March is self-injury awareness month, a time when mental health professionals work to raise awareness of the condition, recognize the signs and work to remove the stigma. Known by clinicians as non-suicidal self-injury, the behavior is described as intentionally harming oneself without intending to end one’s life. The population most likely to engage in self-harm behaviors range from middle school through college, according to the American Psychological Association.

“When teens begin engaging in cutting behavior it is typically because they are feeling overwhelmed by intense feelings or emotions and don’t have the coping skills to manage or respond to how they feel, said therapist Carol Barnaby, MSW, LCSW.

“Adolescents might self-injure to distract themselves from intense negative emotions of sadness or anger, or emotional numbness, added Jerome Short, Ph.D., Associate Professor of Psychology at George Mason University. “They may also want to punish themselves or express a need for help.”

Cuts and burns on the wrists or thighs are among the most common signs of self-injury. “Parents may notice their children have unexplained cuts, burns, or bruises,” said Short. “Adolescents may wear clothing or bracelets to cover themselves even in very warm settings. Parents may find knives or razors in their children’s rooms or notice they are missing from the home.”

“Other signs that your child may be cutting include marks on the skin from scratching, using a paper clip or skin picking, advises Barnaby. “Multiple similar marks on the skin in close proximity for which your child has no explanation,’ said Barnaby.

While cutting and burning oneself causes pain initially, that pain can evolve into relief. “Sometimes cutting can be habit-forming or become compulsive, said Barnaby. “This in simple terms, means that the more the person cuts the more they feel the need to do it and their brain associates cutting with relief.”

Teens might turn to self-injury as a way of regulating their emotions. “For teens who are feeling a lot of strong and intense emotions, self-harming releases the body's natural opiates and endorphins that help them manage their feelings,” said Joanne Bagshaw, Ph.D., Professor of Psychology at Montgomery College. “On the flip side, a teen who is shut down or who feels numb might self-harm to feel their feelings. Alternatively, self-harm may be for the teen to communicate that they need help.”

Several factors might trigger self-inflicted injuries. “Childhood abuse and conflicted parental relationships may trigger self-injury,” said Short. “Self-injury may be a sign of depression, anxiety, substance use, or post-traumatic stress disorders.”

Parents who suspect that their child might be engaging in intentional self-injury should avoid criticism and seek mental health treatment. “Parents should not ignore the problem,” said Short. “If children engage in life threatening behavior, they should take them to a hospital.”

Noticing those marks, however, could require careful attention. "Teens who self-injure often hide the marks that self-injury might cause," said Child Psychologist Stacie Isenberg, Psy. D. "For example, they may wear a long-sleeved shirt in hot weather if there are marks on their arms or multiple bracelets if there are marks on their wrists."

“If parents feel that their teen is engaging in self-harm behaviors they should show compassion for their child and get help, added Barnaby. “Self-harm behavior is very treatable with early intervention.“