engaging in self-harm needs professional help to address triggers that contribute to negative thought patterns and to learn positive coping skills.
Mindy Westlund Schreiner, PhD, instructor and licensed clinical psychologist in the Department of Psychiatry at Huntsman Mental Health Institute, researches self-injurious thoughts and behaviors in youth. "My work centers on integrating brain imaging and interventions to understand self-injury and how treatments, such as therapy, can change the brain," she explains. "In addition to research, I also do outpatient therapy with patients with self-injury."
Treatment options for youth with self-injury behavior include:
- Dialectical behavioral therapy, which teaches how to tolerate uncomfortable emotions, regulate feelings of anxiety, rejection, anger, and fear, and strive for positive behavioral changes.
- Family therapy, which improves communication, teaches conflict-resolution and problem-solving skills, and fosters more meaningful and closer relationships between parents and teens.
- Cognitive behavioral therapy, which challenges negative and distressing thoughts, recognizes the pattern of negative thinking, and teaches replacement strategies.
- Psychodynamic therapy, which focuses on exploring past experiences and emotions.
- Group therapy, which improves social skills and deals with a range of issues such as anger, shyness, loneliness, and low self-esteem.
- Individual therapy focuses on validation, acceptance, and connectedness.
How can parents and friends help teens?
Parents and friends can help teens with self-harming behavior by:
- Learning about self-injury from authoritative resources
- Addressing observed issues promptly
- Validating feelings that lead to self-injury
- Being respectful, offering reassurance, and speaking calmly
- Asking open-ended questions
- Checking in regularly and offering support
- Suggesting alternative ways to relieve feelings of stress
- Praising positive changes
- Being patient and maintaining hope; recovery takes time, and relapses may occur