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
Finding out that your child is self-harming is a distressing situation that feels extremely painful for a parent or loved one. It may trigger panic, and most parents or caregivers may feel helpless and unsure of where to begin. The situation is even worse if you do not understand why they are hurting themselves, but one thing for sure is they need immediate help.
This article aims to help parents deal with the traumatic issue of teen self harm. It will provide valuable insights into the potential reasons that teenagers self-harm, and the telltale signs of self-harm. It also highlights the different teen treatment programs for self harm issues and how to support your teen.
What is Teen Self-harm?
Self-harm or self-injury refers to deliberately harming oneself without intending to die. Although self-harm cuts across all ages, teenagers are more likely to self-harm than adults because they often haven’t yet developed healthy coping mechanisms and emotional regulation skills. It is a maladaptive and harmful way of coping with stress, anger, and emotional pain. Although dying is usually not the intention of such acts, life-threatening injuries may lead to fatal consequences.
Prevalence of Non-Suicidal Self-Injury Disorder
According to studies conducted between 2014-2017, data showed that NSSID was prevalent in adolescents accounting for 5.6%-7.6% of the study population. NSSID drastically reduces once teens reach adulthood, as only 0.2-0.8% of the adult study population presented with symptoms of NSSID. About 74%-78% of adolescents in other studies met the criteria for diagnosis with NSSID.
Types of Self-harm Behaviors
Teens with self-harm behaviors may injure themselves in different forms. The most common type of self-harm behavior among teenagers is cutting the skin using sharp objects, but it is not the only way teenagers self-harm.
Some common forms of self-injury include the following:
Cutting
Teens who self-injure using cutting often use sharp objects to pierce or break their skin. It may be done by carving initials or patterns on the skin or inserting small objects under it.
Burning
Burning is a harmful self-harm habit that involves using hot objects such as cigarettes, knives, spoons, or matches to inflict burn marks on the skin. Teens who self-injure using burning may also use corrosive or burning chemicals such as acids to inflict pain.
Hitting
Teens who self-injure using hitting may hit their heads repeatedly, punch walls, or run into walls to inflict pain.
Rubbing or Scratching
Teens may continuously rub their skin using items of clothing to cause pain.
Other forms of self-harm include but are not limited to:
- Head banging into walls
- Burning the skin with lighters, matchsticks, and heated objects
- Punching, hitting, or slapping themselves
- Piercing the skin with sharp objects
- Excessive scratching to the point it draws blood or leaves marks
- Picking existing wounds
- Hair pulling
They may also engage in other self-harm behaviors that do not necessarily cause physical injury. These include emotional self-harm harm and self-destructive behaviors like insulting themselves, failing to eat, substance abuse, and risky sexual behaviors.
Causes For Adolescent Self-Harm & Cutting
A collection of factors might cause a teen to self-harm. The three main factors attributed to NSSID are poor coping mechanisms, trouble managing emotions, and mental health conditions.
Poor coping mechanisms
Self-harm may be a symptom of poor coping habits. Your teen might be experiencing bullying at school and cannot cope with the intense feelings. They may be unable to develop healthy coping mechanisms from the distress and resort to self-inflicted harm behavior.
Trouble managing emotions
According to the DSM-5 guidelines on diagnosing individuals with NSSID, self-harm should be attributed to a negative emotional state. Teens experiencing complex emotions like anger may not have a way to let it out; they resort to self-injury to alleviate their emotional turmoil. This may also occur if your teen feels they are losing their friends or there is a breakdown of their interpersonal relationships.
These emotions need an outlet and can cause your teenager to start self-harming behaviors. Self-harm is usually an attempt to distract from the pain associated with negative emotions. To teens with NSSID, physical pain is more understandable than emotional pain.
Mental health conditions
Adolescent with mental health conditions like teenagers depression, anxiety, bipolar disorder, gender dysphoria, and Post Traumatic Stress Disorder (PTSD) may begin self-harm behaviors to experience some form of emotion when they feel empty inside.
Risk Factors for Non-Suicidal Self-Injury Disorder
Some factors may make your teen more likely to develop non-suicidal self-harm disorder. Some self-harm risk factors include the following:
- Trauma – Teens who have experienced teenage trauma or traumatic events such as sexual and physical abuse are more likely to develop self-injurious behaviors. These events may trigger unexplainable feelings of fear, and teens who have gone through such traumatic events may feel unworthy and need an outlet for their emotions.
- Age – According to studies, age is a big determinant for developing self-harm behaviors. According to various studies, adults are much less likely to inflict pain on themselves since they have learned more coping mechanisms than growing teens. It is estimated that less than 1% of adults may develop NSSID.
- Gender identity and dysphoria – Teens with gender identity issues are at a higher risk of developing NSSID than cisgender teens. Experts suggest this risk is elevated due to bullying and feeling trapped in a body they do not conform to. Understanding these feelings can be difficult, and your teen may resort to cutting to release the emotions.
- Social isolation – Teens facing social isolation and rejection from their peer groups are at a higher risk of developing NSSID. Loneliness and bullying may cause them to engage in self-harm behaviors as an outlet.
- Sexual orientation – Teens who identify as sexual minorities may develop self-harm behavior due to bullying and other adverse events. They may be afraid to openly identify as sexual minorities because they can be isolated from their family and friends. Guilt, shame, and fear can cause your teen to develop self-harm behavior as a release.
- Mental health conditions – Teens with a history of mental health conditions such as depression, anxiety, dissociative disorders, and Post-traumatic stress disorder (PTSD) are at an increased risk of developing NSSID. These conditions cause complex emotions that can cause your teen to develop unhealthy coping mechanisms such as cutting.
Signs and Symptoms of Self-harm
Due to many different forms of self-harm, the signs and symptoms may vary widely. Emotional self-harm may also be difficult to notice because no obvious physical signs exist. The warning signs for possible self-injury may include the following:
- Unexplained injuries
- Avoiding situations that expose their whole body, like swimming
- Wearing long sleeves and pants even when the weather is hot to hide the injuries
- Scars which are often in patterns on the same part of the body
- Dismissing frequent injuries as accidents
- Keeping sharp objects in their room
- Frequent teenage isolation and social withdrawal
- Difficulties with interpersonal relationships
- Speaking about themselves in a degrading manner
Diagnosis of Non-Suicidal Self-Injury Disorder
Self-harm behaviors were introduced in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) in 2013. According to DSM-5, your teen needs to meet the following criteria to be diagnosed with NSSID. The criteria for diagnosis include the following:
- In the last year, the individual should have engaged in self-inflicted harm on their body tissue on 5 or more occasions. The damage should have induced bleeding or general pain without the intent of suicide.
- The self-inflicted injuries should be with an expectation of relieving negative emotions, resolving interpersonal issues, or experiencing a positive emotional state.
- The self-induced injury should be associated with general distress, depression, anxiety, or other emotional issues. It should also be difficult to control, and thoughts of self-harm should occur frequently, even if not accompanied by actual self-injury.
- The behavior should not be socially sanctioned, such as getting tattoos, piercings, or for cultural and religious rituals.
- The behavior should cause strain on the individual’s day-to-day life.
- The behavior should not occur only during psychotic episodes or episodes induced by delirium or substance use.
If your teen meets all the criteria, the mental health practitioner or clinician can diagnose them with NSSID.
Some practitioners have suggested a review of the DSM-5 criteria to increase the frequency from 5 times and to include a scale for the severity of the issue. They have proposed the change because the DSM-5 does not show what is considered severe NSSID, which would require a more intense form of treatment.
Aims of Self-harming
As indicated, self-harm among teenagers is because they lack healthy coping mechanisms for emotional stress and pain. Teenagers may self-harm in an attempt to:
- Distract themselves from emotional pain
- Communicate their distress to people close to them
- Punish themselves
- Calm themselves down when upset
- Provide a sense of release from emotional distress
The Impact of Self-harm on Teens and Families
Self-harm behaviors may negatively impact teens and their families, affecting their quality of life. The teens have a risk of both physical and psychological effects, while the families are mainly affected emotionally and psychologically.
Consequences of Self-harm on The Teen
Self-harm may cause harmful and sometimes lethal consequences on the teen’s health, physically and mentally. Possible effects may include:
- Permanent scars on the body that they may regret or be insecure about in the future
- Wounds that may be infected and lead to further health complications
- Losing friends because of isolation
- Low self-esteem and increased guilt and shame
Impact on the Families
The emotional state and mental health of the family members, especially the parents, are significantly affected by such behaviors. Most parents experience considerable stress, anxiety, and helplessness when they discover self-harm behavior in their teens. They may also have feelings of guilt, shame, and embarrassment for their children being associated with self-harming.
In some cases, it can strain relationships with their siblings, who may have feelings of resentment, anger, and frustration. They may also feel the stigma associated with the sibling’s self-harm.
Teen Treatment Options for Self-harm
Sometimes, teen self-harm behaviors may be recurrent and involve different types of self-harm. In such instances, it may be difficult for the parents to find solutions to the problem. Seeking help from mental health professionals is necessary to address underlying issues like mental health conditions causing self-harm. The mental health professional can develop a teen mental health treatment plan to focus on a particular condition to stop the self-harm behavior.
Treatment options for self-harm behaviors include psychotherapy, medication, and in-patient care. Let’s expound more on these options.
Psychotherapy
Psychotherapy, also known as talk therapy or psychological counseling, is designed to help patients identify and manage underlying issues and feelings that trigger certain behaviors. It can help treat teen self-harm behaviors by teaching them skills to manage stress and emotions better. It also teaches other valuable skills like problem-solving and improving relationships with others.
Psychotherapy is backed by scientific evidence as an effective method of treating various mental health issues. Types of psychotherapy that may help treat self-harm behaviors include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and mindfulness-based therapies.
Cognitive Behavioral Therapy (CBT)
CBT for teens identify and understand their negative feelings and how to replace such feelings with positive ones. It teaches them skills on how to cope with distressing situations in a healthy manner. Active participation of the teen is required to learn the required skills.
Dialectical Behavior Therapy (DBT)
This is a modification of cognitive behavioral therapy meant for people with intense emotional regulation issues. DBT is the teen treatment for self-harm behaviors by helping teens learn how to control impulses and emotions. The skills help them improve their relationships with other people, leading to happier lives.
Mindfulness-based Therapies
Mindfulness-based therapies teach teenagers to live in the moment and how to deal with negative thoughts. Replacing negative thoughts with positive ones may help reduce symptoms associated with teen anxiety and depression.
Family-Based Therapy
Teen family therapy is family-centered. It involves therapy sessions with the whole family to address underlying family issues contributing to the self-harm behaviors. Family involvement also develops ways in which the family can assist the teenager in recovering from self-harm behaviors.
Medication
Medication can help treat diagnosed mental health conditions causing self-harm behaviors. Mental health conditions like depression and anxiety disorder may be treated using antidepressants and anti-anxiety medications. It is crucial to note that qualified mental health professionals should only prescribe such medications after a clinical diagnosis.
These medications also come with FDA warnings on potential risks, but this is not meant to deter their use. They have been proven to be effective in treating anxiety and depression. Parents, guardians, and caregivers should also be informed of the potential risks of the medication to weigh their pros and cons.
In-patient Care
In-patient care is when the teenager is admitted to a hospital or a facility for psychiatric care. It is suitable for teenagers with serious, persistent self-harm behaviors that cannot be handled in an outpatient setting. The facility provides a safe environment, and trained professionals constantly supervise teenagers.
Key Healthcare offers in-patient care through its Teen Residential Treatment Center (RTC). The RTC offers an intensive 40-60 day program that provides comprehensive psychiatric care for the teenager. During their stay, the teenagers are equipped with skills to cope with their challenges through teen individual therapy and teen group therapy. The teenagers also interact with peers who may have similar experiences and help support each other in their recovery journey.
Supporting Teenagers with Self-harm Behaviors
If you find out that your child is self-harming or have a reasonable belief that they might be self-harming, you should take the necessary steps to try and help them. Your reaction matters in this situation, and it is important to remain calm. It is natural to be worried or even angry but remember that they need help, and snapping at them would be counter-productive. Overreacting may increase their guilt and shame, making them shut down and isolate instead of seeking help.
Here are some tips on how to approach the situation.
- Get more information about self-harming to understand the reason behind such behaviors.
- Approach with 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 like going for a walk or any other activities they like.
- Remove potential objects used for self-harming, like razor blades, needles, and knives.
- Seek help from professionals and parents with similar experiences with their children. Find a support group that can help you throughout the journey.
- Encourage the child to seek professional help and address any misconceptions that may make them unwilling to accept professional intervention.
- Be patient with them because it may take a while to stop such behaviors
- Take care of yourself: Taking care of a loved one with mental and emotional challenges is difficult and may also affect your mental health. Practice self-care routines and take time off to do things you love.
Conclusion
In conclusion, self-harm behavior or non-suicidal self-injury disorder is a serious mental health condition that causes individuals to injure themselves. Self-injury is usually an outlet for complex emotions that teens may be unable to process effectively. The major causes of NSSID include difficulty managing emotions, the development of poor coping skills, and mental health conditions such as anxiety and depression.
Signs and symptoms of NSSID include scars and bruises, usually in patterns, attempts to hide scars by wearing long-sleeved clothing, and constant bruising from self-punching. It is important to seek professional help if your teen exhibits these signs and symptoms. If your teen is diagnosed with NSSID, you can enroll them in Key Healthcare residential treatment center for teens where they undergo therapy using evidence-based approaches like cognitive behavioral therapy (CBT) and dialectal behavior therapy (DBT), which are effective in treating several mental health conditions like NSSID.
RTC programs also utilize holistic treatment approaches such as art therapy, music therapy, and yoga therapy to help teens develop healthy coping mechanisms. Residential facilities are important in treating NSSID because they offer structure, round-the-clock care, and different modalities to treat NSSID.
You can opt to contact us and schedule a consultation to enroll your teen with severe NSSID in a suitable RTC program to ensure they receive high-quality care for their issue.
Frequently Asked Questions (FAQs)
What are some alternative coping strategies that teenagers can use instead of self-harm?
Alternative coping mechanisms include expressive arts and physical activities. Examples of expressive arts include writing, drawing, painting, singing, and playing musical instruments. Physical activities include sports, yoga, and running, among many others.
How can I support my teenager’s mental health even if they are not ready to stop self-harming?
It may be difficult to support someone who doesn’t want help. Ensure you always approach them with empathy and a non-judgmental attitude when trying to talk to them and avoid criticizing or shaming them. Inform them of healthier coping mechanisms and encourage them to seek professional help. Most importantly, be patient with them and respect their boundaries.
Can teenagers who self-harm still lead fulfilling and successful lives?
Self-harming teenagers can still lead successful lives. Self-harming is a negative coping mechanism for processing emotions, but it does not define their entire life. They can learn skills for managing stressful situations through professional help.
Can self-harm be a symptom of an underlying mental health condition?
Yes. In some situations, self-harm behaviors may be 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 an attention-seeking behavior
- Cutting is the only form of self-harming
- Self-harming is a way of manipulating others
- Self-harm is a phase in which 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 such teenagers by partnering with mental health professionals like counselors to provide mental health services to teenagers. The school can also help by incorporating mental health education into their curriculum to teach teenagers about their mental health and the skills to cope with emotional stress. They can also help by creating awareness through campaigns on mental health issues.
