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Preventing Self-harm in Teens: A Guide for Appropriate Intervention

By Zocdoc | January 17, 2023
Medically reviewed by Dr. Nassim Assefi

Teens have the highest rate of self-harmamong any age demographic, with approximately 17% of teens reporting at least one instance of self-harm in their lifetime. The average age of the first incident of self-harm is 13. Often teens will seek out support from loved ones rather than mental health professionals. However, many teens will take extraordinary steps to conceal their self-harm, or even deny engaging in such behavior.

Additionally, they may not even be aware of what professional resources are available to them. As such, it is important for anyone with a teen in their life to be aware of warning signs and understand how to appropriately address instances of self-harm.

Why do teens self-harm?

There is not any single reason that teens engage in self-harm. However, there are a few common factors. Notably, many teens who engage in self-harm do so because they are grappling with difficult emotions that they are unable to healthily manage. Self-harm may provide such teens with a feeling of distraction or release, or may be a means of acting out frustration. Additionally, in some cases, teens may self-harm as a means of demonstrating their pain or stress to prompt help from others. Many risk factors may increase the likelihood of self-harming behaviors, such as mental illness, stress or traumatic experiences.

What is considered self-harm?

Self-harm can be carried out through many different means. Virtually any act in which someone intentionally causes harm to themselves can be considered self-harm. Some acts that can be considered self-harm include:

  • Cutting yourself
  • Punching yourself
  • Punching other objects
  • Slapping yourself
  • Burning yourself
  • Pulling out your hair
  • Pinching yourself
  • Poking yourself with sharp objects
  • Breaking bones

Additionally, all types of self-harm fall under one of two categories: suicidal self-injury and non-suicidal self-injury. Self-harm may co-occur with suicidal ideation and even suicide attempts, but they are not interchangeable. Many different factors can lead to either behavior, although prolonged self-harm can put teens at a higher risk of accidental suicide. Suicidal self-injury is self-harm where the individual is acting with the intention of ending their life or self-harm that is occurring alongside suicidal ideation or suicidal behaviors. All instances of self-harm should be taken seriously and met with immediate intervention, but in the case of suicidal self-harm in particular there must be no delay in life-saving response efforts.

Underlying conditions

As mentioned, in many cases underlying mental illness is the cause of self-harm or a significant exacerbating factor. Many types of mental illness and other underlying conditions or neurodivergent behaviors can contribute to self-harming behaviors. This can include the following conditions:

  • Depression: This disorder is characterized by low mood, reduced energy, and loss of interest.
  • PTSD: This is a disorder characterized by anxiety and flashbacks that are caused by experiencing a traumatic event.
  • Bipolar disorder: Bipolar is a mood disorder that is characterized by drastic shifts in mood and sometimes elements of psychosis.
  • Anxiety: Anxiety is characterized by persistent stress that is not proportional to the person’s current experiences. 
  • Compulsive behaviors: Compulsive behaviors are characterized by an urge to repetitively engage in actions in an attempt to cope with stress. These behaviors can be caused by a variety of underlying disorders. 
  • Schizophrenia: Schizophrenia is a disorder characterized by psychosis and impulsive behaviors.
  • Substance abuse: Substance abuse is the use of various substances in a way that is harmful or self-destructive.
  • Various chronic health conditions: Chronic health conditions can be painful, disruptive or stressful.

If an underlying condition is contributing to self-harm, it is important to address these underlying concerns to successfully treat the self-harm.

Contributing experiences

There are many life experiences that can increase a person’s risk of developing self-harming behaviors, including:

  • Abuse
  • Loss of a loved one
  • Divorce of guardians
  • Moving homes
  • Bullying
  • Unhealthy behaviors modeled by family and friends
  • Financial hardships
  • Discrimination
  • Feelings of shame

It is important to bear in mind that teens typically have not developed the mental and emotional skills that adults have, and therefore guardians and educators should check in with a teen who is experiencing significant change or a stressful event.


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