Helping teenagers who self-harm

At a glance

Self-harm is usually a way of coping with overwhelming feelings, not a wish to die.
It’s often hidden, and the signs can be easy to miss or misread.
It can take different forms, including physical harm, risk-taking or harsh self-criticism.
Shame and secrecy can keep it going, while calm, steady responses make it easier for a young person to open up about how they’re feeling.
It helps to focus on what’s driving it, not just stopping the behaviour.

Understanding self-harm

Self-harm is when a young person intentionally does something that hurts their body or themselves as a way of managing how they feel.

It doesn’t always look the way people expect. It might involve a visible injury, but it can also be less obvious – things like risk-taking, neglecting their appearance or directing harsh criticism at themselves, in person or even online.

For many teenagers, it isn’t about wanting to die. It’s how they cope with feelings that are too intense, confusing or hard to put into words. Common forms include:

Cutting, scratching or burning their skin
Hitting walls or hard surfaces
Picking at skin or preventing wounds from healing
Not eating enough, bingeing on food, or making themselves sick
Using alcohol or drugs to numb feelings
Risky or unsafe behaviour
Digital self-attack (for example, sending or inviting hurtful messages about themselves online)
Withdrawing from those around them
Letting basic self-care slip, like not washing, eating properly or sleeping well

If the behaviour’s getting worse, injuries are becoming more serious, or a young person seems increasingly low or hopeless – treat it as a sign they need help.

What self-harm can look like

From the outside, self-harm is often hard to spot because young people tend to hide it.

You might notice a young person wearing long sleeves even in warm weather, becoming more secretive about their room or time in the bathroom, or being unusually protective of certain belongings.

Sharp objects might be moved or kept out of sight. You may catch glimpses of marks or injuries, but just as often there’s a sense that something just isn’t quite adding up.

None of these signs on their own confirm anything. But it helps to look for patterns of change alongside changes in mood.

It can also look a little different in boys and girls. Girls are more likely to have recognisable signs, such as cutting. While boys more often harm themselves through risk-taking, hitting things, substance use, going quiet for long periods, or pulling away from those around them.

These differences don’t apply to everyone, but they can make self-harm in boys easier to miss.

Why a young person turns to self-harm 

What links all forms of self-harm is not how they look, but what they do: help a young person manage something that doesn’t feel manageable. It usually stems from a mix of pressures, such as:

Friendship difficulties, bullying or feeling excluded
Academic stress or fear of getting things wrong
Family tension, instability, trauma or loss
Low self-worth or intense self-criticism
Feeling misunderstood or unable to talk openly
Big changes, like moving school or going through puberty

With so many causes often at play, the aim should not be to solve everything, but to help a young person develop ways to cope with what’s happening.

What to do

Act quickly if there’s a risk of harm

If you’re worried about immediate safety or serious injury, get urgent medical or emergency help immediately.
Choose a calm moment

Try to talk when things are relatively settled, rather than in the middle of conflict or heightened emotion.
Lead with concern, not blame

Avoid things like “Why would you do this?” or “You’re just looking for attention” because strong reactions can make a teenager hide their feelings even more. Keep things neutral with questions like, “I’ve noticed you don’t seem yourself lately and I’m a bit worried about you”.
Listen more than you talk

You don’t need perfect words. Making sure your child feels you’re trying to understand can really help them settle.
Reduce shame

Shame deepens secrecy, so take them seriously, be calm and keep your tone matter-of-fact.
Focus on what’s underneath

Try to understand what’s driving the emotion, rather than only trying to stop the behaviour.
Encourage safer ways to cope

Things like journaling, exercise, holding ice, drawing on skin instead of injuring it, or using grounding¹ or other sensory techniques can help take the edge off difficult feelings.
Keep routines steady

Sleep, food, structure and spending time outside all help regulate emotions.

When to get more support

It’s important to consider getting additional support if a young person’s self-harm:

Is happening regularly or more frequently
Has led to severe injuries
Seems constantly low, withdrawn or increasingly distressed
Is beginning to involve suicidal thoughts
Is affecting school, friendships or daily life
Leaves you feeling out of your depth or unsure how to help

What to remember

Self-harm can be frightening to see, but it’s usually a sign that a young person’s trying to cope with something that’s overwhelming them.  If you only focus on stopping the behaviour, it can sometimes make things feel more pressured or hidden. What tends to help more is understanding what’s driving it, reducing any shame about it, and helping them find safer ways to manage how they feel.

Footnotes

¹Grounding – simple techniques that help bring attention back to the present moment and away from overwhelming thoughts or feelings, for example, noticing what you can see, hear or feel, or holding something cold.