Self-Harm Signs, Symptoms & Effects In Children

Learn about self-harm

The clinical term for self-harm is non-suicidal self-injury, and it involves intentionally harming your own body to cope with intense emotional pain, anger, or other overwhelming emotions. Not all young people who engage in self-harming behaviors suffer from a mental health disorder, but this behavior may be a symptom of an untreated mental health condition such as depression, posttraumatic stress disorder, or bipolar disorder. 

There are many different ways a child or adolescent might harm themselves, including cutting or scratching themselves with sharp objects; burning themselves with cigarettes, matches, or heated objects; punching themselves or walls or banging their head against the wall; and inserting objects under their skin. Getting tattoos or piercings is not considered self-harm because these are socially sanctioned forms of self-expression and creativity. 

Children and adolescents who harm themselves most commonly self-injure their wrists, arms, thighs, and stomachs, but they may self-injure any area of the body, and they may also use multiple methods of self-harm. Some young people who engage in self-harm may feel an uncontrollable urge to injure themselves when they become upset, and they use self-harm to relieve the emotional pain they are feeling.  

But many young people who self-harm feel shame and guilt after they’ve injured themselves, and the painful emotions they were trying to cope with may come rushing back despite their efforts to manage them. And, although their intention may not be to die by suicide, a young person who engages in self-harm may inadvertently cause serious injuries that can be life–threatening. 

Statistics about self-harm

The American Psychological Association and the American Journal of Public Health have reported the following statistics about self-harm among children and adolescents in the United States: 

• About 17% of adolescents engage in self-harm at least once in their lifetime. 
• Up to 14% of high school-aged boys in 11 states reported harming themselves in the last year without the intention of dying by suicide. 
• Up to 30.8% of high school-aged girls in 11 states say that they self-injured in the last year, also without the intention of dying by suicide. 
• About 1.3% of children ages 5-10 self-injure, though the rates are higher among those who have a mental health disorder diagnosis. 

Causes and risk factors for self-harm

Children and adolescents are at a stage in their development when their emotions are difficult to regulate, and they may not have the support they need to navigate their current challenges. Many influences can contribute to a young person’s urge to self-harm, and some of the factors that may increase their risk of harming themselves include: 

• History of physical, sexual, or emotional abuse 
• Neglectful caregivers or frequently changing caregivers 
• Unstable home environment 
• Untreated mental health condition 
• Friends who self-injure 
• Alcohol or drug use 

Symptoms of self-harm

A young person can self-harm in many different ways, and the urge to harm themselves may come with various thought patterns, physical effects, and behaviors. These are just some of the signs and symptoms that a child or adolescent may be experiencing the compulsion to engage in self-harm: 

Behavioral symptoms:

• Wears long sleeves or long pants, even in hot weather, to hide evidence of self-injury 
• Acts out impulsively or unpredictably 
• Becomes secretive and spends more time alone 

Physical symptoms:

• Fresh cuts, scratches, bruises, or other wounds 
• Scars, sometimes in visible patterns 
• Trouble falling or staying asleep 
• Significant changes in appetite 

Mental symptoms:

• Intense mood swings 
• Explosive outbursts of anger 
• Pervasive sense of shame or guilt 
• Feelings of worthlessness and hopelessness 

Effects of self-harm

The injuries associated with self-harm are not the only negative effects a child or adolescent may experience because of this condition. If a young person does not receive timely, effective care for the self-harming behaviors they are grappling with, they may also experience the following negative outcomes:  

• Serious physical injuries that require medical attention or hospitalization 
• Accidental death due to self-inflicted injuries 
• Onset or worsening of symptoms of a mental health condition 
• Damaged or lost relationships with loved ones or friends 
• School failure or dropout 
• Loss of after-school job 
• Suicidal ideation 
• Suicide attempts 

 If a young person in your care is struggling with the urge to engage in self-harm, you can help them minimize their risk for experiencing these long-term negative outcomes. Getting them age-appropriate care at the first signs that they are harming themselves can help them learn healthier coping techniques, putting them on a path toward a brighter future. 

Common co-occurring disorders among children and adolescents who self-harm

Not every young person who engages in self-harm is struggling with a mental health disorder, but this behavior is often a symptom of an untreated mental health concern. Children and adolescents who are harming themselves may be at an increased risk for the following co-occurring disorders:  

• Posttraumatic stress disorder (PTSD) 
• Depression 
• Bipolar disorder 
• Panic disorder 
• Psychotic disorder