Self-Harm & Cutting in Teens: Signs And Risks

When the pain of substance addiction grows strong, some teens try to relieve it through self-injury, such as cutting. This disorder is an external symptom of internal turmoil. If you find that your child has engaged in self-harm, you can seek professional treatment to help.

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What Is Self-Harm?

Self-harm, also referred to as self-mutilation or self-injury, is the act of inflicting physical pain on one’s own body. Nearly 10% of kids in the U.S. deliberately hurt themselves at some point, with incidents most common around the time of puberty (ages 13–15). Females report doing it more often than males, although the problem demands equal attention no matter who is involved. In 2013, nearly 500,000 people visited a hospital for injuries related to self-injury.

When a teen decides to hurt themselves, it’s often indicative of much deeper issues that need to be addressed. Incidents of self-harm are reported in kids as young as 6 and 7. And the behavior can become habitual. Although 25% of people who self-harm only do it one time, there are millions of others who make it a ritual, resorting to the act on a near daily basis in some cases.

What Causes Teens to Harm Themselves?

teen with hands on fogged glassTeens may experiment with self-harm as a form of pleasure. The body responds to minor pain by releasing endorphins, which has a numbing or pleasurable sensation. It can be the equivalent of “getting high” for a particular set of people. But while some teens may do this for the sheer thrill or at the suggestion of friends, experts believe that most teens self-harm in response to major stressors in their life. These teens often have serious emotional difficulties rooted in their family or social life, and view self-mutilation as a logical coping mechanism.

Co-Occurring Disorders

The “serious emotional difficulties” typical of self-harming teens may be a diagnosable disorder. Around 1 in 5 teens aged 13–18 live with a mental health condition — be it depression, anxiety, ADHD, bipolar disorder or an eating disorder. Struggling with the symptoms of these conditions can easily lend itself to lashing out. This can involve using substances like drugs or alcohol, or self-harm in other cases.

Kids living with mental health disorders often don’t get the help they need until late in the game, if they do at all. In fact, the average time between the onset of symptoms and intervention is 8–10 years. Without getting the necessary attention, they’re at risk for harmful behaviors that can make matters worse. Approximately 90% of teens who die from suicide had an underlying mental illness.


Nearly half of people who self-harm report physical and/or sexual abuse during their childhood, and as many at 90% say there were discouraged from expressing their emotions (particularly anger and sadness) while growing up. A troubled teen may feel that self-injury is a release of sorts, or a form of self-punishment if they’re disappointed in themselves. In instances like theses, self-harm is a cry for help.

Self-harm happens among teens across all demographics. Much like substance use, experimenting with cutting or burning might be discussed among peers and viewed in the media, leading otherwise well-balanced kids to think about trying it. But teens burdened with serious hurdles in their personal life gravitate towards the act more than others.

Kids who live in dysfunctional homes, experience childhood trauma, struggle with mental illness or abuse substances (drinking, smoking and/or using illicit drugs) are more likely to consider self-harming. In some social circles, it’s possibly even encouraged. Among teens who identify as “goth” — black hair and clothes, gloomy taste in music and movies, stark make-up — 37% admit to self-harming. This cliquey social group has had a presence in high schools for decades, often attracting teens who identify as outcasts.

Other risk factors for teen self-harm can include:

  • Being bullied
  • Having trouble in school (bad grades, difficulty learning, etc.)
  • Poor self-image
  • Having friends who do it
  • Sexual identity confusion
  • Being female

If your teen balances one or more of these qualities, and is depressed, introverted or anxious, you should address these problems before they lead to something like self-injury.

Types of Self-Harm

girl with knife to own armThe most common methods of self-harm are cutting and burning. Cutting, carving or puncturing the skin can be done with tools, like razors or scissors, that teens can easily find at school or around the house. Among teens who self-harm, 1 in 3 report cutting. Burning, on the other hand, is done with lighters, lit cigarettes, stovetops or whatever hot surface they can find.

Teens on a mission to self-harm will go about it in a variety of ways. Other than cutting and burning, 15 other self-injury behaviors have been documented on college campuses, where 17% of students report some amount of self-harm (20% of females and 14% of males). Young people who hurt themselves often use multiple methods, and tend to focus on the hands, wrists, stomach and thighs — although no body part is off limits.

Methods of self-harm can include:

  • Scratching
  • Pinching
  • Pulling hair
  • Punching walls or other objects
  • Hitting oneself
  • Rubbing chemicals or sharp objects into skin
  • Interfering with healing of sickness or injuries
  • Choking or suffocating

What Are the Effects of Self-Harm?

First and foremost, self-harm adds an element of physical pain to your teen’s already stressful life. The severity can range from mild to severe. Depending on how intensely they hurt themselves and for how long they do it, your teen’s self-harm can result in perpetual cuts, scars, bruises, burns and even broken bones. Permanent disfigurement can result from one serious incidence of self-mutilation. Extreme cases can result in death, even if it wasn’t their intention.

A study by Oxford University revealed that people with a history of self-harm are more than 3 times as likely to die prematurely as the general population — 6% of patients who visited the ER after self-harming died at some point in a 6-year follow-up period. Accidental poisoning was the most common cause, but deaths from natural causes were 2–7.5 times greater than expected.

A teenager who self-harms can face various other outcomes, which can impede their health, happiness and success for years to come. These effects might include:

  • Shame and guilt
  • Compounding depression
  • Social isolation
  • Poor physical and emotional health
  • Fractured relationships
  • Suicidal thoughts
  • Continuing self-harm into adulthood
  • Difficulty getting a job

If a teen who self-harms isn’t already using substances, they might develop a habit as a result. Once a teenager begins to explore a destructive behavior, it can be a slippery slope into other high-risk, harmful and illegal activities.

Teen Suicide

Suicide, or any serious injury for that matter, is rarely the desired outcome in self-harm. Teens who cut, burn or otherwise hurt themselves do it mostly in secret, and don’t want to die — rather, they might hope that it makes their negative feelings go away. But in the long-term, people who self-injure do have a higher risk of suicide. When these individuals’ underlying problems fail to see resolution, or they refuse to find or reach out for help, suicide can eventually seem like a logical next step.

“We have known for some time that there is an elevated risk of suicide among people who self-harm compared to the general population,”Professor Keith Hawton, Oxford University

Following accidental poisoning, suicide is the most common cause of premature death in ER patients treated for self-injury. While females are more prone to self-harm in general and 3 times as likely to attempt suicide, males are 4 times as likely to die by suicide. Someone in the US dies from suicide every 12.8 minutes.

As a loved one, it’s critical that you identify when somebody you know develops a self-harming habit and take action to address it. Research from Cornell University shows that risk of suicide attempts in college is predicated by frequent self-injurious behavior — self-harming more than 20 times — and having been in clinical treatment for some length of time prior to the attempt. These habits may end spontaneously and without treatment, but it’s absolutely not worth the risk — especially when you consider that the causes of their self-harm usually remain undiscussed and unresolved.

Signs of Self-Harm

upset teen sitting on stepsThe signs of self-harm aren’t always easy to spot, and teens may revisit the habit for months until they get discovered — if they do at all. For this reason, parents need to take any hints of a problem as cause for further investigation.

Behavioral Signs

A teen’s foray into self-harm will often come paired with emotional and behavioral changes. Depression and anxiety are two common symptoms related to self-harm. Your son or daughter may be removing themselves from family and social settings, have increasing difficulties in school, and seem generally tired, irritable and unmotivated as a result. They may start hanging out with new, suspicious groups of friends, or avoiding friends entirely. They may also start lying to cover up their disjointed behavior and possible physical signs, such as claiming to have frequent “accidents” or that they’ve been getting into fights.

Even if your teen isn’t self-harming, any sign of emotional turmoil should be investigated, as your teen likely needs comforting and support of some kind.

Physical Signs

If they are indeed hurting themselves, physical evidence might be detected in a number of ways. These signs of self-harm can include:

  • Wounds or scars without explanation
  • Blood stains on clothes or personal possessions
  • Random sharp objects or lighters in their room, laundry or belongings
  • Wearing long sleeves or pants constantly to cover up wounds

Other Signs

Your know your child better than anybody. Any odd or unnerving behavior can be a red flag, and shouldn’t be ignored. Feelings of shame, guilt, disgust and self-loathing, or other disturbances in their personality, are natural precursors and symptoms of self-harm.

If you feel your presence in their life (or lack thereof) could be a contributing factor, you should see a counselor about how to amend this. Otherwise, look into their daily routine to see what other factors might be playing a role. These could include:

  • Bad experiences at school or relationships with teachers
  • Being ignored or mistreated by friends
  • Romantic relationship woes
  • Money struggles
  • Unrealistic expectations for themselves
  • Involvement with drugs or alcohol

Does My Teenager Need Help?

If you believe your child may be engaging in self-harm, approach them about it gently. Tell them you love them more than anything in the world, and you know that life can sometimes feel like it’s too much to handle. Let them know that this behavior cannot continue, and that you are going to seek professional therapy for them. We at can help you find a therapist in your area. Just give us a call — our help is free and confidential.

When self-harm behavior co-occurs with substance abuse, rehab is often necessary. Your child’s therapist can assess the need for rehab or other dual diagnosis treatment options. We can also recommend effective, vetted rehab facilities and programs that specialize in your child’s particular issues.

It can be frightening to realize that your child needs rehab, but you are not alone — we are here for you. If you ever need someone to talk to about your child’s substance problem, you can call and speak to one of our addiction specialists for free. We have years of experience helping families through problems, and our hearts are always open to offer as much help as we can. Call today to begin bringing your child back from the brink.

If your child threatens suicide or mentions a desire to die, immediately call the National Suicide Hotline at 1-800-273-8255. Do not delay.

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Self-Harm & Cutting
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