Just stopping young women on the streets of Seattle to talk about self-harm can bring out unexpected personal experiences.
“I've had a lot of friends who have dealt with like depression, and different self-harming issues," said Anne O’Neill, who has personally seen what depression can do. So has community college student Malinn Pa.
“It's so sad. I'm sorry, I don't want to get emotional. It's just sad because you have a lot to live for. You’re so young.”
Twenty-year-old Arianna Riley knows the pain first hand.
“I used to self-harm when I was much younger,” Arianna said.
Alarming statistics from the Journal of American Medicine show girls and young women ages 10 to 24 are harming themselves at an increased rate. In fact, since 2009 the number emergency room visits for self-harm in young girls age ten to 14 have increased by almost 19 percent.
“I think a very common thing is cutting oneself with scissors or a razor blade or knife. On their arms or legs,” said attending psychologist at Seattle Children's, Dr. Molly Adrian.
Behaviors like cutting, burning or ingesting poisons can be a cry for help. And if they go unanswered can lead to suicide.
“When you cut, it's like a release. It doesn't make you feel any better. You're sitting there, and you're like, wow I feel really bad and horrible. And I'm sitting here crying, but crying is better than nothing. That's how it feels,” explained Arianna.
According to the Centers for Disease Control (CDC), death by suicide in teens has tripled since the 1940s.
The CDC says it is now the third leading cause of death among teenagers.
“I think of both non-suicidal self-injury and suicide attempt as ways of coping with intolerable pain,” said Dr. Adrian.
If the child doesn’t ask for help, it’s up to parents, friends or educators to look for red flags.
“The warning signs to look for are really talking about suicide, writing about or posting about urges or thoughts to harm themselves, and giving away belongings, things that would indicate that they're planning for their own death,” said Dr. Adrian.
She warns that young people often learn to hide their pain and depression, making it difficult for parents intervene.
“I think the best strategy for parents is to approach their child. When they are calm and when the child is calm and kind of look for an opportunity to raise the parent's concern and really asked the question directly of, are you harming yourself? Are you thinking about suicide?” Dr. Adrian explained.
Research has shown a direct link between bullying and suicide. In fact, according to bullying.org, 20 percent of kids who are cyberbullied think about suicide.
And with smartphones providing access to the internet 24-7, there is little escape.
“I think it's easier to say things through the phone than in person. So your gonna say things that are hurtful that you wouldn't say to someone in person,” said Emily Serebryakov.
Identifying the signs of depression is the first step, but even if the issue is recognized quickly, getting help isn’t always easy.
“There's definitely not enough help out there, but people have gotten really creative about how to use existing resources so there are wonderful crisis lines that can be accessed by phone or by text,” said Dr. Adrian.
Professional help and a safe home environment can provide a strong safety net for a teen, in addition to inspiration and peer support.
“At the end of the day don't worry about what people think because you just have to live your truth,” said Anne O'Neill.
“Get out there. Live your life. Be the best that you can be,” said Malinn Pa.
“It gets better. I know that's so cliché, and at the time you feel like the world is ending, but you know, life goes on. And if it's your parents your friends or whatever, drop your stupid friends at one point. You'll turn 18 and then you can be happy,” said Arianna Riley.
Many of the young women we talked to said being active in clubs or athletic activities is the perfect way to boost confidence and keep you healthy while distracting you from negative influences.
For more information visit Seattle Children’s Psychiatry and Behavioral Medical support page, or for help in Washington state you can access the State Mental Health Crisis Lines here.
For immediate support contact the National Suicide Prevention Lifeline at 1-800-273-8255