Be aware of symptoms of self-harm in your teen

There are many misconceptions surrounding self-harming behaviors. Though not often talked about, self-harm is more common than many people realize.

Adults are often shaken and confused to learn that some young people choose to injure themselves. Parents may wonder if they have missed signs of self-harming behaviors or why their child chose to self-harm.

Why Do Some Young People Harm Themselves?

Self-harm typically is not meant as a suicide attempt. Rather, this type of self-injury (known as nonsuicidal self injury, or NSSI) is a way to cope with emotional pain, intense anger, or frustration.

“Self-injury can take several forms, such as cutting, burning, eraser burns, hair pulling, and punching or hitting things,” explains Mandy Fauble, PhD, executive director of UPMC Western Behavioral Health at Safe Harbor in Erie. “The human body is wired to ease pain, releasing soothing hormone after an injury. Self-injury is very effective in distracting from emotional pain and creating a more exhausted and calmer feeling.”

Experts are still studying the cause of self-harm.

“Mental health concerns, lack of coping skills, and difficulty managing overwhelming emotions are all associated with nonsuicidal self-injury,” explains Dr. Fauble. “A childhood history of trauma and abuse also is linked to self-harm, but there can be many other contributing factors,”

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Self-Harm Warning Signs in Children and Teens

Children engaging in self-harm may have low self-esteem or have trouble maintaining relationships and friendships. They may have difficulty functioning at home or school.

While there’s a common belief that self-harming is a “girl thing,” Dr. Fauble reports that it is not true. “Boys also self-injure, but it tends to be more aggressive, like hitting themselves or punching things until their knuckles bleed,” she says.

What self-harm warning signs should you look for?

Dr. Fauble recommends parents become aware of the following physical indications of self-harm:

  • Scars, often in patterns.
  • Unexplained fresh cuts, scratches, or bruises.
  • Excessive rubbing that creates friction burns.
  • Wearing long sleeves/long pants (especially in hot weather).
  • Finding razors, lighters, or other harmful or sharp objects in uncommon areas.

If you notice any of these self-harm warning signs, it’s critical to remain calm and have an open conversation with your child. Avoid being accusatory. “If you can stay calm, it is more likely your child will accept help,” advises Dr. Fauble.

Help Is Available

If your child is practicing or showing signs of self-harm, it is important to reach out to a professional for help. Talk with your child’s pediatrician or primary care provider. Share your concerns and ask them for a referral to a child or adolescent psychologist.

“Self-harming behavior is treatable and a trained mental health therapist and/or psychiatrist can help with these issues,” says Dr. Fauble. Individual therapy and group therapy sessions are available for both children and their parents or guardians.

“Self-injury can be linked to attempted suicide or accidental death,” adds Dr. Fauble. “So it is important to ask young people if they are also experiencing thoughts of suicide, and to take steps if the self-injury requires medical attention or is extremely risky.”

With the right help and support, your child can learn to manage and overcome self-harming behaviors.

Tips for Parents

In addition to reaching out to your child’s doctor or mental health care professional for help, try to:

  • Make sure your child feels supported and encouraged to share their emotions with you or another trusted adult. Let them know it is always okay to ask for help.
  • Pay attention to what you child shares on social media. A child might disclose self-harm thoughts or behaviors more readily to peers.
  • Remove common objects used for self-harm from your child’s room, such as sharp tools, lighters, and hazardous chemicals.
  • Reach out to your child’s school counselor or psychologist for resources both within and outside of school.

With the right help and support, your child can learn to overcome self-harming behaviors.

UPMC Behavioral Health Services for Children and Teens

UPMC offers pediatric and adolescent behavioral health care through UPMC Western Behavioral Health and the UPMC Children’s Community Pediatrics network of pediatricians’ offices located throughout Pennsylvania. UPMC Western’s community and outpatient locations provide mental and behavioral health services for children and their parents or guardians, including:

In addition, UPMC Western offers a spectrum of mental health crisis services throughout Allegheny county:

resolve Crisis Services

resolve Crisis Services is a 24-hour, 365-day crisis center sponsored by Allegheny County and UPMC Western Psychiatric Hospital. Services are provided free of charge to all Allegheny County residents. At resolve, a trained counselor is always available to talk and to help—whether the problem feels big or small. Resolve also has a mobile crisis team that can travel anywhere within Allegheny County to respond to a crisis. They provide face-to-face support and will work to arrange further care and stabilization if needed.

Don’t wait for a problem to get out of control. Call resolve Crisis Services for help at 1-888-796-8226 or visit the walk-in crisis center located at 333 North Braddock Ave in Pittsburgh. No appointment is necessary. Walk in anytime to talk, get a break from stress, or connect with more long-term care and support.

Child and Adolescent Crisis Team Intervention Services (CACTIS)

Child and Adolescent Crisis Team Intervention Services (CACTIS) is a part of resolve Crisis Services and provides crisis intervention and supplementary support in the home, school, and community to children and adolescents with emotional and behavioral issues. CACTIS also provides support to children and adolescents who have been identified as being at high risk for psychiatric hospitalization or out-of-home placement. Crisis and support services are free to all children and adolescents who are residents of Allegheny County. For more information, call the CACTIS intake line at 412-864-5065.

Services for Teens at Risk (STAR) Center

Services for Teens at Risk (STAR) Center is a program that combines clinical and outreach services to help prevent adolescent suicide. Its mission is to offer state-of-the-art responsive care for children and adolescents with depression or anxiety, or who are at risk for suicidal behavior.

For an emergency or to learn more, please call 412-624-1000 or toll-free 1-877-624-4100.

For College Students: Services for Transition-Age Students at Risk (CO-STAR)

Services for Transition-Age Students at Risk (CO-STAR) was created in response to state-wide concern about suicide among young adults who are attending a western Pennsylvania college or university. CO-STAR partners with local colleges and universities to provide rapid and comprehensive assessment and treatment for depressed, anxious, and suicidal undergraduate college students.

For an emergency or to find out more, please call 412-624-1000 or toll-free 1-877-624-4100.

For Educators and Schools

Postvention and Crisis Response Services can help educators and schools prepare for crisis situations. Advance planning has been shown to reduce the impact of an in-school tragedy. STAR-Center outreach staff consults with educators on providing postvention services and recommends that school districts — working closely with their communities — prepare for tragedies by developing policies and procedures that may be activated on very short notice.

Our staff is available to any district or agency, 24 hours a day, by calling 412-864-3346.

Editor's Note: This article was originally published on , and was last reviewed on .

About UPMC Western Behavioral Health

UPMC Western Psychiatric Hospital is the hub of UPMC Behavioral Health, a network of community-based programs providing specialized mental health and addiction care for children, adolescents, adults, and seniors. Our mission is to provide comprehensive, compassionate care to people of all ages with mental health conditions. UPMC Western Psychiatric Hospital is a nationally recognized leader in mental health clinical care, research, and education. It is one of the nation’s foremost university-based psychiatric care facilities through its integration with the Department of Psychiatry of the University of Pittsburgh School of Medicine. We are here to help at every stage of your care and recovery.