Self-Harming Behaviors in Children and Teens

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KEY POINTS

• Self-harm means your child hurts her body on purpose.
• Self-harming behaviors may be treated with therapy or medicine. If your child is a danger to herself, she may need to be treated in the hospital.
• Journaling, art therapy, relaxation techniques, physical exercise, and other behaviors may be useful to replace self-harm behaviors.

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What does it mean to self-harm?

Self-harm means that your child hurts her body on purpose. It often leaves marks or causes damage. It may also be called self-injury, self-mutilation, and self-abuse. Self-harm is a way to cope with or relieve painful or hard-to-express feelings, but the sense of relief your child may get does not last long.

If your child self-harms, she may be at a higher risk for suicide due to the danger of certain self-harm behaviors.

What is the cause?

The exact cause of this disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Problems in the family may increase the risk. For example, if your child has been abused, she may have learned to blame herself or to feel that she deserves to be hurt. The risk is higher if someone in the family has the disorder, or if parents abused drugs or alcohol.
• Having friends who self-harm can increase the risk.
• Abuse of alcohol and drugs may also lead to self-harm.
• Stress plays a part. If your child deliberately harms herself, she may be trying to:
  • Distract herself from something that she feels he cannot deal with
  • Express feelings she can’t put into words
  • Help her feel in control
  • Make her feel something, instead of feeling numb
  • Release stress and tension and provide a sense of relief
  • Relieve guilt or punish herself or others

Self-harming can happen at any age, but it is most common in teens and young adults.

What are the symptoms?

Symptoms may include:

• Cutting, biting, rubbing, or scratching herself until his skin is broken and bleeds
• Head banging or hitting herself hard enough to cause bruises
• Burning her skin using heat, chemicals, or cigarettes
• Pulling hair from her scalp or eyebrows
• Pulling off her fingernails or toenails
• Picking at scabs continually until they bleed and the sore does not heal
• Swallowing poisons or other non-food items

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child.

How is it treated?

Therapy may help.

• Behavior therapy helps your child recognize that the way she acts affects others. This can help your child change problem behaviors.
• Cognitive behavior therapy (CBT) is a way to help your child identify and change views she has of herself, the world, and the future. CBT can make your child aware of unhealthy ways of thinking. It can also help your child learn new thought and behavior patterns.
• Dialectical behavior therapy helps your child be aware of her thoughts and behavior, learn how to express her needs, deal with stressful situations, and manage her emotions.

Medicine may be prescribed if your child also has problems with anxiety, panic, depression, or obsessive thoughts.

Trying to stop the behavior may be very stressful. Journaling, art therapy, relaxation techniques, and physical exercise may be useful to replace self-harm behaviors.

If your child is a danger to herself, she may need to be treated in the hospital. Your child may also need to be in a day or evening treatment program for several months to learn how to manage emotions in a safe way.

What can I do to help my child?

Develop trust by not judging your child. Quietly listen to what your child tells you and try to understand what she is feeling. Repeat back what you are hearing her say to you. Tell her that what she is feeling is understandable. Tell your child you want to help and support her.

Getting your child to stop self-harming without helping her find something to replace the behavior may be very stressful. Help her find something else to do when she feels the need to self-harm, such as journaling, art therapy, relaxation techniques, physical exercise, or talking to you, other family members, or friends.

Other things that may help include:

• Try to accept that your child has a problem and is not just trying to get attention.
• Use a calm, assertive voice when speaking with your child.
• Remind your child that you love her and accept her as she is, and let her know that you want to help her find healthier ways to deal with her feelings.

If your child threatens to commit suicide, take it seriously. Seek help immediately.

For more information, contact:

• National Institute of Mental Health
  866-615-6464
  https://www.nimh.nih.gov/index.shtml