Experts estimate that over 83 million people suffer from some form of diagnosable mental illness. Some generalize it as anxiety. Some generalize it as depression. Some generalize it as bulls**t. The media romanticizes suicide attempts and self-harm because they make a touching story about someone overcoming struggles by finding “the one” or through some feat of their own strength. But the very real truth is that these conditions are not fun. They are not sexy. They do not come with a tearful confession at just the right moment or a swell of dramatic music when you make a breakthrough. They wound those who have the resources and support to get through them, and they cripple or kill those who don’t. Many people don’t know what mental illness is, or what it looks like. So I guess I’ll have to try to explain it. Listen up.

Self-harm (formerly called self-mutilation) is the process by which an individual deliberately inflicts harm on themselves. Roughly 53 million Americans will engage in self-harm a year—one in seven men, and one in five women. It can include burning, bruising, scratching, pulling out hair, and preventing wounds from healing properly. But the one everybody knows is cutting. The poster child for self-harm is the tween with the scars on their wrists and arms that everybody says are there “just for attention.”

In middle school, I knew a girl who engaged in self-harm. She said that “every cut made her stronger” and told me not to tell anyone. I told her parents about it, and she yelled at me. I didn’t care.

Another friend showed me a tiny mark on her wrist and said she made it when she was fourteen. Her niece found her with the knife still in her wrist. Her parents yelled at her for it, and the authorities put her on suicide watch. But as far as I know she never did it again.

I was eating lunch with a friend at college when I noticed a series of neat lines on her upper arm. She didn’t try to hide them. I didn’t ask.

There’s a curious thin line on my right arm where my wrist meets the heel of my hand. I joke that it looks like I tried to kill myself once. That isn’t true, but I’ve never been able to remember how I got it or how long it’s been there.

One time at work, I was chopping vegetables when I accidentally sliced the tip of my index finger. It bled a lot, and I still have a tiny scar on that finger. I still remember how it felt and how my finger recoiled when I cut into it. I can say that it isn’t high on my priorities list to inflict that on myself intentionally.

Self-harm never made sense to me. It seemed entirely counterproductive. You’re hurting emotionally, so you’re going to hurt yourself physically? Now you’re hurting emotionally from whatever bothers you, adding to that emotional hurt from the shame of self-harm, and hurting physically. Didn’t seem like a good idea.

One Saturday night in November, out of frustration and desperation at my inability to fall in love with someone I obviously cared about (for the umpteenth time), and believing I deserved it, I pulled the eight-inch chef’s knife from the drawer in my apartment and flicked the edge with my thumb to test the blade. My three years in a kitchen made sure it was sharp as hell. I set it back in its container, put it back in the drawer, and went to bed.

One Sunday night in November, out of frustration and desperation at my inability to fall in love with someone I obviously cared about (for the umpteenth time), and believing I deserved it, I drew my house key across my left wrist three times. The neat red lines puffed up like cat scratches, and disappeared in a day or two. I never did it again.

The next day in class I Googled whether admitting self-harm to my therapist would require her to have me institutionalized.

It didn’t.