If you caught someone you know carving up their own skin on purpose, you'd probably assume they'd either lost their fucking mind or joined some kind of cult. Or, even worse, that they were just being edgy and trying to get attention ("Look! Blooood!"). But it's not all that complicated -- self-harm releases endorphins, meaning it literally makes you high. It's the same reason some people find exercise or spicy foods addictive.

Tomwang112/iStock/Getty Images But some people don't want to deal with the fiery diarrhea later on.

So if you ask me why I cut myself, it was for the exact same reason that you fall into your own vices -- I've hurt myself to defuse anger, to punish myself, to feel relief from emotional pain (by giving myself physical pain), to feel something when I'm feeling numb, and to stop feeling bored.

And, like with other drugs, your brain eventually develops a tolerance to self-harm, requiring more and more for you to get the same high. When I started, I would just scratch my arms without even drawing blood, and I could go for weeks without doing it again. Within two years, I was hurting myself for hours at a time, and even required stitches on one occasion. I once stepped into a public bathroom stall to self-injure at 8 p.m. The next time I looked at my watch, three hours had passed. I approached cutting my thigh with the same time-dilating attentiveness normally reserved for marathoning Orange is the New Black.

Netflix At least viewers get to have a year-long break between sessions.

Since most people think of addiction as a chemical thing, this highlights the difference between an "addiction" and a "coping mechanism": Basically, coping mechanisms don't mess up your life. If you get into exercise or knitting, you can build sexy new biceps or a new sweater to cover those biceps with (those two coping mechanisms don't have a lot of synergy). But with an addiction like self-harm, you still "cope" with the immediate problem, but you also get loads of scarring, shame, and a new secret to keep from everyone around you.

And yes, there are withdrawal symptoms if you try to quit (another person with experience in self-harm I've spoken with describes tremors and headaches when they tried to stop). Endorphins function like heroin, so when you stop doing the thing that produces them, your body gets mad as hell and starts screaming for that metaphorical needle in your arm. It's been shown that treating victims of self-injury with endorphin-blockers magically makes them stop wanting to cut.

Ryan McVay/Photodisc/Getty Images "We have this pill that completely cures you, so now we'll roll a 20-sided die and see how much your copay on it will be."

But it gets even weirder. Another person I spoke to, who we'll call Emily, said she eventually developed an allergy to Band-Aids. And she's not alone; it's not technically an allergy, but a condition called contact dermatitis, which develops after prolonged exposure to some irritating substance -- in this case, the adhesive in the Band-Aids that you keep plastering on yourself. Eventually, your skin goes on constant high alert, freaking the hell out whenever that substance touches you. So in addition to being all strung out and achy, now you're breaking out in itchy hives. Because the scars and bleeding clearly weren't making you self-conscious enough.

Considering we know this is an addiction and a symptom of deeper problems, that shouldn't be that surprising -- things used to suck a lot more than they suck now, and their understanding of mental illness was, somehow, even more bass ackwards than ours. But to this day, the average person is mostly in the dark about self-harm. It doesn't help that ...

The point is that when self-harm is depicted in media, it's an afterthought, or worse, something the main character gets over immediately. Degrassi (Yeah, I watch it. What) has featured three self-injurers: Ellie saw a therapist once and got over it, the transgender character Adam indulged during his transition to being male (and never again), and for Cam, well, it was used to foreshadow his suicide, because what other direction could it possibly take him?

But the worst example is Maggie Gyllenhaal's character in the movie Secretary -- she self-harms until her boss orders her to stop, setting the tone for their future BDSM relationship (Incidentally, I had a friend who was into BDSM try this on me once. It didn't work). In movies, if kinky sex isn't causing psychiatric problems, it's curing them, which forces me to conclude that no one in Hollywood has ever had sex.

Lionsgate Films Not being able to use your arms doesn't mean you're cured.

Obviously the point isn't that I'm jealous of all the attention the cooler addictions get -- the point is that the culture has spent an entire generation teaching people to take those addictions seriously, and that make a huge difference. Like it or not, Hollywood depictions goes a long way toward telling us how to feel about things, and movies are full of ruined heroin addicts and tearful interventions. Cutters, well, we're just going through a rough patch, or doing it for shock value, right?

That's why I have to keep reminding people that ...

I'm not saying we need some famous sufferer to come out and take one for the team -- only that self-harm is in a rough patch where it's known, but not well understood. It's easy for a bystander to either panic and declare it a de facto suicide attempt, or write it off as an "emo" cry for attention. And everyone sees it as an adolescent thing, a temporary phase caused by too many hormones and too few opportunities to get your hands on "real" drugs.

Well, when I was at SAFE, I was in the adult unit because I was over the age of 18. Approximately half of the people in our group were over the age of 30. This ratio was even higher in one support group I joined earlier. Most of the adults in these groups started self-harming when they were younger, but a few had started as recently as that year. Studies show that there are plenty of full-on grown-ups, with boobs and beards and everything, who self-harm. These guys think that somewhere between 400 and 1400 out of every 100,000 adults self-injure every year, but this estimate is based largely on hospital attendance, so it's not counting the people who don't "get caught." And while some of these people have been self-harming since they were young (like me), some don't even start until late adulthood.

Oscar Siagian/Getty Images News/Getty Images "For a midlife crisis, it is cheaper than the Corvette ..."

The main reason self-harm is so much more visible among adolescents is that it's much harder to hide self-injury as a kid than as an adult. When you're in school, you're being watched constantly. Remember when I talked about hiding behind plants in college? That happened during my freshman year orientation at a small liberal arts school, when I was surrounded by peers and authority figures 24/7, all of whom were legally required to report anything they saw that was suspicious, because college is high school 2.0.

But once you leave school and live on your own, no one is looking at your wrists. Your employers don't care what you do to yourself as long as you're still getting your work done, and since self-harm doesn't give you a hangover or make you hate-stab everyone in your HR office for being lizardmen, it's fairly easy to slip under the radar. To get help, you have to want to get it. And even then ...

In that case, your only hope is the suicide lines -- but then it's the hotline worker's turn to be confused when you explain that you're not actually suicidal. They don't have a script for that (one hotline worker yelled at Emily for wasting her time). Most of them do try to help anyway, but their suggestions usually boil down to finding ways to distract yourself. Which, gee, why didn't she think of that?

Other counselors suggest some form of self-harm that won't do permanent damage, like holding an ice cube (I'm not an expert, but it seems like that's not getting to the root of the problem, even if frostbite doesn't become an issue). Emily got advice from doctors, books, and the Internet to put a rubber band on her wrist to snap when she got the urge, but she just kept using bigger rubber bands and snapping harder. So ... problem solved?

Keith Brofsky/Photodisc/Getty Images The only benefit was terrific resistance training.

You can try talking to your friends, but that's tough when your addiction is still stigmatized as a pathetic, "emo" plea for attention. Well, let me offer this as advice: if someone you love is pleading for attention, there's nothing pathetic about that. It's part of being human.

When I was at SAFE Alternatives, we had to fill out these logs whenever we wanted to hurt ourselves, and one of the questions was "What are you trying to communicate?" This seemed insane because I had done everything I could to hide my cuts. I'd tell people that my boyfriend's cat scratched me, or that I fell into a rose bush on the way home from school. Eventually, I started cutting myself in places I didn't expose to the public, like my thighs and breasts. When my freshman year roommate caught me and turned me into our RA and the dean of students, I spent the better part of three days doing what I could to avoid all of them, literally hiding behind plants, sleeping in other peoples' rooms, and leaving for class extra early to avoid meeting them in the hallway. How could it be about communication if I was spending so much energy keeping it secret?

studiovespa/iStock/Getty Images "Turtlenecks in July is totally a fashion trend. Just check Vogue."

As they explained it, all action is a communication, even if it's only to yourself. One of the most gratifying things anyone ever told me at SAFE was that attention is a basic human necessity. All people have social needs, and if they're not met, we fall apart. Yes, people do hurt themselves to control other people, but they also hurt themselves because they desperately need a problem solved, and this is the only thing they can figure out to do. Fear of being seen as a whiner made me more likely to self-harm, turning the whole thing into a circular ouroboros of bullshit.

But hopefully society will come around on this, the same as it has on other addictions. So if you find out somebody close to you is doing this, don't freak out about it, but don't ignore it, either. After all, there's more of us than you think.

Lauren Ipsum lives close enough to Disney to see their fireworks from her apartment. She can be found on Tumblr here.

For more insider perspectives, check out The Gruesome Truth About Getting Shot (a First-Hand Account). And then check out The 30 Most Ill-Conceived Movie Monsters.