Julia's streak of self-mutilation began when she entered Secondary 2.

During lessons, she would sit with her legs crossed on her chair. Then, she would use a penknife to cut her ankle, feeling satisfied only after she had drawn blood.

Julia (not her real name), now 18, even took pictures of her scars. 'I probably thought the scars were quite artistic looking,' she said.

Her self-mutilation was erratic. She would go for weeks without cutting herself, then start doing so three days in a row.

'I cut myself whenever I felt particularly upset. There were lots of reasons. It wasn't caused by a single event,' she said.

'I felt that life was horrible, and I hated school. I didn't fit in with my new class, and I was starting to do badly in a couple of subjects. Also, there was this problem with a boy who upset me, and someone close to me had died the year before.'

She said she did not have close friends to share her feelings with.

'I felt that no one understood me and that I was losing the friends I had.'

'I also didn't get along with my parents. Basically, I was lonely. '

She said that her parents never found out about her self-mutilation: 'I mean, who looks at your ankle anyway?'

But they soon realised that their daughter was unhappy.

She also did not seek professional help, although she sat through a therapy session with a counsellor as a 'one-off experiment'.

'I just wanted to see what would happen if I went to see someone who didn't know me, to talk about a person's death. I was told that because someone important to me died a year ago, the wave of depression could have hit as a delayed reaction.'

After that one session, Julia never went back. She also gave up on seeking professional therapy, as she believed that 'no one could have helped me anyway.'

Her self-mutilation continued for nine months, before it stopped in September that year.

She explained:'I got along better with everyone else, I made new friends and I met this guy who made me want to be the best that I could be, for my sake, for his and for everyone else's.'

'I guess I grew up,' said Julia. 'I also started to put things in perspective and realised that they could be different.'

But, she said, she still had some worries.

'I wouldn't dismiss what happened as 'just a phase'. It showed an inadequacy in dealing with problems properly. Growing up, changing your world view and actively trying to employ a positive mindset helps.'

It has been almost five years since she last cut herself and she is now at peace with herself.

'It's not something that I'm proud of, but I accept it as part of my past, even if it's not a very flattering part,' she said.

Dr Clarice Hong, consultant psychiatrist and psychotherapist at Raffles Hospital, said that teenagers may stop cutting themselves because 'the thing that has perturbed or disturbed them has gone away'.

It may also be that they stop as 'they may realise that it's not doing anything for them'.

This article was first published in Mind Your Body, The Straits Times on Mar 12, 2008.