Adolescent Self-Harm Signs & Symptoms

Adolescent self-harm can be hard to spot. Learn about the warning signs & symptoms to watch for.

Understanding Adolescent Self-Harm

Learn about adolescent self-harm

The act of self-harm is characterized by any behavior in which someone purposefully causes injury to him or herself in some way. Also referred to as self-injury and self-mutilation, acts of self-harm can include many different types of behaviors. Examples of the most common forms of self-injury include, but are not limited to, cutting, burning, biting, picking skin, pulling out hair, purposely breaking bones, banging one’s head against hard objects, or drinking harmful substances like bleach or detergent.

There can be any number of reasons why a young person engages in these devastating behaviors. One common misperception, however, is that the act of self-mutilation is due to a person’s desire to end his or her life. Not to say that this is not the case for some youth, it is just not typically so. The more probable cause behind most young people’s decision to partake in these behaviors is due to the presence of some type of inner emotional turmoil that they do not know how to appropriately cope with. Many children and adolescents lack the support network or the skills necessary to manage emotional distress in a healthy manner. For this reason, they seek out other ways to put an end to their pain. By inflicting outward pain on themselves, they are able to physically see their pain and control the intensity of that pain. This offers them a temporary reprieve to their inner turmoil. Yet, regardless of a youth’s reasons for choosing to start such behaviors, the sad reality is that such behaviors can rapidly escalate into ones that result in unintentional death.

Fortunately, there are viable treatment options available that can help these children and adolescents who engage in self-harm behaviors to come to terms with their inner struggles and learn healthy, successful ways in which to cope with their distress.


Adolescent self-harm statistics

The true prevalence of how many children and adolescents partake in the act of self-harm is difficult to determine as it is commonly something that is done in private. However, there have been studies done on the topic and, based on reports provided from the young people who took part in the study, it has been estimated that nearly 10% of adolescents between the ages of 12 and 18 have experimented with self-mutilation. Sadly, additional studies have concluded that approximately one in every 200 girls between the ages of 13 and 19 purposely injures herself in some way on a regular basis.

Causes and Risk Factors

Causes and risk factors for adolescent self-harm

Experts in the field of mental health have determined that there are various contributing factors that come into play when coming to understand the origins of self-harming behaviors. Consider the following:

Genetic: Self-injurious behaviors are commonly symptomatic of the presence of a mental health condition. Due to the fact that mental health conditions are known to run in families, the presence of various disorders that have been known to ultimately lead to the onset of self-harming behaviors, such as depression, bipolar disorder, and anxiety, are believed to have a strong genetic component in their development. In other words, children and adolescents who have a family history of such mental health conditions, or who have family members who engage in self-injury, are more likely to fall into the pattern of this self-destructive behavior themselves.

Environmental: The environments that young people are exposed to can play a significant role in determining their susceptibility to begin engaging in self-harming behaviors. For example, when youth are exposed to environments where there exists much stress and chaos that is out of their control, they are vulnerable to turning to the act of self-harm as a way to find something over which they can have a sense of control. Additionally, children and adolescents who are bullied or who have fallen victim to various types of abuse and/or neglect are at a heightened risk for engaging in self-mutilation because they find comfort in knowing that they are inflicting pain onto themselves and are in control of the amount of pain that they experience, while they do not have such control during times of victimization.

Risk Factors:

  • Being female
  • Being of younger age
  • Family history of mental health conditions
  • Personal history of depression, anxiety, bipolar disorder, or another type of mental health condition
  • Being the victim of abuse and/or neglect
  • Having friends who self-harm
  • Experiencing peer pressure
  • Experiencing trauma
  • Poor or lack of parental involvement
  • Lacking healthy coping skills
  • Lacking healthy interpersonal relationships and support networks

Signs and Symptoms

Signs and symptoms of adolescent self-harm

Due to the fact that self-harming behaviors are typically something that youth engage in while in private, it can often be difficult to discern whether or not a child or adolescent is, in fact, purposely inflicting pain onto him or herself. However, there are various behavioral, physical, cognitive, and psychosocial symptoms that may arise that could potentially be indicative of the fact that a young person is engaging in self-injurious behaviors and needs professional help. Examples are such symptoms can include:

Behavioral symptoms:

  • When questioned about injuries, explaining them away as being “accidents”
  • Wearing long-sleeved shirts or pants, even during warm weather, in an attempt to hide evidence of self-mutilation
  • No longer taking part in activities that were once enjoyed
  • Isolating oneself from family and friends
  • School refusal
  • Decline in academic performance
  • Incessantly picking at scabs
  • Hiding tools that can be used for self-harm

Physical symptoms:

  • Patches of missing hair
  • Unexplained broken bones
  • Frequent presence of bruises
  • Frequent presence of scabs and/or scars
  • Frequent presence of scrapes, scratches, or cuts

Cognitive symptoms:

  • Intrusive, unwanted, and all-consuming thoughts about wanting to self-harm
  • Memory disturbances / experiencing lapses in memory
  • Declined ability to control impulses
  • Concentration difficulties
  • Dissociation
  • Derealization
  • Depersonalization

Psychosocial symptoms:

  • Feelings of helplessness and hopelessness
  • Feelings of worthlessness
  • Feelings of loneliness
  • Feelings of inexplicable guilt
  • Heightened levels of anxiety, especially when unable to self-injure
  • Emotional instability
  • Periods of emotional detachment


Effects of adolescent self-harm

The longer that a child or adolescent partakes in the act of self-mutilation, the greater the chance that he or she will experience a number of negative long-term consequences becomes. Depending on the method by which a young person chooses to inflict pain onto him or herself, the following negative physical effects may occur:

  • Nerve damage
  • Improperly healed bones
  • Infected wounds
  • Permanent tissue damage
  • Scarring
  • Organ damage or multi-organ failure
  • Anemia
  • Permanent numbness or weakness in certain parts of the body
  • Hemorrhaging
  • Accidental death

In addition to the numerous negative health effects that can arise, children and adolescents who partake in self-harming behaviors are at risk of experiencing detrimental ramifications in other aspects of their lives as well. Examples of such ramifications can include:

  • Academic failure
  • Social isolation / increased conflict with peers
  • Familial discord
  • Increased feelings of shame, guilt, and disgust with oneself
  • Deterioration of self-esteem
  • Chronic abuse of drugs and/or alcohol
  • Experiencing the onset or worsening of symptoms of mental health conditions

Co-Occurring Disorders

Adolescent self-harm and co-occurring disorders

When children and adolescents are engaging in self-harming behaviors, the likelihood that they are suffering from a mental illness is drastically high. Disorders that are known to have self-injury as a symptom include:

  • Depressive disorders
  • Bipolar disorder
  • Anxiety disorders
  • Obsessive-compulsive disorder
  • Post-traumatic stress disorder
  • Reactive attachment disorder
  • Schizophrenia
  • Substance use disorders

I was diagnosed with depression 1 year ago and had weekly sessions with my Harbor Oaks therapist whom is the most supportive and understanding person. Without her and the rest of the staff I would not be who I am today.

– Former Patient
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