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Teens and Self-Harm: The Causes and Signs

Upset boy holding skateboard

​The Boys Town National Hotline® deals with the victims of self-harm every day. The majority of adults we speak with think the idea of deliberately hurting yourself to achieve relief from guilt or stress is unthinkable. But to a teen, self-harm is easy because it is fast and always available. And for a young person dealing with the pressures of everyday teenage life in 21st century America, it can be a tempting solution. As one 13-year-old explains, "Why sit and wait and dwell on your feelings when in less than two minutes, you could let them out and then go on with your day?"

It's truly shocking for a mother or father to find out that their teenager is engaging in self-harm. After all, the primary evolutionary urge of all parents is to protect their children. So finding out that you have to protect them from themselves is a lot to take in.

After the initial shock, it is essential for parents to remain calm, and to be open and understanding when discussing the issue with their teen.

Self-harm is not a declaration of suicide intent. Instead, it is a sign that a teen is experiencing some level of emotional pain and needs to develop more positive coping skills. A teen may feel that self-harm helps him or her to express feelings that can't readily be put into words. The teen may see it as a distraction from life problems or a means to release emotional pain. Afterwards, the teen may feel better - at least for a little while. But then the painful feelings return, and the urge to self-harm occurs again.

Self-harm can also generate feelings of guilt, which can lead to more self-harm, eventually spiraling into a cycle that's hard to escape. As another teen put it, "Self-harm is winning and I'm losing."

Another insidious thing about self-harm is that it's easily concealed. After all a teen who wears long-sleeved hoodies and likes to hang out in his or her room, away from the prying eyes of the rest of the family, is hardly an unusual thing. So parents need to be extra-vigilant when it comes to recognizing the signs of self-harm.

Typical forms of self-harm include cutting, scratching, burning, picking at wounds, and hitting or punching objects. Red flags include:

  • Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
  • Bloodstains on clothing, towels, or bedding; or blood-soaked tissues.
  • Sharp objects or cutting instruments, such as razors, knives, or needles, in the person's belongings.
  • Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
  • Wanting to be alone for long periods of time, especially in the bedroom or bathroom.
  • Isolation and irritability.

Unfortunately, there are no easy fixes. Some teens are able to kick the habit by learning better coping skills and sharing their feelings with supportive people in their life. Others may need professional therapeutic care to help them work through their emotional crisis. Either way, friends and family can help their teens by listening with the intent to understand, rather than trying to "fix" problems for them.

Teens can help themselves by making a list of distractions and coping skills to use when the urge to self-harm strikes. Journaling, exercising, watching a movie, or social interactions are good alternatives. Another option is the "Fifteen Minute Rule": If teens want to cut, they set a timer and wait for 15 minutes rather than acting on their urge. When the 15 minutes are up, they find something to do for another 15 minutes. They continue doing this until the urge passes. Hopefully the need to self-harm will decrease and they will learn to control their impulses over time.

It is important for teens to keep in perspective that their current problems won't likely be problems forever. It takes courage, perseverance, and time to overcome the need to self- harm - but the reward is living life free from both physical scars and emotional pain.

One positive note: Teens who engage in self-harm often want to stop but they simply don't know who to talk to. Listen to the words of one such teen: "I really, really want to tell someone, because I know that I need help. But I don't want my parents to know. I don't want my school to know. I don't want to get in trouble. I just want support and help."

But help can only come when parents recognize it's necessary in the first place. So keep your eyes and ears open. Talk to your teen. Be aware of any suspicious activities or symptoms. And let them know you love them and are there for them whenever they need you.

If you're ever in doubt, call the Boys Town National Hotline for help at 1-800-448-3000.