Trigger warning: This post discusses in detail someone engaging in self-harming behaviour.

The Canadian Institute for Health Information (CIHI) recently released new statistics on self-harm among Canadian teens. The CBC reported that in 2013-2014 one in four hospitalizations among youth age 10 to 17 were due to intentional self-harm injuries. But even more shocking than that is that self-harm hospitalizations for girls saw an increase of 110%, according to CTV News. Although self-harm hospitalizations also increased among boys in this age group (up 35%), the rate of growth isn’t nearly as staggering. I find these numbers so concerning, and unsurprising, because I could have easily been one of these statistics.

For the uninitiated, self-harm behaviour can include cutting, burning, hitting or punching yourself, intentionally preventing wounds from healing, and self-poisoning. However, binge drinking, drug use, and reckless driving can also be forms of self-harm.

I engaged in the most common self-harm behaviour, cutting, although I was a bit older than the demographic the CIHI reported on. I was eighteen and in my second year of university when I first resorted to cutting. It was during a time when I was struggling to adjust to university life after the summer off. I was living in a house with five other girls and had little patience or time for their antics. I was finding it almost impossible to keep up with my full course load and I was dealing with a long distance relationship. It doesn’t sound like an unusual stress for an eighteen year old and it isn’t, but what I have learned over the years is that some of us have a capability to bear more stress than others.

I was two months into the semester when I started to isolate myself. I’d close my bedroom door and stay there for most of the day. I stopped eating, I skipped lectures and slept all of the time. When I wasn’t sleeping, I was crying. Now I know these are all symptoms of depression, but at the time I had only a vague inkling of depression. I thought that depression was a profound sadness that happened after a traumatic life event, like someone dying. Nothing like that had happened to me. For all intents and purposes, I should have been happy. I should have been enjoying university life. But I wasn’t.

I try to think back to what compelled me to start cutting and honestly, I have no idea. I never had a friend who engaged in self-harm. It wasn’t like today with self-harm blogs pervading the internet. All I remember is that one night when I couldn’t sleep, I found myself in the kitchen with a knife. I looked from the blade to my arm and knew what I was going to do. I dragged the blade across my skin. The burning pain jolted me back to life like an electric shock. As I watched the blood well up, I felt better. I could breathe. It was like the cut was a release valve and the pressure that had been building inside of me finally had a way to escape. So I made another cut and another. Each cut releasing my anxiety like air leaving a balloon. After that moment, I was hooked.

When my friends, family, and partner saw the cuts, it scared them (as it should). They assumed (mistakenly) that I was trying to kill myself, but that’s not what most instances of self-harm are about. Non-Suicidal Self Injury is more about manifesting your psychological pain into something physical. I didn’t understand why I was hurting so much and I couldn’t find the words to talk about it, so cutting was a method of expression.

I learned through therapy that self-injury is an unhealthy coping mechanism, just like someone who drinks or does drugs. However, what I was never told was that it could be addictive like drugs or alcohol. I used to promise my partner and parents that I wouldn’t do it again, but like an addict I broke those promises over and over again. The lure of the blade would beckon to me in my pain. It didn’t matter that I was lying or breaking a promise to those that I loved; I had an itch and it needed to be scratched. It was only once I entered an intense inpatient therapy program that I finally broke the habit.

It’s been over five years since I last cut and my scars have mostly disappeared, but truthfully, in my most anxious moments, my mind instinctively thinks about cutting. But instead of trying to fight it, I give myself five minutes to think about it and then I replace it with a healthy coping mechanism, like writing or telling someone I’m struggling.

Ultimately, I was very lucky because my self-injury never led to a hospital visit. But, as the statistics show, not everyone is so lucky.

What are some of the warning signs that a friend or family member may be engaging in self-harm? (from helpguide.org):

• Unexplained wounds or scars from cuts, bruises, or burns, usually on the wrists, arms, thighs, or chest.
• Blood stains on clothing, towels, or bedding; blood-soaked tissues.
• Sharp objects or cutting instruments, such as razors, knives, needles, glass shards, or bottle caps, in the person’s belongings.
• Frequent “accidents.” Someone who self-harms may claim to be clumsy or have many mishaps, in order to explain away injuries.
• Covering up. A person who self-injures may insist on wearing long sleeves or long pants, even in hot weather.
• Needing to be alone for long periods of time, especially in the bedroom or bathroom.
• Isolation and irritability

If you suspect someone is engaging in self-harm behaviour, here are some ways you can help support them from Befrienders.org):

• Ask how they are feeling
• Do not be judgmental
• Do not make them feel guilty about the effect it is having on others
• Let the person who self-harms know that you want to listen to them and hear how they are feeling when they feel ready and able to talk.
• When they do discuss it with you be compassionate and respect what the person is telling you, even though you may not understand or find it difficult to accept what they are doing
• Do not give ultimatums such as ‘If you don’t stop self-harming you have to move out’. 
• Understand that it is a long and hard journey to stop self-harming. Be aware that someone will only stop self-harming when they feel ready and able to do so.

This post originally appeared on Healthy Minds Canada.