Self Harm in Adolescents

  •   Mon, Mar 10 2025
  •   By Dr Supriya Hegde Aroor

March 10, 2025

March is Self-Harm Awareness Month.
 
What do we mean by self-harm?

Self-harm refers to intentional behaviors that cause harm to self. The self-harming behavior is regardless of suicidal intent.

Synonyms include - cutting, self-injury, and self-mutilation. 
 
What are th Common forms of self-harm ?
  • Cutting or deeply scratching the skin
  • Piercing skin with sharp objects
  • Burning skin
  • Hitting or punching self
  • Banging head or other body parts against hard or sharp surfaces
  • Pulling out hair
  • Picking at existing wounds
  • Swallowing objects that will harm internal organs or cause life-threatening damage
Prevalence

Many studies involving more than 2 lakh adolescents demonstrated an aggregate prevalence of around 22.0% with repetitive non suicidal self injurious behavior more common than episodic (20.3% vs. 8.3%) The top three methods in adolescents were banging/hitting (12.0%), pinching (10.0%), and pulling hair (9.8%), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%). 
 
Risk factors
Mental illness like depression
Personality disorder
female gender
substance abuse
belonging to a single-parent family
Past experiences of neglect, sexual, physical or emotional abuse, or other traumatic events
growing up and remaining in an unstable family environment
questioning personal or sexual identity social isolation
Life stressor
Gambling related disorders
 
Why is self- harm dangerous?
Although self-harm is non-suicidal in intent, it may still be life-threatening.People who do self-harm are more likely to die by suicide in future , and self-harm is found in 40–60% of suicides.At times, self harm can causes serious infections or injury which may result in death later.
 
Why do people self-harm?
 
People may self-injure for many reasons. For some, might feel relief, like taking the lid off a pressure cooker. Others might self-harm because the physical pain reminds them that they’re alive. Some report satisfaction at the sight of blood, some want to teach a significant other a lesson by hurting themselves. Others report they do it impulsively without much forethought in anger not bothered about the consequences.

They might see self-harming as a way to cope with difficult feelings and relieve emotional pain. The physical pain helps them temporarily forget the emotional pain.

Self-harm is definitely not a healthy behavior and should be viewed as a cry for help.
 
Warning Signs of Self-Harm

It’s important to pay attention to a teen’s words and behaviors. They may struggle to talk about their feelings. Below are some tell-tale signs of self harm
  • Several or frequent cuts, scratches, bruises, bite marks or other wounds
  • Several scars, often in patterns or on the same area of the body
  • Excessive rubbing of an area to make it burn
  • Keeping sharp objects nearby, such as in their bedroom, bathroom or personal belongings
  • Constantly wearing long sleeves or pants, especially in hot weather
  • Frequent accidental injuries
  • Difficulties in interpersonal relationships, connecting with family and friends
  • Behavioral and emotional challenges
  • Acting impulsively or being unpredictable
  • Making statements of feeling hopeless or worthless
  • Increased isolation
  • All this should raise the index of suspicion regarding probable self harming behavior being present
What to do as a parent who thinks that their child may be intentionally hurting self ?
 
First and foremost do not panic. Understand that teenage is a challenging period and the teen will be more emotional and impulsive that others.
 
Talk to the teen openly. Discuss about things that are concerning them. Find out about the issues frustrating them. Discuss how they can cope more effectively with stress. Let them know that you are non judgmental. Be flexible about taking an appointment with a psychiatrist for diagnosis and treatment.
 
What should a teacher who suspects that a student is self harming, do?
 
As a teacher establish rapport with the teen and discuss about the issues troubling them. Find out the precursor to the self harming behavior. Inform the parents regarding same in person. Have a counselling session with the parents. Be open about referring to a mental health professional.
 
Self harming behaviors are very common. Usually they are not life threatening. But they are a cry for help. A teen who injures self may be having underlying depressive disorder or unable to cope with a significant stress.
 
Focus should be laid on promoting school mental health, resilience building and teaching teens coping strategies.
 
De stigmatizing seeking treatment for mental health disorders should be done. 

As a society we must be more progressive and accepting of persons struggling with mental health issues and life stressors.
 
By reducing self injurious behaviors regardless of intent, we will be moving towards reducing future suicide attempts and deaths due to suicide.
 
 
 
 
 
 
By Dr Supriya Hegde Aroor
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