7 Self-Harm Signs in Teenagers

Writer’s note: Hey, Psych2Goers! This article isn’t meant for diagnosis or treatment. It is to create awareness among the general public, so if you or someone you know may be struggling, don’t hesitate to seek professional help from Psychiatrists or other trusted professionals.

Trigger warning: The following article discusses on self-harm and suicide which might be triggering to some. If you feel triggered, please know there are resources to support you:

Helpful Resources

Self-Harm:
1-800-DON’T-CUT and 1-800-334-HELP

1-800-334-HELP is a 24-hour service for a number of things.
http://www.selfinjury.com

Insomnia:
https://sleepfoundation.org/

Eating Disorders:
https://www.nationaleatingdisorders.o…
https://www.eatingrecoverycenter.com/…

PTSD:
Boys Town National Hotline 1-800-448-3000.
Text CONNECT to 741741 for PTSD episodes. They are also on call 24-hours.

Suicide:
1-800-273-8255 for the National Suicide Prevention Hotline.

“Other times, I look at my scars and see something else: a girl who was trying to cope with something horrible that she should never have had to live through at all. My scars show pain and suffering, but they also show my will to survive. They’re part of my history that’ll always be there.”

― Cheryl Rainfield, Scars

Self-harm or otherwise known as non-suicidal self-injury (NSSI) is classified in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (2013) as a “new disorder in need of further study,” as well as a symptom of borderline personality disorder, which is characterized by emotional instability, unstable relationships and chronic feelings of emptiness.

Among the examples of self-harm are:

Cutting, scratching, carving, branding or marking the body
Picking at scabs so they don’t heal
Pulling hair
Burning or grazing yourself
Biting, bruising or hitting yourself
Hitting a part of your body on something hard

According to medical records and insurance claims data analyzed by nonprofit Fair Health (2021), there is a substantial increase of overdoses, intentional self-harm claims, substance use disorders and claims for depression and anxiety disorders among teenagers in the United States in 2020 compared to the previous year. From January to November 2020, the claims for intentional self-harm among the 13 to 18 age group increased 99.8% compared to the same timeframe in 2019.

It is fairly common for adolescents to get entangled in romantic relationships, however, due to its transient nature, relationship breakups are also common. According to a study in which the respondents consist of 15 to 18-year-old Canadians teens, 23% of them experienced a breakup within the past 6 months. Megan et al. (2016) stated that it was more likely for post-relationship concerns (including breakups) to be associated with concurrent mental health issues (36.8%), self-harm (22.6%) and suicide (9.9%) than pre- or during-relationship concerns.

As a parent or a caregiver to teenagers, how can you tell if they involve in self-harm behaviour? Below are the 7 signs that you can look for:

Unexplained wounds or clusters of cuts

Your daughter has always been conscious of her body weight. She always laments how her body looks fat, although in your eyes she looks fine and has a healthy body proportion. One day, when you went inside her room to switch off the lights that she forgot to turn off, you saw the scar with the word ‘fat’, etched onto the right forearm of your sleeping daughter.

David Rosen, MD, MPH, a professor of paediatrics at the University of Michigan and director of the Section for Teenage and Young Adult Health at the University of Michigan Health Systems in Ann Arbor, stated that parents should look for small linear, straight lines, often parallel like railroad ties cuts. These cuts are often engraved into the forearm, upper arm and sometimes the legs. If the teenagers are struggling with body image issues, they may cut the word ‘fat’ into themselves. Another words that can be seen regularly are ‘stupid’, ‘loser,’ ‘failure,’ or a big ‘L.’ These teenagers are those who are having trouble at school.

2. Heavy use of wristbands

“Dear, why do you have those wristbands on?” You ask such a question to your daughter, when you notice she has been involved in heavy use of wristbands quite recently.

However, your daughter remains silent. She then immediately goes inside her room and locks herself in.

It is difficult to detect self-injurious behaviour as it is often done discreetly (Psychology Today, n.d.). So, when you notice that your children have been involved with heavy use of wristbands, you should be alert that your children might be harming themselves, but they want to hide it from you.

3. Wearing long-sleeve shirts (even during hot weather)

“Son, it is summer. The sun is blazing so fiercely outside. You might want to change into lighter clothes,” you said to your son when you were planning to go fishing with him in the nearby lake.

“Nah, Dad, I’m fine. I like wearing long-sleeve clothes,” replied your son.

Your son has always been the one who wears short-sleeve shirts and shorts during summer. However, that particular summer is different. At first, you are nonchalant about it, but as the time goes on, you become more suspicious of it.

Teenagers who have been involved in self-injurious behaviour tend to wear long-sleeve shirts, even during hot weather because they want to conceal the scars on their bodies. They are afraid and self-conscious of what people would think of them if the latter noticed their scars on their forearms. They also want to prevent their loved ones from knowing their self-injurious behaviour.

4. Withdrawing to their dark rooms

You notice your son has exhibited a peculiar behaviour recently. After coming back home from school, he would withdraw to his dark room. He can spend countless hours inside his room and can sometimes even skip his dinner.

Children with self-harming tendencies might isolate themselves inside their room as they perform the self-harming deeds. They want to conceal them from getting known by their family members (Maker, 2021).

5. Being sad and tearful

Have you ever noticed your child become frequently tearful and often make comments about their sense of hopelessness or worthlessness?

These can actually be indicators that your child is suffering deeply and might get involved with self-harm.

According to a licensed clinical psychologist and the author of Family Changes: Explaining Divorce To Children and Where Did My Friend Go? Helping Children Cope With a Traumatic Death, Azmaira H. Maker, Ph.D. (2021), children with self-harming tendencies would portray loss of sparkle and hope, apart from living “vampire lives” – sleeping all day and staying up all night. They would appear sad and tearful most of the time.

6. Using vaping and marijuana to numb themselves

According to an article on cutting and self-harm written by Davis and reviewed by Smith (n.d.), teenagers with emotional problems might get involved with vaping and marijuana in order to numb themselves. Consequently, such actions can progress into self-harm as it has a similar effect to cocaine and other drugs that release endorphins to create a feel-good feeling. There is a painkiller effect that such teenagers feel from self-injury. When they are drowning in emotional pain, they would not feel that pain as much when they perform self-injury on themselves.

7. Texting self-loathing or suicidal messages to friends and family.

“I hate myself. I feel so much pain. I want all these to end.”

Your eyes widened in shock as you read the above text sent by your best friend. Dr. Maker (2021) stated that such behaviour might also be a sign that your friend is thinking to engage in self-harming behaviour. It is a form of negative coping skill towards emotional pain.

What are the appropriate steps that you can take to help your friend? First and foremost, you need to understand where those feelings come from. Feelings of self-hatred are rooted from continual feelings of inadequacy, guilt, and low self-esteem (Psychology Today, n.d.). It is extremely agonizing, however exploring such emotions is the first step towards healing. As a best friend who cares for the emotional needs of your friend, you might also want to advise your friend to consult mental health professionals or even accompany them to such appointments.

Final thoughts

If you notice that your child is showing the above behaviours, it is important that you ask them how they are feeling and what they need. Provide them with additional mental health support by bringing them to consult a counsellor or psychologist (Maker, 2021). A mental health professional can assist your child to talk through what they are experiencing and develop healthy coping skills. Your child can be subjected to dialectical behaviour therapy (DBT), which is a type of therapy that teaches how to manage difficult and overwhelming emotions without hurting oneself. In DBT, mindfulness is one of the skills taught, where it will teach your child to be aware of their feelings without being overwhelmed by them. DBT can help your child express and manage the emotional pain that can cause self-injury behaviour (Lockwood et al., 2017).

REFERENCES

Connolly, J., & McIsaac, C. (2009). Adolescents’ explanations for romantic dissolutions: A developmental perspective. Journal of Adolescence, 32(5), 1209-1223. doi:10.1016/j.adolescence.2009.01.006

Davis, J., & Smith, M. W. (n.d.). Cutting & Self-harm: Warning signs and treatment. Retrieved May 26, 2021, from https://www.webmd.com/mental-health/features/cutting-self-harm-signs-treatment

Health, F. (2021). The Impact of COVID-19 on Pediatric Mental Health. doi:https://s3.amazonaws.com/media2.fairhealth.org/whitepaper/asset/The%20Impact%20of%20COVID-19%20on%20Pediatric%20Mental%20Health%20-%20A%20Study%20of%20Private%20Healthcare%20Claims%20-%20A%20FAIR%20Health%20White%20Paper.pdf

Lockwood J, Daley D, Townsend E, Sayal K. (2017). Impulsivity and self-harm in adolescence: a systematic review. European Child & Adolescent Psychiatry. 26(4):387-402.

Price, M., Hides, L., Cockshaw, W., Staneva, A., & Stoyanov, S. (2016, May 6). Young love: Romantic concerns and associated mental health issues among adolescent help-seekers. Retrieved May 26, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4931381/

Psychology Today (n.d.). Self-hatred. Retrieved May 26, 2021, from https://www.psychologytoday.com/us/basics/self-hatred