What Causes Thoughts of Self-Harm in Teens

What Is Self-Harm?

Self-harm (sometimes called self-injury or self-mutilation) is the act of intentionally harming
oneself in a physical manner. Self-harm is an expression of personal distress and often a coping
mechanism. Self-harm is not a mental illness itself (but can be a symptom of mental illness), a cry for
attention, or something people do for fun. The majority of people who participate in self-harm are
between the ages of 11 and 25.

Self-harm has been on the rise amongst young people since the 1960s, especially for females. A
2005 study estimates that between 17-28% of adolescents and teenagers will self-harm at some point.
These numbers demonstrate why self-harm is a public health concern, and unfortunately, the negative
consequences of self-harm go far beyond the physical effects.

Types of Self-Harm

A wide range of behaviors fit into the category and definition of self-harm, including:

• Cutting – cutting is one of the mostly commonly talked about forms of self-harm. Cutting
  involves using any form of sharp object to slice into one’s skin (usually to the point of drawing
  blood).
• Burning – another very common form of self-injury, burning one’s skin is often achieved by using
  matches, lighters, hot pans, etc.
• Scratching or pinching – this form of self-harm involves severely scratching or pinching with
  one’s fingernails (or other objects), often to the point of drawing blood or leaving marks on the
  skin.
• Pulling out hair – hair-pulling is a type of self-harm known medically as trichotillomania. With
  trichotillomania, a person experiences compulsions to pull out his or her own hair (and in some
  cases, ingest that hair).
• Hitting or punching – this behavior includes banging or punching oneself, often to the point of
  bleeding or bruising.
• Impact with objects – this way of self-injuring includes hitting, banging on, or punching objects
  to the point of bruising or bleeding.
• Persistent picking of wounds – self-mutilation through persistent picking means interfering with
  the healing of one’s wounds (often caused by self-harm).
• Carving – this form of self-harm occurs when a person carves into his or her skin (typically words
  or symbols).

For most teenagers, the arms, legs and torso are the common targets of self-harm, as these areas of
the body can be easily hidden with clothing. Nonetheless, teens may inflict self-harm on other parts
of the body.

Why Do Teens Self-Harm?

People use self-harm in much of the same way that people use drugs, alcohol, food, or sex – to
feel better in the short-term. Yet many misunderstand the intention behind self-harm, often confusing
it with an attempt to commit suicide. Adolescents and teenagers who self-harm do not intend to die,
but instead, inflict harm and physical pain upon themselves. Nonetheless, evidence shows those who
engage in self-injurious behaviors are at an increased risk of suicide. Researchers suggest that self-injury
is a sort of “primer” for suicide in that if people are able to overcome the fear and pain of self-harm,
they are more apt to follow through with suicide if suicidal thoughts arise.

Teenagers engage in self-harm for a variety of different reasons. In most cases, self-
harm is a behavioral symptom of something “deeper” (usually emotional in nature) going on with the
teen. Regardless of the deeper emotional issue, teens cite using self-harm as a way to:

• Numb out – when teenagers self-harm, it is often in an attempt to stop feeling or “numb out”
  from the often overwhelming emotions (sadness, hurt, loneliness, etc.) they are experiencing.
  Many who self-harm report the act of self-harm causes physical pain, which can distract from, or
  create a sense of numbness, when it comes to emotions.
• Feel something – for some adolescents and teenagers, mental health issues (such as depression)
  can actually cause a sense of numbness, or not being able to feel emotion. Thus, these young
  people tend to participate in self-injury as a way to feel something.
• Feel in control – when youth experience their lives as being out of control, they will often aim to
  gain control through any means possible, including self-harm.
• Punish – when youth (or anyone) experience overwhelming feelings of guilt or shame, and do
  not have a healthy outlet and/or expression for these emotions, they frequently feel the need to
  punish themselves. Punishing is often achieved through self-mutilation.
• Express complicated or hidden feelings – sometimes teenagers can experience feelings and
  emotions that they struggle to understand or have difficulty communicating about. Young
  people often do not have the language needed to talk about deeper emotional issues, or do not
  feel they have a safe person to go to. These teens sometimes turn to self-harm as a way to
  express or “communicate” what is going on internally.

Regardless of why a young person uses self-injurious behaviors, overall, teens report self-harm
“works” in terms of bringing about an immediate sense of relief.

Risk Factors for Self-Harm in Teens

While any young person may engage in self-harm, there are certain factors that make a teen
more likely to (or have a higher risk of) participating in self-injurious behaviors.

Biological Risk Factors

• Being young – adolescence is considered a “prime time” for self-harm behavior. From a
  developmental perspective, young people experience many changes during adolescence, not
  only physically, but also socially. Thus, it is very common for teens to experience high levels of
  emotion.
• Being female – research shows self-injury is far more amongst females, yet the reason why is
  still up for debate.
• Family history of self-harm – if an adolescent or teenager has a family member with a history of self-harm, he or she may be at an increased risk for engaging in self-harm at some point in life. This may be due to a genetic component.

Environmental Risk Factors

• Isolation – lack of social support from significant adults and/or peers can cause a young person
  to experience overwhelming isolation and loneliness, often resulting in self-harm.
• Bullying – being the victim of bullying is a risk factors for many unhealthy or dangerous
  behaviors, including self-injury.
• Difficulty asking for help – mental illness has long been a stigmatized topic in this country.
  Because of this, many young people find it near impossible to ask for help and instead, act out
  and cope with self-harm.

Psychological Risk Factors

• Mental illness – having a mental health diagnosis, especially without sufficient treatment and
  support, makes it more likely a person will experience overwhelming emotions (which causes an
  increased likelihood for coping with self-harm). Additionally, certain mental illnesses (such as
  borderline personality disorder) cite self-injury as a common behavioral symptom.
• Traumatic experience(s) – emotional/sexual/physical abuse, or another early childhood trauma
  is a key risk factor for self-injurious behavior amongst adolescents and teenagers.
• Life event – a serious or recent loss (such as the death of a family member, friend, or animal) or
  a separation (such as a breakup with a girlfriend/boyfriend) may increase a teenager’s likelihood
  of engaging in self-harm.
• Alcohol or substance abuse – any high-risk behavior, including alcohol or drug use and abuse,
  make a young person more apt to act out with self-harm. Other “high-risk” behaviors include
  breaking the law, having disciplinary problems, etc.
• Prior suicide attempts – those who have attempted suicide in the past are more likely to engage
  in self-injurious behaviors.
• Negative body image – when adolescents or teenagers are unaccepting of and/or dislike their
  body, it often makes it easier to inflict harm upon that body.
  Warning Signs of Self-Harm
• Wearing clothes that cover the body (i.e. – long sleeve shirts) when the weather is hot
• Being more secretive or less communicative
• Changes in eating habits
• Changes in sleeping patterns
• Keeping sharp objects on hand
• Statements of hopelessness or helplessness
• Difficulties in relationships
• Unexplained cuts, scratches, bruises, or other wounds
• Because self-harm is often coupled with feelings of shame and/or guilt, noticing the warning
  signs in teens may be difficult. If you think your teen is struggling with self-harm, or you notice signs of
  self-harm, it is vital you get him or her the necessary support and treatment.