Teenagers and Self-Harm: Why They Do It

Why do teenagers cut themselves or use other forms of self-mutilation? Teens who cut or burn themselves are not attempting suicide. Instead, they are using methods of self-harm as an unhealthy coping mechanism to deal with difficult emotions.

Self-harm in teens is a way for them to release feelings of pain, tension, and anxiety. These painful emotions may include anger, shame, grief, guilt, and self-loathing. They see self-injury as a way to feel more in control of their emotions, or they use it to distract themselves from their emotions or life circumstances. In addition, they may engage in self-harm because they want to punish themselves for what they see as their faults or flaws.

Moreover, teens sometimes injure themselves because the physical pain of self-harming seems better than numbness and emptiness that come with depression. Thus, cutting and depression are often linked.

Self-injury may bring a temporary feeling of calm and a release of tension. However, the painful emotions quickly return. Some teens self-injure only a few times and then stop. But others continue repeatedly, over a long period of time. Therefore, self-harming can turn into a compulsive behaviour.

What Are the Different Types of Self-Harm?

Not all forms of self-harm look the same. One of the most common of the different types of self-harm is cutting, using a knife or other sharp object. Often teens cut themselves as a kind of ritual that leaves patterns on the skin. They may carve words or symbols on their skin.

But teens also use different forms of self-harm, including one or more of the following:

• Scratching or biting the skin
• Burning their skin with lit matches, cigarettes, or other hot, sharp objects
• Hitting or punching themselves or the walls
• Piercing their skin with sharp objects
• Pulling out hair
• Picking at scabs and wounds
• Poisoning
• Disordered eating
• Inserting objects into the body
• Overdosing on drugs or drinking to excess
• Exercising to the point of collapse or injury
• Getting into fights in which they are likely to be hurt
• Banging head or body against walls and hard objects
• Driving recklessly
• Having unsafe sex.

Self-Harm Symptoms

Parents and other adults who work with teens should learn the red flags related to different forms of self-harm. Here are some signs and symptoms that may indicate that a teen is self-harming:

• Scars or scabs
• Unexplained cuts, scratches, bruises or other wounds, often on the wrists, arms, thighs, or torso, which they explain as the result of accidents
• Keeping sharp objects on hand
• Wearing clothes that cover up the skin, such as long sleeves or long pants, even in hot weather
• Impulsive and unstable behavior
• Expressing feelings of hopelessness or worthlessness
• Difficulties with relationships
• Blood stains on bedding, clothing, towels, or tissues
• Having sharp objects in their possession, including razors, safety pins, nail scissors, knives, needles, shards of glass, or bottle caps
• Spending long periods of time alone, often in the bathroom or bedroom
• Increased isolation and social withdrawal
• Avoiding situations in which they need to reveal skin, such as swimming or changing in a locker room.

Complications and Consequences of Self-Injury

Self-injury can cause dangerous and even fatal health consequences. Furthermore, it can have a continued negative impact on mental health.

Possible complications of self-harm include:

• Increased shame, guilt, and low self-esteem
• Wound infections
• Permanent scars or disfigurement
• Broken bones
• Isolation that results in losing friendships
• Higher risk of major depression, drug and alcohol addiction, and suicide.

Treatment for Self-Harming Behavior

Treatment for self-injury addresses the root causes of the self-destructive behavior. Therefore, treatment for anxiety or depression may be necessary. Other underlying issues might include low self-esteem, dysfunctional family dynamics, or other mental health conditions, such as borderline personality disorder.

In addition, teens learn new coping mechanisms for dealing with difficult circumstances or painful emotions. Treatment provides them with different ways to stop self-harm behaviors by substituting other, healthier behaviors, such as breathing exercises and compassionate self-talk.

For some adolescents who injure themselves, residential or outpatient treatment may be appropriate. Therapists may offer one or more of the following modalities for addressing different forms of self-harm.

• Cognitive Behavioral Therapy (CBT) helps teens to identify and modify thought and behavior patterns. Therefore, they learn how to shift their outlook from the negative toward the positive and how to identify triggers for self-harm.
• Dialectical Behavioral Therapy (DBT) helps teens acknowledge that they are using self-harm to cope with underlying issues. Subsequently, they develop ways to modify this behavior. In addition, they address the root causes of self-harming.
• Meditation & Yoga An increasing number of studies show that mindfulness meditation can help support mental health. Meditation encourages us to witness our emotions from a distance rather than getting caught up in them. Therefore, teens learn to cope with their emotions and manage distress without self-harming.