Self-harm in adolescence is considered common in the presence of depression, anxiety disorders, personality disorders, low self-esteem, and a history of abuse or other trauma. Many teens who harm themselves do so as a means of coping with severe emotional turmoil, or as a way to establish a feeling of control over their personal lives. Self-harm in adolescence is also sometimes a means of drawing the attention of others to one's distress, in hopes of receiving validation or help. The signs of self-harm in adolescence can include depressed mood, problems relating to others, poor performance in school, and secretive behavior. Adolescents who practice self-harm will often have frequent injuries, most often scratches, burns or cuts, and they may make excuses for these injuries, seem embarrassed about them, or go to great lengths to hide them beneath clothing.
One of the most important signs of self-harm in adolescence may be the frequent appearance of small wounds on the body. Most adolescents practice self-harm by cutting, often on the limbs. The wounds often appear as short lines stacked atop one another, though some adolescents may carve letters or words into their own flesh. The injuries usually appear quite often and the adolescent may make suspicious excuses for their appearance.
There will also usually be a great effort made to hide the self-inflicted cuts, scratches, bruises or burns. Adolescents may wear clothing that is inappropriate for the weather, such as long trousers on a very hot day. They typically refuse to disrobe in the presence of another, and may refuse to wear swimsuits. They may spend long periods of time alone.
Self-harm in adolescence may be accompanied by problems with low self-esteem or body image, or possibly by psychiatric disorders like depression. The typical self-harming adolescent struggles with negative emotions, may have trouble making or keeping friends, or may have problems in school or at work. There is usually an inability to express or cope with stress and painful feelings.
Most adolescents who practice self-harm do so by cutting or scratching themselves. Some adolescents burn or hit themselves, pull their own hair, or pick at blemishes on the skin. They may slam their heads or other body parts against or between hard surfaces, and some adolescents may even break their own bones. Some teens may may ingest large quantities of over-the-counter drugs or other potentially dangerous substances. Sometimes self-harm in adolescence includes repetitive scab-pulling, so that injuries never quite heal.