This Article Seeks to Address the Following Issues:
- What is self-harm?
- Types of self-harm behaviors
- Why do teenagers self-harm?
- The risk factors and signs of self-harm
- Impacts of self-harm on teenagers and their families
- Effective treatment options for self-harm behaviors
Discovering your child is self-harming can be a distressing and painful experience for any parent. This discovery may cause panic, leaving many parents feeling helpless and unsure where to begin. While you may not understand why they are hurting themselves, it is clear they need help right away.
This article is designed to help parents deal with the traumatic issue of teen self-harm. It provides valuable insights into why teenagers self-harm and the common warning signs. We will also highlight different teen treatment programs for self-harm and explain how to best support your teen.
What is Teen Self-harm?
Self-harm, or self-injury, is when someone purposely harms themselves without the intent to die. While it can happen at any age, teenagers are more likely to self-harm because they may lack healthy coping mechanisms and skills to manage their emotions. This behavior is a harmful way of dealing with stress, anger, and emotional pain. Although death is not the goal, serious injuries can sometimes have fatal results.
Prevalence of Non-Suicidal Self-Injury Disorder
Studies from 2014-2017 showed that NSSID was common in adolescents, affecting 5.6%-7.6% of those studied. The rate of NSSID drops sharply in adulthood, where only 0.2-0.8% of adults showed symptoms of the disorder. In other studies, about 74%-78% of adolescents met the diagnostic criteria for NSSID.
Types of Self-harm Behaviors
Teens who self-harm may injure themselves in various ways. While cutting the skin with sharp objects is the most common method, it is not the only form of teen self-harm.
Some common forms of self-injury include the following:
Cutting
Teens who cut may use sharp objects to break or pierce their skin. This can include carving patterns or words on the skin or inserting small objects under it.
Burning
Burning is a form of self-harm where hot objects like cigarettes or matches are used to create burn marks on the skin. Some teens may also use burning chemicals or acids for self-injury.
Hitting
Teens who use hitting for self-injury might repeatedly hit their heads, punch walls, or run into objects to cause pain.
Rubbing or Scratching
Some teens may cause pain by repeatedly rubbing or scratching their skin, sometimes with clothing, until it becomes sore.
Other forms of self-harm include, but are not limited to:
- Banging their head against the walls
- Burning skin with lighters, matchsticks, or hot objects
- Punching, hitting, or slapping themselves
- Piercing skin with sharp objects
- Scratching until it bleeds or leaves marks
- Picking at existing wounds
- Pulling out hair
A teen might also engage in self-destructive behaviors that are not physically violent. This can include emotional self-harm like insulting themselves, refusing to eat, substance abuse, or engaging in risky sexual activity.
Causes For Adolescent Self-Harm & Cutting
Several factors can lead a teen to self-harm. The three main causes linked to NSSID are poor coping skills, trouble managing emotions, and mental health conditions.
Poor coping mechanisms
Self-harm can be a sign of poor coping habits. A teen might be bullied at school and unable to handle the intense feelings that result. Instead of developing healthy ways to cope with the distress, they may turn to self-inflicted harm.
Trouble managing emotions
According to DSM-5 guidelines, self-harm is often linked to a negative emotional state. Teens with complex emotions like anger may lack an outlet and turn to self-injury to ease their inner turmoil. This behavior can also be triggered if a teen feels they are losing friends or their relationships are breaking down.
These powerful emotions need an outlet, which can cause a teenager to start self-harming. The behavior is often an attempt to distract from negative emotional pain. For some teens with NSSID, physical pain can feel easier to understand than their emotions.
Mental health conditions
Adolescents with conditions like depression, anxiety, bipolar disorder, gender dysphoria, or PTSD may use self-harm behaviors. This can be an attempt to feel something when they otherwise feel empty inside.
Risk Factors for Non-Suicidal Self-Injury Disorder
Certain factors can increase the risk of a teen developing non-suicidal self-injurious disorder. These risk factors for self-harm include the following:
- Trauma – Teens who have experienced trauma, such as sexual or physical abuse, have a higher risk of developing self-injurious behaviors. These events can trigger deep fear, and teens may feel unworthy and need an outlet for their emotions.
- Age – Studies show age is a key factor in self-harm. Adults are far less likely to inflict pain on themselves since they have developed more coping skills than growing teens. It is estimated that less than 1% of the adult population may develop NSSID.
- Gender identity and dysphoria – Teens with gender identity issues have a higher risk for NSSID than cisgender teens. This elevated risk is often because of bullying and feeling trapped in a body they do not identify with. These feelings can be hard to understand, leading a teen to cut as an emotional release.
- Social isolation – Teens who face social isolation or rejection from their peers are at a higher risk of developing NSSID. Loneliness and bullying can cause them to use self-harm behaviors as an outlet.
- Sexual orientation – Teens who identify as sexual minorities may develop self-harm behavior due to bullying and other negative events. They might be afraid to be open about their identity because they could be isolated from family and friends. Guilt, shame, and fear can lead your teen to self-harm as a release.
- Mental health conditions – Teens with a history of conditions like depression, anxiety, dissociative disorders, or PTSD are at an increased risk for NSSID. These conditions cause complex emotions that may lead a teen to develop unhealthy coping mechanisms like cutting.
Signs and Symptoms of Self-harm
Because there are many forms of self-harm, the signs can vary. Emotional self-harm is often harder to spot because there are no physical marks. Possible warning signs of self-injury may include the following:
- Unexplained injuries
- Avoiding activities like swimming that expose the body
- Wearing long sleeves or pants in hot weather to hide injuries
- Scars, often in patterns on the same part of the body
- Calling frequent injuries “accidents.”
- Keeping sharp objects in their room
- Frequent teenage isolation or social withdrawal
- Difficulties with interpersonal relationships
- Talking about themselves in a negative way
Diagnosis of Non-Suicidal Self-Injury Disorder
Self-harm behaviors were added to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. For a teen to be diagnosed with NSSID, the following criteria from the DSM-5 must be met:
- In the past year, the individual has intentionally harmed their body on five or more occasions. This damage caused bleeding or pain, but was done without the intent of suicide.
- The self-inflicted injuries are done with the expectation of relieving negative feelings, resolving relationship issues, or experiencing a positive feeling.
- Self-injury is associated with distress, depression, anxiety, or other emotional issues. The urge is also difficult to control, and thoughts of self-harm occur frequently.
- The behavior is not part of a socially accepted practice, such as getting tattoos, piercings, or cultural and religious rituals.
- The behavior causes strain on the individual’s day-to-day life.
- The behavior does not happen only during psychotic episodes or periods of delirium or substance use.
If your teen meets all these criteria, a mental health professional or clinician can diagnose them with NSSID.
Some professionals have suggested a review of the DSM-5 criteria, proposing an increase in frequency from 5 times and the inclusion of a severity scale. This change is suggested because the DSM-5 does not define what is considered severe NSSID, which would require more intense treatment.
Aims of Self-harming
As mentioned, self-harm among teenagers often happens because they lack healthy ways to cope with emotional stress. A teenager may self-harm in an attempt to:
- Distracting themselves from emotional pain
- Show their distress to people close to them
- Punish themselves
- Calm themselves down when they are upset
- Feel a sense of release from emotional distress
The Impact of Self-harm on Teens and Families
Self-harm behaviors negatively impact teens and their families, affecting their quality of life. Teens face both physical and psychological risks, while families are mainly affected emotionally.
Consequences of Self-harm on The Teen
Self-harm can have dangerous and sometimes deadly effects on a teen’s physical and mental health. Possible consequences may include:
- Permanent scars on the body that may cause future regret or insecurity
- Wounds that get infected and lead to other health problems
- Losing friends because of isolation
- Low self-esteem and increased guilt, and shame
Impact on the Families
The family’s mental health is significantly affected by these behaviors, especially the parents. Most parents experience stress, anxiety, and helplessness when they discover self-harm in their teen. They may also feel guilt, shame, and embarrassment that their child is self-harming.
In some cases, the behavior can strain relationships with siblings, who may feel resentment, anger, and frustration. They may also feel the stigma associated with their sibling’s self-harm.
Teen Treatment Options for Self-harm
Sometimes, teen self-harm can be a recurring issue that involves different methods, making it hard for parents to find solutions. Seeking help from mental health professionals is needed to address the underlying issues causing the behavior. A professional can create a teen mental health treatment plan to focus on a particular condition and stop the self-harm.
Treatment options for self-harm include therapy, medication, and inpatient care. Let’s look at these options more closely.
Psychotherapy
Psychotherapy, also known as talk therapy, is designed to help patients identify and manage feelings that trigger certain behaviors. It can treat teen self-harm by teaching skills to manage stress and emotions. It also teaches other valuable skills like problem-solving and improving relationships.
Scientific evidence supports therapy as an effective method for treating various mental health issues. Types of psychotherapy for self-harm include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and mindfulness-based therapies.
Cognitive Behavioral Therapy (CBT)
CBT for teens helps them identify negative feelings and learn how to replace them with positive ones. It teaches them skills to cope with difficult situations in a healthy way. The teen’s active participation is required to learn these skills.
Dialectical Behavior Therapy (DBT)
This is a form of CBT for people with intense emotional control issues. DBT is an effective teen treatment for self-harm behaviors because it helps teens learn to control impulses and emotions. These skills help them improve their relationships and lead happier lives.
Mindfulness-based Therapies
Mindfulness-based therapies teach teenagers to live in the moment and manage negative thoughts. Replacing negative thoughts with positive ones may help reduce symptoms linked to teen anxiety and depression.
Family-Based Therapy
Teen family therapy is centered on the family. It involves therapy sessions with the whole family to address issues that may contribute to self-harm behaviors. Family involvement also helps determine ways the family can help the teenager recover.
Medication
Medication can help treat diagnosed mental health conditions that cause self-harm. Conditions like depression and anxiety disorders may be treated with antidepressants and anti-anxiety medications. These medications must be prescribed only by qualified mental health professionals after a clinical diagnosis.
These medications have FDA warnings on potential risks, but this is not meant to stop their use. They have been proven effective in treating anxiety and depression. Parents and caregivers should also be informed about the risks of the medication to weigh the pros and cons.
In-patient Care
Inpatient care is when a teenager is admitted to a hospital or a facility for psychiatric care. It is suited for teens with serious, ongoing self-harm behaviors that cannot be handled in an outpatient setting. The facility provides a safe environment where trained professionals supervise teenagers at all times.
Key Healthcare offers inpatient care through its Teen Residential Treatment Center (RTC). The RTC has an intensive 40-60 day program that provides full psychiatric care for teenagers. During their stay, teenagers are taught skills to cope with their challenges through teen individual therapy and teen group therapy. Teens also interact with peers who have similar experiences, supporting each other in recovery.
Supporting Teenagers with Self-harm Behaviors
If you find out your child is self-harming, or you believe they might be, you should take steps to help them. Your reaction matters in this situation, so it is important to remain calm. It is natural to be worried or angry, but snapping at them is not productive. An overreaction may increase their guilt and shame, causing them to shut down instead of seeking help.
Here are some tips on how to approach the situation.
- Learn more about self-harm to understand the reasons behind such behaviors.
- Start an open, non-judgmental conversation. Avoid criticizing and allow them to express themselves.
- Let them know you care and express empathy.
- Make time to connect with them through activities they enjoy, like going for a walk.
- Remove potential objects used for self-harming, like razor blades, needles, and knives.
- Seek help from professionals and parents with similar experiences. Find a support group that can help you throughout the journey.
- Encourage your child to seek professional help and address any wrong ideas that may make them unwilling to accept treatment.
- Be patient with them, because it may take a while to stop such behaviors.
- Take care of yourself. Supporting a loved one with mental and emotional challenges is difficult and may also affect your mental health. Practice self-care and take time to do things you love.
Conclusion
Non-Suicidal Self-Injury Disorder (NSSID), or self-harm behavior, is a serious mental health condition in which teens intentionally injure themselves to cope with overwhelming emotions. Common contributing factors include difficulty managing emotions, limited coping skills, and coexisting mental health conditions such as anxiety or depression.
Signs of NSSID can include noticeable scars or bruises, patterns of injury, frequently wearing long sleeves to hide marks, and repeated bruising from behaviors like self-punching. Recognizing these warning signs and seeking professional help early is critical.
For teens diagnosed with NSSID, residential treatment centers provide a structured, supportive environment with 24-hour care. Programs often include evidence-based therapies such as cognitive behavioral therapy (CBT) and dialectical behavior therapy (DBT), alongside holistic treatments like art therapy, music therapy, and yoga therapy. These approaches help teens develop healthy coping strategies, manage emotions effectively, and build resilience.
Contact us to schedule a consultation and explore enrolling your teen in a residential treatment program that offers comprehensive care tailored to the needs of adolescents struggling with NSSID.
Frequently Asked Questions (FAQs)
What are some alternative coping strategies that teenagers can use instead of self-harm?
Alternative coping skills include expressive arts and physical activities. Examples of expressive arts include writing, drawing, painting, or playing music. Physical activities include sports, yoga, and running.
How can I support my teenager’s mental health even if they are not ready to stop self-harming?
Supporting someone who isn’t ready for help can be difficult. Always approach them with empathy and a non-judgmental attitude. Avoid criticizing or shaming them when you talk. Inform them of healthier coping skills and encourage them to seek professional help. Most importantly, be patient and respect their boundaries.
Can teenagers who self-harm still lead fulfilling and successful lives?
Yes, teenagers who self-harm can go on to lead successful lives. Self-harm is a negative coping skill for processing emotions, but it does not define a person’s life. They can learn skills for managing stressful situations with professional help.
Can self-harm be a symptom of an underlying mental health condition?
Yes. In some cases, self-harm behavior is due to mental health conditions like depression, anxiety disorders, and teen post-traumatic stress disorder.
What are some common misconceptions about teenage self-harm?
Common misconceptions about teenage self-harm include the following:
- Self-harm is a way to manipulate others
- Cutting is the only form of self-harming
- Self-harming is a way of manipulating others
- Self-harm is a phase the teen will eventually outgrow
- Self-injury is not treatable
How can schools and communities support teenagers who are struggling with self-harm?
Schools can support teens by partnering with mental health professionals, like counselors, to provide mental health services. Schools can also help by adding mental health education to their curriculum to teach coping skills for emotional stress. Creating awareness through campaigns on mental health issues is also helpful.
