Finding out your teen is hurting themselves can be initially shocking, confusing, and heartbreaking. You might be wondering: why would my child hurt themselves? Are they suicidal? How did I miss the signs? You probably feel a whirlwind of emotions while wondering what to do and what to say to your teen.
FIRST: Take a breath. What matters most is helping your teen feel safe and understood. Everything else can come from there.
Why Do Teens Self-Harm?
Self-harm is also sometimes called self-injury. In many cases, the intent of self-harm is not to die, in which case it is referred to as nonsuicidal self-injury (NSSI). NSSI involves intentionally hurting oneself as a way of coping with emotional distress. It can look different, but commonly, self-injury looks like cutting, burning, or hitting oneself.
For some teens, self-harm provides temporary relief from intense emotional distress. For others, it’s a way of coping with feelings of emptiness, self-criticism, shame, anger, or emotional numbness. Some teens describe the purpose of self-harm as a release, a way to feel something, or punishment. Self-harm is not necessarily a suicide attempt, and it doesn’t automatically mean a teen is suicidal. However, self-harm and suicidal thoughts can and often do occur together to some degree, and a teen’s risk can change over time. Any self-harm should be taken seriously and assessed with care.
Importantly, self-harm is not simply attention-seeking or a manipulation tactic. Even when a teen has other behavioral concerns, self-harm is usually a sign of significant emotional pain.
How Should I Respond If My Teen Is Self-Harming?
Your first reaction might be to panic, ask questions, or insist your teen stop immediately. You’re probably worried and want to do your best to control the situation and ensure your teen is safe. These responses often come out of fear and concern, which is always understandable. However, how you respond can influence whether your teen feels safe coming to you when you’re struggling. Here are some ways to approach the situation:
Stay calm and lead with compassion. You don’t have to hide your concern, but try to avoid reacting with anger, punishment, or shame. Try: “I’m so glad you told me. I love you, and I want to help you figure out what’s going on.”
Listen before trying to fix the problem. You may want to understand why your teen is doing this, but they may not have a clear answer right away. Give them room to talk without pressing for every detail. Try open-ended questions: “What has been feeling hard lately?” “What happens for you when you feel the urge to hurt yourself?”
Ask directly about suicide. Don’t assume that your teen’s self-harm is separate from suicidal thoughts. Try: “Have you been thinking about suicide or wishing you weren’t alive?” Asking directly does not plant the idea of suicide in someone’s mind. It creates an opportunity for your teen to tell you what they’re experiencing and helps you get clarity about the situation.
Avoid threats, punishment, or guilt. Don’t focus on how much they are hurting the family or being selfish. Don’t demand a promise not to do it again, and don’t threaten to take away things they enjoy. These responses are likely to make it harder for your teen to ask for help in the future when their safety is at risk. Instead, focus on your teen’s safety, understanding their pain, and finding healthier ways to cope.
Take steps to support your teen’s safety. If your teen has any current injuries that need treatment, seek medical care first. You can also reach out to crisis lines, such as 988 or Teen Lifeline in Arizona. You and your teen can work with a qualified professional to create a plan for what to do when urges become intense and reduce access to items your teen could use to hurt themselves.
Remember: there is no one way to handle this perfectly, but continuing to show up for your teen with care and compassion can make a meaningful difference.
When Should I Seek Professional Help?
If you learn your teen is self-harming, it’s important to arrange an assessment with a qualified mental health professional who has experience working with adolescents and self-injury. Even if the behavior seems occasional or your teen says they aren’t suicidal, professional support can help you undestand what is happening and determine what level of care is appropriate. A therapist can help your teen identify emotional triggers, recognize patterns, develop healthier coping skills, and learn ways to manage distress safely. Treatment can also help address the underlying issues such as anxiety, depression, or trauma.
Parents also play an important role in this process. Depending on your teen’s needs and what resources are available in your area, treatment may also include parent sessions, family conversations, safety planning, and guidance on how to respond at home. Your teen will need some privacy to speak openly in therapy, but safety concerns should always be addressed with parents as well.
If your teen has a serious injury, has taken an overdose, or may be in immediate danger, seek emergency medical help. If they have current suicidal intent, a plan, or cannot stay safe, do not leave them alone; secure access to potentially dangerous items when you can do so safely, and seek immediate help. You can call 911 or go to the nearest emergency department for an immediate life threatening emergency. You can also call, text and chat 988 for crisis support and guidance.
About the Author
Marlee Gordon, LPC is a licensed professional counselor and the founder of Meadowlight Counseling LLC, a private practice in Goodyear, Arizona. Marlee has over 13 years of experience working with adolescents in educational and therapeutic settings, including school-based therapy and intensive outpatient programming for teens. She treats a wide variety of mental health concerns but focuses primarily on treating anxiety, perfectionism, life transitions, relationship challenges, and academic/athletic performance concerns.