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Parents have been asking me some painful questions about whether their teenager could be self-harming themselves — and what they can do if that is the case.

First, how do you recognize if self-harm is occurring in your older child or adolescent?

You may see scratches, picking of skin, cuts, small burns, or scars on your child’s arms, legs, or even belly.

Children will often hide their injuries by wearing lots of jewelry or long sleeves even in hot weather. In addition, youth who have feelings of depression, anxiety and other mental health concerns are more apt to demonstrate this behavior.

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Why does this happen?

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While there may not be one clear cause, it appears to be a result of a teenager feeling overwhelmed with emotional pain, loneliness, or by the pressures of school and family. They want to either punish themselves or escape from these feelings by inflicting self-harm upon themselves.

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Ways to help your child

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If there are worries that your child may be self-harming themselves, talk about it with them. A supportive parent-child relationship can go a long way to reducing stress and building resiliency in your child.

Be a good listener and be nonjudgmental in asking if your child or friends are engaged in the behavior or thinking about it.

Make your home safer by removing sharp objects that can be used for cutting from being easily accessible to your teenager. That also includes making sure firearms and medications in the home are also locked away, given the risk of there also being suicidal thoughts.

If you suspect self-harming behavior is occurring in your older child or teenager, please contact their health care professional so that steps can be taken as soon as possible to help prevent the self-harm from continuing.

Most importantly, please understand that if self-harm is occurring, it does not make you a bad parent. Be there to help your child recover by expressing hope, embracing treatment and making sure they feel your loving unconditional support.

Hopefully, information that I’ve shared will relieve the hurt you and your teenager may be feeling if you suspect they may be at risk for or engaging in self-harm.

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Lewis First, MD, is Chief of Pediatrics at The University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at the University of Vermont’s Larner College of Medicine. You can also catch “First with Kids” weekly on WOKO 98.9FM and NBC5.