There are a variety of reasons why a teen might engage in self-harming behavior. Professionals in the healthcare field, such as doctors and psychologists, refer to cutting as Non-Suicidal Self-Injury or NSSI.
Self-injury is harming one’s own body without the intention of committing suicide. It can include cutting, biting, scratching, burning, and bruising the skin. Teens might harm themselves as a way to feel physical pain, to create a lasting sign of distress, as a punishment for perceived failure, to release feelings, or to cope with strong emotions that might result from trauma or challenging past experiences. Using self-harm as a coping mechanism for anxiety and other strong emotions is most common among teens and adults. The Diagnostic and Statistical Manual of Mental Disorders (DSM) recognizes that acts of self-harm are not those that are socially sanctioned, such as body piercing or tattooing.
When adolescents cut or burn themselves, endorphins are secreted into the bloodstream and they often experience a numbing or pleasurable sensation. For some teens, cutting or harming their own body numbs any unpleasant thoughts and feelings and often a high comes with the experience. It is not unlike a high that comes with drug use. Over time, that high builds a psychological dependence and creates a compulsive need to continue.
When the lights are dim and the door is closed, cutting the skin and seeing red blood flow can actually provide a sense of relief. Although it sounds odd, cutting can easily become a primary coping mechanism that continues over time. As the pattern continues, most teenagers will do their best to hide this behavior. They are often ashamed about the injury they are inflicting upon themselves and, as a result, will wear long sleeve shirts to cover their wounds. Sadly, this shame and the need to hide what they’re doing only adds to the stress they experience.
It’s typical for cutting to begin during adolescence, and it appears to be more common among female adolescents than boys. NSSI occurs in about 12% to 37.2 % of US high school students and among 12%-20% of late adolescent and young adults. Although cutting is seen to take place among those between the ages of 10 to 25, NSSI is more typical between 11-15 year olds.
Depending on the reason behind cutting, it can be a single episode or a chronic pattern. Approximately one quarter of adolescents and young adults who report NSSI have only done it once. Among those who repeat the injury, 40% stop within a year and almost 80% stop within five years of starting. Teens and young adults who self-harm might also have psychiatric diagnoses, such as teen depression or anxiety. Self-destructive behavior is common in many illnesses including addiction, eating disorders, and bipolar disorder. It’s not uncommon for teens with an addiction, which could be defined as a cycle of destruction, to self-harm.
Treating self-harm is multifaceted because, as mentioned earlier, there are multiple reasons why a teen might engage in self-injury. For instance, self-harm is often a way to cope with intense emotions, to calm and soothe, to feel more alive if they feel disconnected or numb, or to release pent up anger. For this reason, part of the treatment itself is to tenderly support an adolescent in getting in touch with the reason behind their behavior.
As a caregiver, if you see marks on the wrists of your son or daughter, don’t automatically assume that it is because of a failed suicide attempt. Instead, it could be a sign that your teenager is having a difficult time coping with strong feelings, with stress, and/or with a mental health condition. Remember that cutting is not a reason to punish your child! It is by all means an invitation to understand your teenager and find out more about what he or she is experiencing. It’s an opportunity to provide your teenager with support, love, and understanding during this difficult life stage.