It was like a blow to the stomach, Stephanie* remembers. Over dinner one evening, as her daughter raised her fork to her mouth, the colorful stack of bracelets dropped, revealing a cluster of small, angry red dots. Immediately, Stephanie recognized the signs of self-harm on her daughter's skin and it terrified her.
Self-harm, or self-injury, is when a person hurts themselves on purpose. It is a sign of emotional distress and can manifest in a variety of ways, from cutting with a knife or other sharp object, to burning or other behaviors that inflict physical pain or physical injury.
In this case, Stephanie's daughter was using pins from her bulletin board to prick herself. While the tiny wounds were not likely to leave scars, she did risk infection. Of greater concern was the emotional toll the behavior was taking on her — self-harm is often accompanied with deep feelings of shame and can cause sufferers to withdraw from the people and activities they once loved.
When confronted about the cuts on her arm, Stephanie's daughter admitted she'd been struggling with anxiety and having trouble eating, sleeping and focusing throughout the day. She seemed almost relieved to have someone else understand the pain she was going through and was ready to seek help.
"It might be harder to spot in individuals who try self-harm once or twice," says Dr. Kelsey Bradshaw, a clinical child psychologist with Sharp Mesa Vista Hospital. "But it is important that parents check in with their children to have an understanding of the stressors in their life and how their kids are managing them."
According to a recent study, nearly 1 in 4 teen girls and 1 in 10 teen boys in the U.S. self-harm. Risk factors for self-harm include:
- Sexual assault
- Eating disorders
- Drug or alcohol abuse
- Post-traumatic stress
Self-harm is not a mental illness, but rather a behavior used as a coping mechanism. When someone has difficulty coping with the intensity of certain emotions, they may turn to self-harm as a release or a way to feel something, such as pain, when they may otherwise be feeling numb or without emotion.
According to the National Alliance on Mental Illness (NAMI), self-harm isn't the same as attempting suicide. It should, however, be taken very seriously. Someone who practices self-harm is unable to cope with difficult emotions or circumstances, and may be at greater risk for feeling suicidal.
Recognizing self-harm behaviors, understanding the reason someone may use them, and learning new, healthy skills to cope with stressors can lead to relief. Some signs that a loved one might be self-harming include:
- Frequent bruises or bandages
- Wearing long-sleeve tops and long pants even in hot weather
- Poor impulse control
- Relationship difficulties
- Withdrawal from normal activities
- Expressing feelings of worthlessness or despair
Dr. Bradshaw recommends that parents take the time to talk often to their children and watch for signs of emotional distress or self-harm. If self-harm might be a real concern, ask your child directly if they have considered self-harm, are currently self-harming or have thought about suicide.
There are effective treatments for self-harm, including psychotherapy and medication. The first step is talking to your child's primary care doctor, who may recommend that they see a specialist who can diagnose any underlying mental health disorders, create a treatment plan and help them learn new, healthy coping behaviors.
Sharp Mesa Vista Hospital offers inpatient and outpatient programs for children and teens experiencing serious behavioral and emotional problems, including self-harm, aggression, depression and suicide. Learn more about child and adolescent mental health services.
If you or someone you know is considering suicide, seek help as soon as possible. The National Suicide Prevention Hotline is available 24 hours a day at 1-800-273-8255.
*Name changed upon request
For the news media: To talk with Dr. Kelsey Bradshaw about self-harm for an upcoming story, contact Erica Carlson, senior public relations specialist, at firstname.lastname@example.org.