Signs, Symptoms, and Effects of Teen Self-Harm

The term self-harm refers to a variety of behaviors that involve the intentional infliction of physical pain or damage on one’s own body. Common forms of self-harm include pulling out one’s hair; pinching, cutting, or burning one’s skin; intentionally breaking’s one’s bones; hitting one’s head against a wall or other hard surface; and ingesting caustic substances.

Also sometimes referred to as self-injury or self-mutilation, self-harm is a dangerous behavior that can have a powerful and potentially catastrophic impact on a person’s life. However, while teens and others who engage in self-harm put their health and possibly even their lives at risk, the majority of the behaviors that fall under the description of self-harm are not necessarily attempts at suicide. Instead, many self-harming behaviors are actually maladaptive means by which teens attempt to alleviate psychological turmoil, deal with overwhelming stress, or exert a modicum of control over what they believe to be out-of-control lives.

Regardless of whether or not they intend to cause lasting or even permanent damage, teens who engage in self-harm put themselves in significant danger and are in need of effective, professional help. Whether a teen’s self-harm is a self-defeating coping mechanism or a symptom of a mental health disorder, professional treatment can help the teen to overcome this dangerous compulsion and empower him or her to deal with stress and other negative experiences in a more healthy and productive manner.

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Mental Health America (MHA) reports that about 15 percent of adolescents and teenagers engage in self-harm, and experts estimate that the prevalence among college students may range from 17 percent to as high as 35 percent. Ninety percent of all people who engage in self-harm first do so during their teen years. Experts estimate that about 60 percent of teens who self-harm are female, and that about half of those who engage in self-harm have been sexually abused.

Causes and Risk Factors for Suicidal Ideation

As is the case with many types of maladaptive behaviors, the likelihood that a teenager will engage in self-harm or self-injury may be influenced by several genetic and environmental factors, including the following:

Genetic: Self-harm can be a symptom of a mental health disorder, such as depression, an anxiety disorder, or an eating disorder, all of which have a genetic component. Teens who struggle with impulsivity, poor anger management, or ineffective emotional regulation may also be at increased risk for engaging in self-harm.

Environmental: Growing up in an abusive, unstable, or otherwise dysfunctional family may increase a teenager’s risk for engaging in self-harm, as can experiencing one or more type of trauma. Being exposed to overwhelming stresses and pressures, abusing alcohol or other drugs, and associating with an unhealthy peer group are also environmental factors that can put a teenager in increased danger for self-harm.

Risk Factors:

  • Suffering from certain mental health conditions, such as anxiety, depression, or posttraumatic stress disorder (PTSD)
  • Being female (self-harm is more common among teen girls than among teen boys)
  • Family history of mental illness
  • Substance abuse
  • Personal history of trauma
  • Being abused or neglected during childhood


Signs and Symptoms of Self-Harm

Many teens who engage in self-harm will go to great lengths to hide the evidence of their behaviors, and the broad range of behaviors that fall under the general term of teen self-harm means that no single definitive sign or group of signs exists. However, the following are among the common signs and symptoms that may indicate that an adolescent has been engaging in self-harm:

Behavioral symptoms:

  • Wearing long-sleeved shirts or long pants even in hot weather (as a means of hiding burns, cuts, scars, and other evidence of self-harm)
  • Participating in risky, reckless, or otherwise dangerous activities
  • Acting in an uncharacteristically secretive or otherwise deceptive manner
  • Possession of knives, lighters, and other instruments that can cause harm
  • Withdrawal from family and friends
  • Decreased academic performance


Physical symptoms:

  • Frequent unexplained cuts, bumps, bruises, and other physical injuries
  • Noticeable changes in physical appearance
  • Sleep problems, including insomnia or hypersomnia
  • Changes in appetite and resultant weight loss or gain


Cognitive symptoms:

  • Impaired focus and/or concentration
  • Memory problems
  • Persistent and pervasive thoughts of self-harm


Psychosocial symptoms:

  • Dramatic mood swings or significant change in mood
  • Overwhelming sense of hopelessness
  • Loss of interest in significant activities
  • Diminished self-esteem and/or declining self-worth
  • Self-hatred or self-loathing


If you feel that you are in crisis, or are having thoughts about hurting yourself or others, please call 9-1-1 or go to the nearest emergency room immediately.

Effects of Self-Harm

Depending upon the type, frequency, and severity of a teenager’s self-harming behaviors, he or she may experience a broad range of physical, psychological, and social effects, including but not limited to the following:

  • Broken bones
  • Infections
  • Permanent scarring
  • Organ damage or failure
  • Strained and ruined interpersonal relationships
  • Substandard academic performance
  • Physical injury due to reckless behaviors
  • Exacerbation of symptoms of a mental health disorder
  • Legal problems, including fines, arrest, and incarceration, related to reckless behaviors
  • Social withdrawal or ostracization
  • Suicidal thoughts or behaviors


Co-Occurring Disorders

As noted earlier on this page, self-harm may be a symptom that a teen is struggling with a mental health disorder, including but not limited to the following:

  • Posttraumatic stress disorder (PTSD)
  • Schizophrenia
  • Bipolar disorder
  • Anxiety disorders
  • Depressive disorders
  • Substance use disorders


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