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Megan is 15 and sometimes she feels like the whole world is coming down on her.

She worries about homework, social problems in school, and her future. Her parents are fighting again. Her dad might lose his job.

She's stressed.

She's anxious.

Megan takes a paper clip, straightens it out, puts the point against the inside of her forearm and breaks the skin. She slowly pushes the four-inch wire under her skin.

Some teenagers become so anxious they deal with stress by injuring themselves. You've probably heard about cutting as a form of self-mutilation. Doctors around the country, including specialists in Seattle, are seeing more cases of embedding.

Dr. Cora Collette Breuner, a pediatrician at Seattle Children's, has seen a few patients who deliberately embedded things under their skin - from paperclips and staples to broken bits of CD cases and pencil lead.

"Once the object is under the skin you would think it would bother some people, but for many it doesn't. That's, of course, a problem," says Breuner.

How common is this? Recent studies suggest that one in five high school students has tried deliberate self-injury at least once, according to a group of Chicago radiologists who first documented embedding. Their study will appear in October's issue of the medical journal Radiology. Embedding is a rare form of self-mutilation, perhaps only about one percent of teens, says Breuner.

Why do young people harm themselves?

"There is underlying anxiety. They feel worried or nervous about something that they many times don't have any control over," Breuner says. "The one they they do have control over is their own physical reaction to something they do to themselves."

Self harm usually shows up in the form of teens cutting themselves. It is far more common with girls than boys, and usually shows up between the ages of 13 and 18.

"I don't think the kids realize the consequences of doing something that can lead to significant damage, not only to the appendage that they've put something in, but in terms of the efforts to get it out," she says.

A few of the cases Breuner has seen involve kids who were experimenting with sticking things under their skin because they've heard about it. But for the most part, embedding and cutting are done by kids who are anxious - not necessarily suicidal. Warning signs parents should look for include an inability to sleep at night, and extreme difficulty concentrating in school.

Breuner says in all of the cases she's dealt with, the kids left "clues" for parents because they want help. They know something's wrong, so a parent might noticed wadded up, bloody tissue in a wastebasket, she says.

Part of the solution for teens is recognizing the triggers that make them anxious. Some kids will find relief through a calm activity like yoga. Others might need a stronger physical jolt, such as sucking on a fireball candy or holding an ice cube in their hands.

If you can get a teen to refocus their attention for about 15 minutes, Breuner says the desire to either cut themselves or embed something other their skin usually passes.

More resources for parents can be found here through Seattle Children's, and here are tips for teens to reduce the urge to injure themselves.

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