Self harm in teens and young people is a big concern. This behavior, which can include such actions as purposely cutting or burning yourself, might be something a teen or young adult known to you is struggling with.
Self-injurious behavior has been reported to be occurring in an estimated 14% to 17% of teenagers and young adults (Whitlock, Eckenrode, and Silverman, 2006).
Another research study found that 46.6% of participating adolescents reported that they engage in non-suicidal self-injury behaviors (Lloyd-Richardson, Perrine, Dierker, and Kelley, 2007).
Intentionally harming yourself is called Non-Suicidal Self-Injury (NSSI). These behaviors involve an individual purposefully harming themselves in unacceptable ways, but without suicidal intentions. Basically, NSSI means self-harming actions.
Understanding why someone would choose to harm themselves is difficult. There are, however, warning signs, and there are ways you can help. In this article, we will address many aspects of this frequently misunderstood subject and hopefully lead you to a better understanding of self-harming behaviors and how to recognize them.
Understanding What Self Injury May Look Like
Those who engage in self-harm may do so in various ways. Behaviors may range from mild to more severe over time, such as scratches to cutting, increasing to even more severe levels of harm.
Research suggests that self-injury can be addictive (Nixon, Clouter, and Aggarwal, 2002). This makes self-injury more difficult to stop. The methods used to cause self-injury vary and a complete list would be long. Punching things, pinching oneself, pulling hair out, breaking bones, and interfering with the healing of wounds are some examples.
One research study found that the types of self-injury that were most frequently reported were biting, hitting oneself, burning, and cutting (Lloyd-Richardson, Perrine, Dierker, and Kelley, 2007).
Cutting, often performed on the arms and legs, especially upper thighs, can be done with a myriad of objects ranging from razors, pencil sharpener blades, scissors, or paper clips. Anything object that can be used to inflict pain may be used for self-harm.
Reasons Why Someone Self Injures
Intentionally inflicting pain on oneself is difficult to understand. In order to offer support to someone who engages in self-harm, it’s important to understand the reasons why they are doing it.
Common reasons for self harm in teens include:
- The need to cope with emotional pain with which the individual is struggling, like anger and depression (e.g., Peterson, Freedenthal, Sheldon, & Andersen, 2008; Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007).
- Participating in self-injury provides something other than difficult emotions on which to focus.
- Chemicals are released in the brain in response to injury, and that may lead to a calming effect.
- Managing emotions can be challenging, so a person may self-injure because they can better manage physical wounds.
- An individual may have difficulty communicating emotional pain, so instead of words, they communicate their emotional pain in the form of self-injury.
- Feelings of being out-of-control may lead individuals to self-harm in an attempt to gain control (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007).
- Teens often face situations that cause anger, such as failing a test or losing a game. These situations can produce intense emotions. Instead of coping with the emotions in a healthy way, they may engage in self-harm as a method of self-punishment.
- Engaging in self-harm may also release tension for teens that are feeling stressed (Nixon, Cloutier, & Aggarwal, 2002).
- When depressed, an individual may feel numb. Not feeling their emotions, they self-harm seeking to feel something, even though it is pain.
- Self-harm can be a result of a desire to manipulate others although it should not be assumed that is the only reason behind the self-harm.
- Gaining attention or seeking a reaction may be the cause of self-injury (Lloyd-Richardson, Perrine, Dierker, & Kelley, 2007). It’s important not to assume the behavior is only to seek attention. Additionally, it’s vital to understand why the person would want the attention.
Although there are many reasons why someone may participate in these behaviors, self-harm brings relief that is merely temporary. Once they self-harm, the individual usually experiences intense feelings of guilt and shame.
This can contribute to a continuous cycle of self-injury, meaning that treatment is an important step toward giving a person the tools to handle the feelings that prompt the self-injury.
At Risk for Self-Injury
Self-injury can be the result of a host of factors. These factors are often related to emotions and their regulation.
Risk factors for self harm in teens may include:
- Diagnosis of mental illness, including, but not limited to, substance use disorders, borderline personality disorder, PTSD, eating disorders, anxiety, bipolar disorders, and depression
- A history of being abused
- Low self-esteem
- Troubles controlling emotions
- Internalizing intense emotions, specifically anger
- Having a friend who engages in self-harm
Warning Signs of Self-Injury
Feeling ashamed of or hiding the fact that they are hurting themselves is common in people who self-injure. This means it might be difficult to recognize physical effects of the behaviors.
There are some key indicators to look for that could suggest that someone is intentionally hurting him or herself. It should be borne in mind, however that not everyone who shows the following signs engage in self-harm.
- Long-sleeves worn even when the weather is warm or hot
- Wearing concealing clothing and avoiding situations where concealing clothing is out of the norm
- Wearing arm jewelry to disguise injuries
- Refusing to wear a swimsuit (although body image issues may also cause this)
- Frequently acquiring marks, scratches, or other accidental injuries that are quickly explained away (e.g., “I feel on the concrete. The dog jumped on me. I fell on my pencil.”)
- Increased desire to be alone (often a result of depression)
Self Harm in Teens and the Connection to Suicide Attempts
Research indicates that self-harm is a risk factor for attempted suicide. Klonsky, May, and Glenn (2013) report that self-injury was second only to suicidal thinking in its association with attempted suicide attempts in the study population.
Other factors related to suicide attempts included impulsivity, anxiety, depression, and borderline personality disorder. A host of other studies have shown that self-injury is a major risk factor for suicide attempts. Nevertheless, it should be pointed out that not everyone who engages in self-harm actually tries to commit suicide.
In point of fact, many do not. However, because of the increased risk for suicide, it is critical to identify any suicidal thoughts. If someone is considering suicide it is vital to get professional help immediately, such as at the closest hospital.
How to Help
Understanding your own feelings and reactions is the first step before you can help someone who is engaging in self-harm. It’s important that you remain both calm and willing to create a safe space where they can honestly communicate their feelings since often they will need to learn to express their feelings in a healthy way.
Letting them know you are there for them, but that you have to help keep them safe is a must. Self-harm can cause medical issues, such as infection, so it’s necessary to inform the teen’s caregivers. Although this can cause fear or distrust with the teen, it is a necessary step.
When talking with someone who self-injures, there are some dos and don’ts.
- DON’T require the teen to stop the self-injury right away because it may just make them more secretive and more creative at hiding their injuries.
*Note: Immediate intervention may be required if the self-harm is severe and more than superficial wounds.
- DON’T give a punishment for the self-harming behaviors
- DON’T talk about the injuries with others unless they are a trained professional.
- DON’T make them feel ashamed by saying demeaning comments. This causes guilt and shame, which might already be the root cause of the behaviors.
- DO let them know you’re concerned and that you are there for them if they want to talk.
- DO treat the self-injury as serious.
Treatment for Self-Injury
Stopping self-harm can be challenging, as this they may perceive it as the only way to come to terms with and reduce emotional suffering. Self-injury may be the only consistent thing they feel they can rely on in their life. Relapse is common, inducing uncontrollable desires to harm themselves.
Despite this, however, real recovery is possible. If you or anyone you know are struggling with self-harm, you need to seek out a capable counselor who both understands is able to treat these types of behaviors. Treatment may be for individuals, families, and/or groups, and medication may be prescribed.
A therapist can help an individual who self-harms by giving them the tools to cope with and express emotions in healthy, non-destructive ways. They will also teach them to make connections with others in emotionally vulnerable ways.
It should always be borne in mind that no one self-injures without a reason. These may include anger, anxiety, or depression. A trained counselor will work with you or your loved one to discover the best approach to address and treat the reasons behind the self-injury. Getting help is critical and can save the life of someone that engages in self-harm.
If you or a loved one is struggling with self-harm, please get help immediately. We are here to work with you on your path to healing!
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