Why do teens engage in self harm?

Written By Pauline Bailo

Teenage self-harm is more common than many people realize, and it’s usually an unhealthy coping strategy, not a suicide attempt—though it can increase suicide risk over time.

What self-harm is

Self-harm includes behaviors like:

  • Cutting or scratching skin

  • Burning

  • Hitting or punching oneself

  • Picking wounds to prevent healing

The key point: it’s typically done to manage overwhelming emotions, not to die.

Why teens self-harm

Adolescents often don’t yet have strong emotional regulation skills, so self-harm can feel like relief. Common reasons include:

  • Emotional release (turning emotional pain into physical pain)

  • Feeling something instead of numbness

  • Self-punishment (linked to shame or guilt)

  • Regaining control when life feels chaotic

  • Communicating distress when they can’t express it verbally

Underlying factors often include:

  • Depression or anxiety

  • Trauma or bullying

  • Identity struggles

  • Family conflict

  • Perfectionism / high pressure

Warning signs

Some signs are subtle. Things to watch for:

Physical

  • Unexplained cuts, burns, or scars (often on arms, thighs)

  • Wearing long sleeves even in warm weather

Behavioral

  • Spending long periods alone (especially in bathrooms/bedrooms)

  • Carrying sharp objects without clear reason

Emotional

  • Intense mood swings

  • Withdrawal from friends/family

  • Expressions of worthlessness or self-hatred

How to respond (as a parent)

What helps most is calm, non-judgmental connection.

Do:

  • Stay calm and grounded

  • Say things like:

    • “I’m really glad you told me”

    • “I want to understand what you’re going through”

  • Focus on the function of the behavior (what it does for them)

  • Encourage healthier coping alternatives gradually

Avoid:

  • Punishing or threatening

  • Saying “just stop”

  • Overreacting with panic (can increase secrecy)

Healthier coping alternatives

These won’t replace self-harm instantly, but can reduce reliance over time:

  • Holding ice or snapping a rubber band (safer sensation)

  • Drawing on skin instead of cutting

  • Intense physical activity (running, punching a pillow)

  • Journaling or voice notes

  • Grounding techniques (5-4-3-2-1 sensory exercise)

When to be more concerned

Self-harm becomes higher risk when:

  • It’s frequent or escalating

  • Injuries are severe

  • There’s co-occurring suicidal thoughts

  • The teen seems increasingly hopeless or isolated

In those cases, professional support is important (therapy, possibly psychiatric evaluation).

Finding out your teen is hurting themselves can feel overwhelming. Most parents aren’t sure how serious it is—or what to say without making things worse.

Self-harm is more common than people think, and it’s usually not about wanting to die. It’s often a sign your teen is struggling with intense emotions and doesn’t yet have the tools to cope.

What matters most is how you respond. Staying calm, open, and curious can make it more likely your teen will let you in.

As a therapist who works with teens and families, I help parents understand what’s underneath these behaviors and how to support their child without pushing them away.

If you’re worried about your teen, you don’t have to navigate this alone. Reach out to schedule a consultation.

Pauline Bailo
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