12–15-year-olds are most susceptible to begin self-harming.

Self harm is hurting oneself on purpose as a means of coping. It’s difficult to diagnose and even harder to understand as it goes against our biological intuition to avoid pain and injury. Most instances of self-harm go unnoticed, but roughly 2 million cases are reported annually in the U.S. While it can be easy to slip into self-harming, the road out is lonely, scary, and anything but smooth.

Self-harm is not typically the first step people take to reconcile unrest. You will often hear people who self-injure say they started cutting or burning themselves after experiencing a traumatic event or after a long period of numbness or sadness.

When you keep all your problems in, it feels like you’re screaming inside. But when you cut or burn yourself, the pain is more physical. You feel like you’re releasing that scream.

So what are those who self harm dealing with? It’s a laundry list.

Unhealthy relationships | Bullying | Depression

Work stress | Drug, sexual, and domestic abuse

Financial distress | Loss of loved one

And why is self injuring an attractive option for dealing with these struggles? The reasons vary, but the common thoughts that they want attention or want to die are dangerous stereotypes. People who self-injure need help, but not necessarily the way you think. They are not crazy or dangerous, just coping with trauma. And while it is certainly not an excuse, self-harm is very common:

20% of people in the world self-harm

40% of college students admit to trying self-harm

17% teenagers have used self-harm to cope

60% of those who self-harm are female

Many conceal their cuts or bruises, so others don’t worry or think differently of them. Very rarely is cutting or self-harming a suicide attempt. Most often, they need new outlets to cope with their pain, whether that’s talking to someone or making new friends.

Self harm is not just cutting

Razor blades. Scars on wrists and legs. Commonly seen images of self-harm hardly tell the whole story. These images and actions don’t carry the weight of bleeding cuts dripping down an arm, but they can have equally dire consequences. Binge drinking kills 6 people daily in the US. And while not all are related to sadness or coping with emotional pain, many are. This is in no way exhaustive, but below are some other self-injurious methods:

Burning | Hitting or banging head

Punching hard objects | Picking scabs

Pulling out hair | Binge drinking

The symptoms and long-term concerns

It’s easy to assume someone might be practicing self-harm: they wear heavy, dark makeup, wear dark clothing that covers their arms and legs at all times, they listen to slow, gloomy music with lyrics centered on depression and not fitting in. These are based on some semblance of truth, and are possible red flags, but by no means are they a guarantee someone is self harming. Likewise, someone who wears suits or sundresses and loves country western could harbor a desire to self harm. Look for cuts and blood stains, but also isolation, negative self image, and irritability. If you notice someone displaying these symptoms and you believe they are self-harming, seek help from a qualified professional or the person’s legal guardian if a minor.

It’s easy to downplay the significance of self harm. We see it in movies, online, and even in our music and literature. Certain websites and media glorify self harm as a cool thing to do. But any relief is often short lived. The unintended consequences, however, can last forever. Injuries and cuts can become worse than planned and become habit forming. Self harm is an attractive option for short term relief and as a way to punish yourself for the problems in your life. That’s why the first step is to understand that self-harm is dangerous and not a way out from the pain you feel.

Healing and recovering

Self-injury serves as a distraction or a way of relieving tension and anxiety. But that merely serves as a reaction to the effects of the problem, not the problem itself. The issue may very well be obvious and infiltrate your day-to-day life, but it could also be a mystery: a heavy cloud that you don’t understand and cannot get out from under. Take some steps towards opening up a conversation about your pain with yourself and someone you trust.

Part of what makes self harm such a dangerous and vacuous situation is that many carry their burdens in secret. There’s no way around it, telling someone about your pain and trauma is scary and uncomfortable. So choose the right person, one who you trust and won’t pass blame or judgment. And if someone comes to you with their self harm experiences, listen and love. Don’t show disgust or panic and ask them to talk through their self harm experience to understand their emotions. If necessary, encourage them to talk to a therapist or trauma specialist. Starting a conversation is the most difficult obstacle for many dealing with self injury and coping with trauma. The voyage to healthy coping isn’t over, but once you start moving, you’ll find the waters a little less choppy.

A lifelong battle with self harm

Much like grappling with any crutch or addiction, fighting against the allure of self harm is a lifelong struggle. Slip-ups and regression back to self harm are common, but certainly not inevitable. Experts tell us to diagnose potential triggers and dangerous situations to avoid and experiment with new coping skills: writing, drawing, or exercise. Always remember, things can get better, and you don’t have to carry this burden alone. Release any pain you’re holding onto by sharing your story. Know that others are dealing with similar traumas and social concerns; they could benefit from your path to learning a better way to cope.

If an emergency call 9-1-1 immediately. Talk to someone 24/7 about self-harm: 1-800-237-TALK.

Sometimes it’s easier to begin by opening up to a trusted friend or family member. When you’re ready, find a counselor or therapist you feel comfortable talking to.