Why do teenagers self-harm and which signs matter? A step-by-step guide for parents on staying calm when you notice it and finding the right support.
Long-sleeved tops worn even in summer heat, long spells in the bathroom, unexplained marks, or a wound you happen to see one day... For a parent, discovering that their child is harming themselves is an extremely shocking experience. Fear, bewilderment, guilt and anger can be felt all at once. Self-harm in teenagers is, contrary to what is often assumed, not an attempt to "get attention" but a painful way in which a young person tries to cope with intense feelings they cannot manage. In this article we look at why self-harm emerges, which signs need attention, what you can do when you notice it and how professional support works.
If your child is seriously injured right now, is talking about ending their life, or you have an urgent concern for their safety, stop reading this article and call 112 (emergency services) immediately.
What Is Self-Harm in Teenagers?
Self-harm means a person deliberately hurting their own body. A significant proportion of self-harming behaviour seen in teenagers occurs without the intention of ending their life. Young people often do it to soothe a feeling that has become unbearable, to cope with a sense of emptiness or numbness inside, or to punish themselves.
Even so, self-harming behaviour must always be taken seriously. This is because the behaviour is an indication that the young person is in intense emotional pain and that their healthy ways of coping are not enough. In addition, young people who self-harm may from time to time also have thoughts of ending their life. For this reason, whatever the purpose of the behaviour, it needs to be assessed by a specialist.
Self-harm is not a diagnosis but a behaviour. It can be seen together with different psychological difficulties such as depression, anxiety disorders, post-traumatic stress and eating disorders, and it can also appear during a period of intense stress without any clear diagnosis.
Why Do Young People Self-Harm?
There is no single reason behind self-harming behaviour. However, there are some functions that are commonly seen:
Soothing intense emotions
The most common reason is to get away, even briefly, from a feeling that seems unbearable. When anger, shame, sadness, anxiety or helplessness become very intense, physical pain comes before these feelings and brings temporary relief. This relief is short-lived; guilt and shame often follow. But the relief itself is a powerful mechanism that keeps the behaviour repeating. Over time, the young person may turn to the same route more quickly when faced with a difficult feeling.
Numbness and emptiness
Some young people, because of the emotional load they are carrying, may feel numb, empty or "as if unreal". In this case, self-harm may be a way of "feeling something".
Self-punishment
Intense thoughts of guilt and worthlessness such as "I ruin everything" and "I'm a bad person" can lead a young person to punish themselves by self-harming.
Being unable to express pain
For young people who find it hard to put their feelings into words, or who think they will not be understood if they do, self-harm can be a silent way of expressing the pain inside.
Triggering life events
Peer bullying, cyberbullying, relationship problems or break-ups, conflict at home, parental divorce, loss and grief, abuse or traumatic experiences, exam pressure and a feeling of failure can trigger self-harming behaviour. In Turkey, the losses, migration and displacement experienced after the 6 February 2023 earthquakes have also added to the emotional load of some young people.
Social influences
Coming across content about self-harm on social media, or the behaviour being talked about in a friendship group, can make it easier for some young people to try it. It is therefore important to be curious about what young people encounter in the digital environment and to be able to talk about it. Experiences of exclusion and ridicule at school or online can also be decisive in this process; our article on peer bullying can guide families on this.
Signs of Self-Harm in Teenagers: Which Signs Need Attention?
Young people often try to hide this behaviour. The following signs may be situations that need attention:
- Unexplained wounds, scratches, bruises or burn marks
- Wearing long-sleeved clothes even in hot weather to cover wrists, arms or legs
- Avoiding activities that require exposing the body, such as swimming, the beach and sport
- Spending long periods alone in the bathroom or their room
- Finding unexplained sharp objects in their room or bag
- Frequently saying they were injured through an "accident"
- Withdrawal, moving away from friends and family
- Sudden and intense mood changes, irritability
- Statements such as "Nobody understands me", "I'm a burden", "I wish I'd never been born"
- Changes in sleep and appetite, a drop in school performance
- No longer enjoying activities they used to like
Each of these signs alone does not mean self-harm is happening. But if several occur together and you are worried, it is important to talk calmly and get specialist support rather than wait.
What Should You Do When You Notice? A Step-by-Step Guide for Parents
1. Calm yourself first
It is entirely natural to experience intense feelings when you notice signs of self-harm. However, facing the young person with panic, anger or tears can make them feel even more ashamed and guilty. Give yourself a few minutes before talking, take deep breaths and, if possible, share your feelings with your partner or an adult you trust.
2. Check physical safety
If the wounds look serious, if the bleeding will not stop, if there are signs of infection, or if the young person says they have taken a harmful substance, call 112 (emergency services) without delay or go to the nearest emergency department. In this case the priority is the young person's physical safety.
3. Start a calm, non-judgemental conversation
Talk at a suitable moment, in private and in a calm setting. You could start like this: "I saw the marks on your arm. I'm not angry with you. I just think you might be going through something very hard and I want to be there for you." Avoid blaming, interrogating or threatening language.
4. Listen; do not rush to fix
Listen to what the young person says without interrupting or judging. Instead of "Why did you do this?", ask questions such as "What do you feel at the moments you do it?" or "What is hardest for you?" The young person may not want to talk straight away; in that case, tell them you will be there when they are ready.
5. Ask directly about thoughts of ending their life
Many parents fear that asking about this will put the idea in the young person's head. Yet asking openly and calmly about thoughts of ending their life does not trigger these thoughts; on the contrary, it opens a door for the young person to share this burden. You can ask, "Do you sometimes think you don't want to live at all?" If the answer is yes, or if you are not sure, get professional support the same day; if there is immediate danger, call 112 (emergency services).
6. Avoid threats and bans
Sentences beginning "If you ever do it again...", punishments, or keeping the young person under constant watch do not stop the behaviour; they often only make it more secret. Asking the young person to promise is also not enough, because the behaviour is not a problem of willpower but a difficulty with regulating emotions.
7. Make the home environment safe
Keep medicines and dangerous objects that the young person could use to self-harm somewhere they cannot reach. Explain this not as a punishment but as a safety measure.
8. Get professional support
Self-harming behaviour must always be assessed by a specialist. A psychologist and, when needed, a child and adolescent psychiatrist can consider the young person's situation as a whole and draw up an appropriate support plan.
9. Get support for yourself too
This process is extremely tiring and frightening for parents. Finding a space where you can share your own feelings lets you offer your teenager calmer and more consistent support. Instead of blaming yourself, remember that being by their side right now is the most valuable thing.
10. Work carefully with the school and those close to you
The school counselling service is an important resource for noticing and supporting a young person's difficulties at school. However, make this sharing, as far as possible, by talking with the young person and respecting their privacy. Telling the wider family, neighbours or friends about the situation in detail can increase the young person's shame and shake their trust. Decide who needs to know what by thinking together about the young person's safety and dignity. Siblings also sense the tension at home; it is good to give them a simple explanation suited to their age and to make room for their questions too.
What a young person who self-harms needs most is to be listened to without judgement and to feel that their pain is taken seriously.
For Young People: When the Urge to Self-Harm Comes
You may be a young person reading this article. The pain you feel is real, and you are not alone. When the urge to harm yourself comes, the following may help:
- Reach out to an adult you trust, a friend or your school counsellor
- Change your surroundings: leave your room, go somewhere where there are people
- Remember that the urge rises and falls like a wave; waiting a few minutes can reduce its strength
- Wash your hands in cold water, hold an ice cube or do some intense physical movement
- Write, draw or say out loud what you are feeling
- If you do not feel safe, call 112 (emergency services) straight away
These methods can bring short-term relief; but real healing begins with talking about what you have been through with a specialist.
When Should You Seek Professional Support?
Professional support should be sought the moment self-harming behaviour is noticed. The behaviour looking "mild", having happened only once, or the young person saying "I won't do it again" does not remove the need for an assessment.
The following situations, however, require urgent assessment:
- Serious injuries or those needing medical attention
- Thoughts, a plan or an attempt to end their life
- "Goodbye"-type messages, giving away belongings, an unexpected sudden calm
- Self-harm together with alcohol or substance use
- Signs that contact with reality is weakening
In these situations, call 112 (emergency services) without delay or go to the nearest emergency department. Once the emergency has passed, an assessment by a psychiatrist and regular psychotherapy support are important steps in the process.
How Is Self-Harm in Teenagers Addressed in Therapy?
In therapy with young people who self-harm, safety is always the priority. In the adolescent counselling process, in cooperation with a psychiatrist when necessary, the following steps are followed:
Safety plan: Together with the young person, a written safety plan is prepared covering what to do at the moments the urge comes, whom to contact and which steps to take in an emergency.
Understanding the function of the behaviour: What function self-harm serves in the young person's life, which feelings it soothes and in which situations it occurs are examined together.
Emotion regulation skills: Alternative ways of coping with intense emotions are developed. Work focuses on recognising and naming emotions, tolerating them and expressing them in healthy ways.
Cognitive Behavioural Therapy: Negative thoughts about the self ("I'm worthless", "I deserve this") are noticed and tested against reality. Problem-solving skills are strengthened.
A schema-focused perspective: Early maladaptive schemas such as "defectiveness", "punitiveness" or "emotional deprivation" can deeply affect the way a young person sees themselves. Understanding these patterns is an important step towards lasting change.
Working with the family: Work focuses on how the family should react when they notice the behaviour, how the home environment can be made safe and how communication with the young person can be strengthened.
For information on accompanying depressive symptoms, you can look at our article on depression in teenagers.
Frequently Asked Questions
Is a young person who self-harms trying to get attention?
Most of the time, no. A significant proportion of young people who self-harm try to hide the behaviour. The behaviour is usually an attempt to soothe intense feelings that cannot be coped with. An "attention-seeking" approach can make it harder for the young person to ask for help.
Is self-harm a suicide attempt?
Not always; many young people do this without the intention of ending their life. However, self-harm is an important risk sign with respect to thoughts of ending one's life. For this reason, it must be assessed by a specialist in every case.
Does asking my child about suicidal thoughts trigger them?
No. Asking openly and calmly about thoughts of ending their life does not trigger the thought. On the contrary, it opens a door for the young person to share this burden and get help.
Does self-harming behaviour go away?
With appropriate support, many young people learn healthier ways of coping with difficult feelings, and the behaviour can decrease over time. The process varies from person to person; family support and regular professional follow-up play a decisive role in it.
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Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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