Self-harming teenagers: Reasons, triggers and signs to look out for


Intentionally causing pain or damage to your body by means of cutting, burning, scratching, and self-poisoning through medication or substances in order to relieve emotional distress, is a growing concern among teenagers.

Self-harm is a common cry for help during teenage years that should never be ignored, or worse, downplayed as attention-seeking behaviour. And it’s usually not a once-off act, as about 50% of teens who self-harm will do so repeatedly as it becomes a coping mechanism to deal with anxiety, depression or other mental health problems. 

We asked Dr Terri Henderson, child psychiatrist and member of the South African Society of Psychiatrists (SASOP) to share the triggers, symptoms and signs of self-harm to better understand this growing problem: 

Common triggers of self-harm include: 

  • Puberty, as this is a neurodevelopmentally vulnerable time for teenagers, especially females, when there is an increase in emotional disorders and risk-taking behaviours.
  • Child and family adversity.
  • Emotional neglect.
  • Maladaptive parenting (little time or attention is given to children/teens and families in which negative emotional displays by children are punished).
  • Disruptive, unsupportive home environments.
  • Exposure to negative life events such as parents separating or divorcing, loss of a parent, the experience of any form of abuse, past or current bullying and peer interpersonal challenges.
  • Sexual abuse.
  • High sensitivity to emotional stimuli or the tendency to have extreme reactions.
  • Self-criticism and striving for perfectionism caused by the unrealistic pressures of social media.


Why do they do it? 

Teens who self-harm have the need to show the emotional pain they feel on the inside by causing physical pain. Self-harm is often done to: 

  • Relieve anxiety, anger, unpleasant thoughts or feelings, tension or guilt, loneliness, alienation, self-hatred and depression.
  • Externalise or to provide an escape from emotional pain.
  • Provide a sense of security or control.
  • Self-punish.
  • Stop racing thoughts.
  • Stop flashbacks.
  • Facilitate relaxation.


Signs to look out for

  • Teens trying to hide scars by wearing long sleeves even on hot days or flinching in pain if their arm is touched. 

Other signs of mental distress are often present such as: 

  • Depression. 
  • Increasing isolation.
  • Withdrawal from activities, friendships, schooling and sports. 
  • Decreased focus on self-care behaviours such as bathing. 
  • Changes in sleeping and eating patterns. 
  • Irritability or markedly erratic moods.


If you’ve identified these signs, but the behaviour seems to minimal and limited to one or two incidents, a short-term invention with a family doctor or psychologists should be sufficient. Should the behaviour be long lasting or the self-harm be severe, speak to a specialist and find out about group or individual dialectical behaviour therapy.