Understanding Self-Harm in Teens and Young Adults: What Parents Need to Know

Whether it involves cutting, scratching, burning, hitting, or other forms of self-injury, parents often experience shock, fear, guilt, confusion, or panic when they first learn about self-harm behaviors.

One of the most important things to understand is this:

Self-harm is usually not about “attention-seeking.”
It is often a sign of emotional pain that a child or teen does not yet know how to manage in healthier ways.

As a psychiatrist working with children, adolescents, and adults, I want families to know that self-harm behaviors are more common than many people realize. With support, treatment, healthier coping skills, professional therapy, and appropriate medications when needed, recovery is absolutely possible.

What Is Self-Harm?

Self-harm, also called non-suicidal self-injury (NSSI), refers to intentionally hurting oneself without the intention of ending one’s life.

Common forms may include:

• Cutting
• Scratching
• Burning
• Hitting oneself
• Picking at skin or wounds
• Head banging
• Interfering with wound healing

Although self-harm is different from a suicide attempt, it should always be taken seriously.

Many teens describe self-harm as a way to:

• Release emotional pain
• Feel temporary relief from overwhelming emotions
• Cope with anxiety or emotional numbness
• Punish themselves
• Regain a sense of control
• Express emotions they cannot verbalize

For some individuals, emotional distress can feel so intense internally that physical pain briefly distracts from emotional suffering.

Why Are Self-Harm Behaviors Increasing?

Today’s adolescents are facing high levels of emotional stress.

Many young people are navigating:

• Academic pressure
• Social media comparison
• Bullying or cyberbullying
• Anxiety and depression
• Loneliness
• Identity struggles
• Family conflict
• Trauma or loss
• Perfectionism
• Difficulty regulating emotions

Some teens become overwhelmed by emotions they do not yet have the developmental skills to manage effectively.

Self-harm can become an unhealthy coping strategy when emotional distress builds faster than coping abilities.

Signs Parents May Notice

Some teens openly talk about self-harm, while others go to great lengths to hide it.

Possible warning signs may include:

• Wearing long sleeves even in warm weather
• Unexplained cuts, scratches, or burns
• Frequent “accidents”
• Isolation or withdrawal
• Mood swings or irritability
• Increased anxiety or sadness
• Sharp objects hidden in bedrooms or backpacks
• Blood stains on clothing or tissues
• Negative self-talk or feelings of worthlessness

Sometimes parents are surprised because their child still appears successful academically or socially. Emotional pain is not always visible from the outside.

 

How Parents Should Respond

The way adults respond after discovering self-harm can significantly impact whether a child feels safe seeking help.

Stay Calm

Parents naturally feel alarmed, but reacting with panic, anger, or punishment can increase shame and secrecy.

Avoid statements like:

• “Why would you do this?”
• “You’re just trying to get attention.”
• “Promise me you’ll never do it again.”
• “You have nothing to be upset about.”

Instead, try:

• “I’m really glad you told me.”
• “I can see you’ve been hurting emotionally.”
• “You don’t have to handle this alone.”
• “We’re going to work through this together.”

A calm, supportive response helps create emotional safety.

Focus on Understanding, Not Punishment

Self-harm is usually a symptom of emotional distress, not defiance.

Confiscating every sharp object or constantly checking a child’s body without addressing the emotional pain underneath often increases shame rather than healing.

The goal is not simply to stop the behavior.
The goal is to help the child develop healthier coping skills and emotional regulation.

Healthy Coping Skills That Can Help

Healing takes time, but many teens benefit from learning replacement coping strategies that reduce emotional intensity safely.

Different strategies work for different individuals, but examples may include:

Physical Emotional Release

• Squeezing ice cubes
• Snapping a rubber band lightly on the wrist
• Intense exercise
• Tearing paper
• Punching a pillow

Emotional Expression

• Journaling
• Drawing or painting
• Music
• Talking to a trusted adult
• Voice notes or expressive writing

Nervous System Regulation

• Deep breathing exercises
• Grounding techniques
• Going outside
• Listening to calming music
• Using sensory coping tools

Reducing Isolation

Many teens self-harm when they feel emotionally alone.

Encouraging connection with:

• Trusted adults
• Therapists
• Supportive friends
• Family members
• School counselors

can help reduce emotional overwhelm.

When Professional Help Is Important

Self-harm behaviors should never be ignored or minimized.

Professional mental health support is especially important if a child or teen is:

• Self-harming repeatedly
• Experiencing depression or anxiety
• Talking about hopelessness
• Having suicidal thoughts
• Becoming socially withdrawn
• Struggling at school
• Showing rapid mood changes
• Using substances
• Experiencing trauma

Treatment may include:

• Individual therapy
• Family therapy
• Cognitive Behavioral Therapy (CBT)
• Dialectical Behavior Therapy (DBT), which focuses on emotional regulation skills
• Medication when appropriate for underlying anxiety, depression, ADHD, or mood disorders

Therapy can help teens better understand their emotions, build healthier coping strategies, improve communication, and reduce feelings of shame or isolation.

In some cases, medications can also play an important role by treating underlying mental health conditions such as depression, anxiety, ADHD, or mood disorders that may contribute to emotional distress and self-harm behaviors.

Seeking professional help early often leads to better outcomes and gives both teens and families the support they need during recovery.

One important message for parents:
You do not have to manage this alone.

Talking About Self-Harm Without Increasing Shame

Many parents worry they will “make things worse” by talking about self-harm.

In reality, compassionate conversations often reduce secrecy and emotional isolation.

Helpful approaches include:

• Asking open-ended questions
• Listening without immediately trying to fix the problem
• Validating emotions even if you do not fully understand them
• Avoiding criticism or ultimatums

A child can feel heard without a parent agreeing that self-harm is the answer.

For example:

• “I may not fully understand what this feels like for you, but I want to.”
• “Your feelings matter.”
• “We’ll figure this out together.”

A Message of Hope

Self-harm behaviors can feel overwhelming for both teens and families, but healing is possible.

Many young people who once struggled with self-injury go on to develop healthy coping skills, emotional resilience, stronger relationships, and improved self-esteem.

Recovery does not happen overnight.
It happens through support, connection, treatment, and learning healthier ways to manage emotional pain.

If your child is struggling, remember this:

Seeking help is not a sign of failure.
It is a sign of strength, awareness, and love.

And for teens reading this:

You deserve support.
You deserve compassion.
And you deserve help that goes beyond carrying emotional pain alone.