Why Some Teens Self-Harm, and What Parents Can Understand

Most teens who self-harm are using it to cope with feelings that feel overwhelming, and understanding that is often the first thing that helps a parent respond with care instead of panic. The American Academy of Pediatrics (AAP) notes that there is "no single clear cause" and that young people who self-harm often describe "overwhelming emotional pain," along with loneliness, emptiness, or feeling buried by school and family pressure (AAP, 2024). Self-harm is a sign of pain that needs attention and care, and it is neither a moral failing nor a reflection of how much your teen loves you.

If you're worried about your teen's safety right now, call or text 988 (Suicide & Crisis Lifeline), or call 911 if your teen is in immediate danger. Our crisis page explains what happens when you call.

What is self-harm?

Self-harm means hurting your own body on purpose, and it most often begins in the teen or early adult years. The National Institute of Mental Health (NIMH) describes self-harm as "a person harming their own body on purpose" and notes that it "tends to begin in teen or early adult years" (NIMH, 2024). Clinicians often use the term non-suicidal self-injury, or NSSI, to describe self-harm that happens without an intent to die (AAP, 2024).

Self-harm is a behavior, and it isn't a diagnosis on its own. The American Academy of Child and Adolescent Psychiatry (AACAP) calls it "a complex behavior and symptom that results from a variety of factors" (AACAP, 2019). Some teens who self-harm are also dealing with depression, anxiety, or another mental health condition, and some are not, which is one reason a professional evaluation matters more than any label a parent might reach for.

Why do some teens self-harm?

Some teens self-harm because it gives them a brief sense of relief or control when their feelings seem impossible to manage any other way. The AAP explains that self-harm "may offer a momentary escape from the struggles a child can't seem to handle any other way," and that it "can also be a way for kids to take control of their bodies when they feel a lack of control over other things" (AAP, 2024).

The feelings underneath can look very different from one teen to the next. One teen may be carrying sadness they can't put into words, another may be flooded with anger after a fight with a friend, and another may feel numb and empty and want to feel something. AACAP notes that "adolescents who have difficulty talking about their feelings may show their emotional tension" in this way (AACAP, 2019), which helps explain why self-harm can show up in teens who seem quiet, capable, and fine on the surface.

The relief self-harm brings doesn't last, and that's part of what makes it hard to stop. When something works for a few minutes, a teen in pain may reach for it again the next time feelings spike, even while wishing they could stop. That pattern is why the goal of treatment is usually to help a teen build other ways of coping with the feelings underneath, rather than simply forbidding the behavior.

Is self-harm a way of getting attention?

Self-harm is rarely about attention, and the AAP lists the idea that teens who self-injure are "just seeking attention or being dramatic" among the common misconceptions pediatricians hear (AAP, 2024). Many teens keep self-harm to themselves for a long time, and many feel a great deal of shame when a parent finds out.

Even when a teen does want someone to notice, that wish is worth taking seriously. A teen who needs to be seen in their pain is still a teen in pain, and responding with care rather than an eye-roll is what makes it more likely they'll come to you next time. Our guide on how to talk with your teen about self-harm covers what to say when you're not sure how to begin.

What are the common myths about self-harm?

Several common beliefs about self-harm are wrong, and they can lead well-meaning parents to respond in ways that make things harder. The table below compares common myths with what the AAP and AACAP actually say.

Sources: AAP, 2024; AACAP, 2019.

How common is self-harm among teens?

Self-harm is more common among teens than most parents expect. A 2018 study in the American Journal of Public Health, which used 2015 Youth Risk Behavior Survey data from the Centers for Disease Control and Prevention (CDC), found that 17.59% of high school students in 11 U.S. states reported hurting themselves on purpose without suicidal intent at least once in the previous 12 months (Monto, McRee & Deryck, 2018). Those numbers are from 2015 and from 11 states rather than the whole country, so they're best read as a sign that self-harm is not rare, rather than as a current national rate.

The same study found that rates were higher among girls, ranging from 17.7% to 30.8% across the states studied, compared with 6.4% to 14.8% among boys. Boys self-harm too, and their distress can be easier to miss when it doesn't look like sadness. Our guide on when anxiety shows up as anger or irritability describes how distress in teens doesn't always look the way parents expect.

Did I cause my teen's self-harm?

You almost certainly did not cause your teen's self-harm, and the AAP is clear that parents "should not be shamed or blamed" for a child's struggles (AAP, 2024). Self-harm grows out of many factors, including a teen's temperament, stress at school and with friends, and their own mental health, and no single conversation or parenting choice explains it.

Guilt is one of the most common feelings parents describe after finding out, and it can make it harder to stay steady when your teen needs you most. Our guide on guilt, blame, and what parents need to hear speaks to that directly. Family life does matter in recovery, though, and a therapist can help you understand what kinds of support at home make the biggest difference for your teen.

When should you get help?

Self-harm is always a reason to involve a professional, even if it seems to have happened only once. This guide can help you understand what might be going on, but only a licensed professional can evaluate your teen and recommend the right care.

• Call 911 now if your teen is in immediate danger or has an injury that looks serious.
• Call or text 988 (Suicide & Crisis Lifeline) right away if your teen says they want to die or you're worried about their safety. The 988 Lifeline is free, confidential, and available 24/7, including for people worried about a loved one (988 Lifeline, 2026). Our crisis page explains what happens when you reach out.
• Call your teen's pediatrician or a therapist this week if you've found out about self-harm and your teen is safe right now. AACAP notes that "evaluation by a mental health professional may assist in identifying and treating the underlying causes of self-injury" (AACAP, 2019).
• Mention it at your teen's next appointment if you're noticing changes that worry you, like withdrawal or a low mood, without signs of self-harm. Our guide to the signs of depression in teens can help you describe what you've seen.

If you've just found out, our guide on what to do if you find out your teen is self-harming walks through the first hours and days, and levels of care explained covers the options if a therapist recommends more support. You can find every article in our self-harm guide for parents.

This article shares practical guidance for parents and is not medical advice. We're not clinicians or doctors. If your teen is struggling, contact a licensed mental health professional or your teen's doctor, and if you have a serious concern about their safety, call 911 or call or text 988. Editorial standards