Teens, Cutting, and Self-Injury

Medically Reviewed by Dan Brennan, MD on February 06, 2022
5 min read

Amanda (not her real name) was feeling overwhelmed. Her parents were preoccupied with financial worries. Her algebra teacher had assigned tons of homework. And her best friend was not speaking to her because of a fight they had a couple of days earlier. Amanda felt alone and afraid. After a particularly tough algebra exam, she felt her world was caving in. She ran into a stall in the girls' bathroom, rolled up her sleeve, and cut her left arm as hard as she could with her nails. She drew blood, but she continued to scratch and cut. In her mind, self-injury was the only way she could deal with all the dealing with stress.

A few minutes later, her feelings of hopelessness subsided. And self-injury gradually became a ritual: Every time Amanda was in a stressful or uncomfortable situation, she would "release" the bad feelings by cutting her left arm with her nails or even with a razor blade. She carefully concealed the scars to avoid questions from friends and family.

When teens feel sad, distressed, anxious, or confused, the emotions might be so extreme that they lead to acts of self-injury (also called cutting, self-mutilation, or self-harm). Most teens who inflict injury on themselves do so because they are experiencing stress and anxiety.

Besides cutting and scratching, hitting, biting, picking at skin, and pulling out hair are some of the other ways teens use self-injury to cope with intensely bad feelings. Sometimes teens injure themselves regularly, almost as if it were a ceremony. Other times, they may hurt themselves at moments when they need an immediate release for built-up tension.

Self-injury is an unhealthy and dangerous act and can leave scars, both physically and emotionally.

Everybody experiences stress. But stress can feel very different for different people. Sometimes it is characterized by feeling nervous or jumpy. It can also include feelings of intense sadness, frustration, or anger.

These feelings are often (but not always) caused by things that happen during the day (such as a car accident or a fight with a friend). They can also be caused by something that is going to happen in the future (such as a big test or a dance recital). Stress also appears in different levels, or degrees.

Some people naturally feel higher levels of stress than others. For examples, two performers in a school play might feel drastically different about performing. One might be excited; the other might feel dizzy and nauseous.

This difference may be due to a person's biological makeup, or it might be due to a traumatic experience at a very young age. While these feelings may be triggered by a certain event or by many bad things happening in a short period of time, intense feelings of frustration could also be related to a person's upbringing. Children of abusive parents might lack good role models for dealing with stress in a healthy way.

Just as everyone experiences stress in unique ways, everyone deals with stress in different ways. These ways of lessening bad feelings are called "coping mechanisms." There are healthy coping mechanisms, like:

  • Exercising
  • Playing the piano or drums
  • Meditating or praying
  • Talking with someone you trust

There are also unhealthy coping mechanisms, like:

  • Drug use
  • Alcohol abuse
  • Cigarette smoking
  • Self-injury

Psychologists have found that self-injury can rapidly get rid of tension and other bad feelings. But, like drugs and alcohol, self-injury provides only a quick fix. Besides the physical consequences, one danger of self-injury is that the habit can last into adulthood. That's why it's crucial that teens learn safe, healthy, effective coping strategies so they can deal with anxiety and stress appropriately into adulthood.

Not necessarily.

Imagine a boy about 13 years old who accepts a friend's challenge to play "bloody knuckles" (punching each other's fists until they bleed). Then consider girls around 15, who lie about their age at a booth in the mall and get their eyebrow pierced. Or perhaps you've known a teen couple who got matching tattoos with each other's names.

The thing that distinguishes self-injury from other forms of physical harm is the elevated mood a teen experiences after self-injury. So the above examples -- although potentially dangerous in their own right -- are typically not acts of self-injury.

It's important to understand that a teen who is a self-injurer is not mentally ill. Self-injury is not merely a way to get attention. Even though the self-injurer may not feel the pain while inflicting the wound, they will feel pain afterward.

Thus, such injuries should not be brushed aside as mere manipulation, nor should the teen be made fun of for being different. Self-injury should be taken seriously by friends and family. Trust and compassion can make a world of difference.

People who self-injure to get rid of bad feelings are not necessarily suicidal. Self-injury is almost the opposite. Instead of wanting to end their lives, those who inflict physical harm to themselves are desperate to find a way to get through the day without feeling horrible.

Though the two concepts are different, self-injury should not be brushed aside as a small problem. The very nature of self-injury is physical damage to one's body. It's important for the self-injurer to seek help at once.

A person may not be able to stop injuring themselves "cold turkey." But seeing a counselor or joining a support group will likely help to ease the frequency and severity of self-injury. Intense negative feelings may cause a person to feel isolated from the rest of the world, so a social support system is important to fight self-injury.

There are effective treatment strategies for those who self-injure. The forms and causes of self-injury are unique to each individual. A psychologist or counselor will be able to tailor a treatment strategy to each person.

If you have urges to self-injure, or have already done so, confide in someone who can help you find a better way to cope with bad feelings. That might be a parent, an older sibling, a minister, a rabbi, a guidance counselor, health care practitioner, psychologist, social worker, or another trusted adult.

Do the same if you know of someone who inflicts physical harm on their body. Self-injury deserves immediate attention.