Health Topics Information

Cutting and Other Self Harm Behaviors

There have been an increasing number of reports from parents that their high school aged children are engaging in cutting or other self-harm behaviors. As a clinician in the Bismarck area, I have observed that this is, indeed, a relatively common issue affecting adolescents and young adults. Self-harm is the act of deliberately harming one’s own body. Usually it is not intended to be a suicide attempt but is an unhealthy way to cope with psychological pain and strong emotions. This can be a mixture of worthlessness, loneliness, anxiety, anger, self-hatred and other emotions. Cutting is often done in order to distract from, or diminish these negative emotions; but, also can be a way of gaining a sense of control over one’s self and life, or as a way of expressing or communicating one’s feelings. It can bring a temporary sense of calm that is often followed by guilt, shame and a return of the initial negative emotion. Often, the person who cuts is having difficulty expressing their emotions to others. Self-harm can be linked to several mental health disorders, including depression, eating disorders and trauma-related disorders, but there is no single cause that leads to self-harm. 

If you are concerned that your teenager may be engaging in self-harm behavior, look for risk factors or warning signs. They include teenagers who:

  • Have social problems
  • Have friends who self-harm
  • Have a history of being abused or neglected
  • Spend more time alone
  • Tend to bottle up their emotions or be emotionally explosive
  • Act impulsively and unpredictably
  • Make statements about feeling hopeless or worthless
  • Wear long sleeves or pants when the weather is hot
  • Have white or red scratches or cuts on their body (often on the arms and legs)

If you have a loved one or friend who you think is self-harming, it is important to get help for him or her, even if you are scared that you would be betraying their confidence or don’t know how seriously to take it.  If a person is injuring himself/herself, even in a minor way, it is a sign of bigger problems that need to be addressed. For parents, remember not to criticize or yell at your child if you learn that your child is self- harming. Instead, express concern for your child and get them professional help. You can start by consulting your physician who will evaluate and make referrals to a therapist. For people who are concerned about a friend, encourage the friend to seek out professional help, or talk to an adult they can trust. Tips for you if your loved one self-harms: get informed, find support, keep communication open between you and your loved one and take care of yourself. 

For people who are harming themselves, focus on how to express yourself in positive ways, avoid alcohol and drug use and don’t be afraid to seek out help. You can find professional help that is supportive, nonjudgmental and encouraging. Treatment can involve talk therapy, medications or a combination. For more information on cutting and self-harm, visit the Mayo Clinic’s website. If you are having thoughts of suicide, text or call the National Suicide Prevention Lifeline 24-hour crisis line at 988.

Dr. Sara Horner


Sara Horner, PsyD, is a licensed psychologist with Archway Mental Health Services.