Self-harm in teens

Most self-harm in young people comes from a need to escape strong feelings for a moment, not a wish to die. The relief is short, and the pain underneath comes back, often with shame added on.

Some young people self-harm to feel in control of something when other parts of life feel unmanageable, like family problems or school pressure.

Having a real say in decisions, setting small goals and building routines can give back some healthy control over time.

Some young people want to punish themselves for something they believe they did wrong. Low self-esteem and harsh self-blame are common.

Things that can build up

• Bullying, including online
• Exams and school pressure
• Family problems or parents separating
• Feeling different or left out
• Grief and loss
• Questions about sexuality or identity
• Trauma or abuse

Depression and anxiety often travel alongside self-harm in young people. Getting support for what’s underneath is part of healing.

LGBTQ+ young people have higher rates of self-harm. Experts link this largely to discrimination and rejection, not to who they are.

Acceptance at home, at school and in the community is powerfully protective. The LGBTQ+ mental health guide has more.

Pediatricians note that Native American and Alaska Native young people who self-harm are at particularly high risk of suicidal thoughts and actions.

Culture, family, community and belonging can be deep sources of strength. Support that respects your culture and community matters.

Children and teens who are bullied, isolated or rejected have higher rates of self-harm. Lacking friends was a common risk factor in a large 2023 review.

If you are being bullied, it is not your fault. Telling a trusted adult or a school counselor is a strong step.

In a 2022 global review, about one in five teen boys had self-injured in the past year. All genders, including transgender and non-binary young people, can self-harm.

Boys may be less likely to be noticed or to ask for help. Reaching out is a sign of strength, not weakness.

Depression, anxiety, ADHD, trauma, eating difficulties and substance use all raise the risk of self-harm. Treating both the self-harm and what’s underneath is important.

This doesn’t mean everyone with these experiences self-harms. Only a qualified professional can understand what is going on for you.

In a 2018 survey of 729 U.S. adults ages 18 to 29, 43% had seen a self-harm post on one photo-sharing app at least once. Of those, 80% said they came across it by accident, and 59% said it upset them.

People who had seen this content were more likely to report self-harming themselves a month later, even after the researchers took earlier self-harm into account. A study like this can’t prove cause and effect, but it is a good reason to protect your feed.

Digital self-harm means anonymously posting or sharing hurtful things about yourself online. In a 2016 U.S. survey of 5,593 students ages 12 to 17, about 6% said they had done this. Boys reported it more often than girls (7.1% vs 5.3%).

It was more common among teens who had been bullied, had depressive symptoms, used drugs, or had self-harmed offline. Like other self-harm, it is usually a sign of pain underneath, not a joke to brush off.

Many apps show you more of whatever you pause on, like or search for. That means you can slowly push your feed in a kinder direction. Only follow accounts that make you feel positive and safe.

Ways to take back control

• Use “not interested” or “hide” on posts that upset you
• Turn on sensitive-content filters in your settings
• Report posts that show or encourage self-harm
• Search for and follow recovery, nature, humour or hobby accounts
• Set app time limits, especially late at night

Online support can help, especially if you feel you can’t talk face to face. The safest spaces are moderated, focus on hope and coping, and don’t allow pictures or detailed descriptions of self-harm.

If a group leaves you feeling worse, more triggered or more hopeless, it is okay to leave. Your wellbeing comes first.

You could talk to a parent or relative, a teacher, school nurse, school counselor, youth worker, coach, doctor or trained volunteer.

Pick someone who usually listens without judging. It doesn’t have to be a parent first if that feels too hard.

You can write a note, send a message, or practise first. Let them know it may be upsetting, but that you are asking for help.

You could start with

• “I’ve been having a really hard time and I need help.”
• “I’ve been hurting myself when things get too much.”
• “Can you help me see a doctor?”

Pediatricians recommend that young people have private, one-on-one time with their doctor so they can talk openly. You can ask for this at any appointment.

If someone is at serious risk, professionals may need to share information to keep them safe. You can always ask, “Who will you tell, and what will you tell them?”

If someone reacts badly when you tell them, that says more about them than about you. Your feelings are still valid. Try again with someone else you trust, like a school nurse, doctor or helpline.

A school nurse, counselor or trusted teacher can listen, help you think about next steps, and help you reach a doctor or mental health support.

You can ask them what they would need to share, and with whom, before you go into detail.

Pressure at school is one of the things young people often name when they talk about self-harm.

It is okay to ask for extra time, a quiet space, or a check-in person at school while you are going through a hard time.

Self-harm is common among young adults, especially college students. Moving away from home can mean losing your usual support at the same time as facing new stress.

Most colleges have free counseling services. Reaching out there is a strong, sensible step.

Good relationships and feeling that you belong are among the strongest things that protect young people. A club, team, faith group or creative space can help.

Anti-bullying work and inclusive, welcoming schools help everyone feel safer.

DBT teaches practical skills to manage intense emotions, get through crisis moments and handle relationships. The teen version often includes individual therapy, skills groups with parents, and phone coaching.

In a major U.S. study of teens at high risk, self-harm was about one-third as likely after six months of DBT as with a comparison therapy. A large research review found DBT-A had the best evidence for reducing repeated self-harm in young people.

Other talking therapies, such as CBT and mentalisation-based therapy, are also offered to young people. For teens, the evidence for these is still less clear, and researchers are working to improve them.

What matters most is finding someone you can trust and talk to honestly.

Therapy often includes family when that helps. Guidance says families and carers should get clear information and, where appropriate, help with safety planning.

You can tell your therapist what you are and aren’t comfortable sharing with family.

Treating any other mental health struggle alongside self-harm is important. A pediatrician can make a care plan that fits you.

Teens need about 8 to 10 hours of sleep a night. Too much late-night screen time can get in the way.

Keeping phones out of the bedroom at night, if you can, is one of the simplest changes. The Sleep & mental health guide has more.

Social media is not a direct cause of self-harm, but heavy use can disrupt sleep and fuel envy, isolation and self-rejection. Pediatricians suggest a healthy family media plan.

Parents’ screen habits matter too. Time together without phones makes space for conversation and closeness.

Good relationships with family and friends were the protective factor researchers found most often in young people. A supportive parent-child relationship can buffer against hard times.

Pediatricians encourage families to ease chronic stress, allow downtime without guilt, and make room for self-care.

Regular meals, movement and time with people you like all help your wellbeing.

Trained counselors listen and help you through the moment. You don’t have to be thinking about suicide to reach out. You can also contact them if you’re worried about a friend.

Spanish services and support for Deaf and hard of hearing people are available.

A live, trained volunteer crisis counselor will text back. Texting can feel easier when talking out loud is hard. Message and data rates may apply.

Trained counselors support LGBTQ+ young people in crisis, any time, for free.

School nurses and counselors can listen and help you reach care. Most colleges have free counseling services.

A doctor or pediatrician can listen, treat injuries and connect you with talking therapy. Teens can ask for private time with their doctor.

Find A Helpline is a free directory of verified, confidential helplines in many countries, with phone, text and chat options.

In an emergency, call your local emergency number.