As a parent, few things are more terrifying than discovering your teen is self-harming. Whether it’s cutting, burning, or any other form of self-injury, the immediate questions that come to mind are: Why? What did I miss? How can I help?
Before diving into the details, let me assure you that you’re not alone in this. As a child psychiatrist, I’ve worked with many teens and families facing this heart-wrenching issue. Understanding the “why” behind self-harm can give you the tools to approach this situation with empathy and care.
Symptoms of Self-Harming Behavior in Teens
Self-harming is not always obvious. Teens can be incredibly good at hiding it, especially if they feel ashamed or afraid of being judged. Here are some signs to watch for:
- Unexplained Injuries – Cuts, burns, or bruises that don’t have a clear explanation can be a sign of self-harm. They’re often on the arms, legs, or stomach but could be hidden elsewhere.
- Covering Up – Wearing long sleeves, even in hot weather, or avoiding situations like swimming where their skin is exposed can be a red flag.
- Isolation – Teens who are self-harming might pull away from friends and family, retreating into their own world.
- Mood Swings – Anxiety, irritability, or mood swings that seem extreme for the situation may be connected to self-harm.
- Emotional Outbursts – Self-harming teens might express anger or frustration in outbursts and then quickly spiral into guilt or sadness.
- Avoidance of Social Events – Teens may avoid activities they once loved, preferring to stay alone.
Etiology: What Leads to Self-Harm?
Self-harming behavior is complex, and there’s no single cause. However, a few key factors often play a role:
- Emotional Regulation: Many teens struggle to cope with overwhelming emotions like anger, sadness, or guilt. Self-harm becomes a way to release or control those feelings. It’s a temporary escape from emotional pain.
- Trauma: Experiences like bullying, abuse, or the death of a loved one can trigger self-harming behaviors. The emotional scars left behind from these traumas may lead to self-injury as a coping mechanism.
- Mental Health Disorders: Conditions like depression, anxiety, borderline personality disorder, or PTSD frequently contribute to self-harming behaviors.
- Pressure to Succeed: In my practice, I’ve seen teens who feel immense academic or social pressure. The weight of expectations, especially in highly competitive environments, can lead some teens to self-harm as a way to cope with perceived failure.
- Peer Influence: In some cases, teens may turn to self-harm after seeing peers or influencers online engage in it. The online world, while filled with helpful resources, can also be a place where harmful behaviors are normalized.
Epidemiology: How Common Is Self-Harm in Teens?
Research shows that self-harm is far more common than most parents realize. Studies suggest that about 17% of adolescents have engaged in self-harming behaviors at least once. Girls are more likely to self-harm than boys, with rates being about twice as high among teenage females.
Self-harming typically begins in early adolescence, around the age of 12 to 14, but can continue well into young adulthood if left untreated.
Interestingly, self-harming is not always tied to suicidal intent. In fact, many teens use self-harm as a way to avoid suicidal feelings, though this doesn’t make it any less serious.
History: Understanding Self-Harm Over Time
Self-harm isn’t a new phenomenon, but the way we understand and address it has evolved over time. Historically, it was often dismissed as “attention-seeking” behavior. Teens were viewed as rebellious or manipulative, which, in turn, minimized the seriousness of their pain.
Fortunately, today, we recognize self-harm for what it is: a sign of deep emotional distress. This shift in understanding means that teens who self-harm are now getting the support they need rather than being dismissed or judged.
Pathogenesis: What’s Happening in the Brain?
Self-harming behavior often has a neurological basis. When teens self-harm, their brain releases endorphins—chemicals that temporarily relieve pain and create a sense of calm. This release reinforces the behavior, making self-harm a repetitive coping mechanism.
In addition, teens who self-harm often have heightened activity in the amygdala, the part of the brain that controls emotional responses. Their fight-or-flight response may be more sensitive, making them feel overwhelmed by emotions more easily. The prefrontal cortex, responsible for impulse control and rational decision-making, is still developing in adolescence, making it harder for teens to stop themselves from acting on these intense emotional responses.
A Personal Perspective
I’ll never forget a patient of mine, Rhea (not her real name). She was 15 when her parents brought her to me, after noticing small, deliberate cuts on her arms. Her family was devastated, and they didn’t understand why she was doing this to herself.
Rhea, like many teens, wasn’t trying to end her life. She told me that when her anxiety became too overwhelming, cutting was the only thing that seemed to quiet the noise in her head. Over time, through therapy and open conversations, Rhea found healthier ways to cope with her emotions. She learned mindfulness techniques, and slowly, she began journaling and painting instead of turning to self-harm.
FAQs on Teen Self-Harming
Q: Is self-harming always a sign of suicidal intent?
A: No. While self-harm is serious, it doesn’t always mean a teen wants to end their life. Often, it’s used as a way to cope with emotional pain. However, it does increase the risk of suicidal behavior, so it should always be taken seriously.
Q: How can I help my teen if they’re self-harming?
A: The most important thing is to remain calm and open to communication. Avoid being judgmental or angry. Seek professional help from a child psychiatrist or therapist who specializes in adolescents.
Q: Will my teen grow out of self-harming?
A: Self-harm won’t just go away with time. Without the right support and intervention, it can become a long-term habit. Early intervention can help your teen develop healthier coping mechanisms.
Q: What treatments are available for teens who self-harm?
A: Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and mindfulness-based therapies are commonly used. In some cases, medication may be prescribed if the self-harming behavior is linked to an underlying mental health disorder.
DISCLAIMER
This blog is for informational purposes and should not substitute professional medical advice. Please consult with a licensed mental health professional for diagnosis and treatment.
Dr. Rameez Shaikh, MD, Psychiatrist
Dr. Rameez Shaikh (MBBS, MD, MIPS) is a consultant Psychiatrist, Sexologist & Psychotherapist in Nagpur and works at Mind & Mood Clinic. He believes that science-based treatment, encompassing spiritual, physical, and mental health, will provide you with the long-lasting knowledge and tool to find happiness and wholeness again.
Dr. Rameez Shaikh, a dedicated psychiatrist , is a beacon of compassion and understanding in the realm of mental health. With a genuine passion for helping others, he combines his extensive knowledge and empathetic approach to create a supportive space for his patients.
