A blue humming bird freshly tattooed on Peggy Horan’s right thigh covers scars from her dark past – the nights she spent cutting her fair skin.

Just beneath the bird, “Psalm 32:1” is written. A week before, when Horan knew she wanted the tattoo, she opened the Bible to the page and the passage stood out: “Blessed is he who has forgiveness of his transgression continually exercised upon him, whose sin is covered.”

Horan, now 19, started hurting herself in December 2008. She was going through outpatient treatment for an eating disorder and everything seemed to be going wrong. The Winona State University freshman was in an emotional hole. Digging her nails into her skin seemed to be the only thing that was real.

But soon, that wasn’t enough. Horan had to go deeper – and she did.

Horan is not alone in her story. People are cutting, burning and bruising their bodies; some hiding it where only they can see. Across the nation, there is a high prevalence and a low understanding of the act, according to some self-help officials.

Healthy Place, a mental health Web site, stated an estimated 750 people out of 100,000 self-mutilate. These rates have some self-help officials worried, especially with the lack recognition on the subject.

“(Self-mutilation) is huge,” said Karen Conterio, CEO and founder of the S.A.F.E. ALTERNATIVES program, a nationally-recognized help center for self-mutilation. “I’m blown away by it, even after 25 years in the field.”

When Conterio started the program, most of her patients were in their 30s and 40s. Now, she is seeing kids as young as middle school age. Not many statistics are kept on self-mutilation because it is something that goes along with another emotional problem like depression – but the people who spend their lives helping self-mutilators know just how high the prevalence is.

“It needs to be talked about,” Conterio said.

Horan didn’t like talking about it. The first time she used a razor, Horan was alone in a hotel in California on vacation with her family. She took her shaving razor from her bag and started slitting her knuckles.

“No one noticed,” she said.

That pain was good for a while, but the adrenaline soon wore off. She needed to go deeper. So Horan moved the cutting to her forearms. At first it was once or twice a week, but it quickly moved to once a day.

Horan knew that with the amount of cutting she was doing, she would have to find skin that wouldn’t draw attention. So she moved to her legs – they were easier to cover.

“Only amateurs do it on their arms,” she said.

Conterio said people hurt themselves for many reasons: Stress, jobs, school. They all play their part. But the age of self-mutilators continues to decrease; drawing younger and younger children into the act, which gives a new meaning to the crisis for many officials.

“There is a push to be perfect on kids,” Conterio said.

Horan thought her body had to be perfect. So she stopped eating regularly and exercised excessively. She turned anorexic. After she started out-patient treatment for her anorexia, Horan’s life was engulfed in darkness. She grew depressed and needed a release.

One out of five college students has self-injured, she said. At least, those are the ones who admit it.

Horan told one of her friends once about her cutting. The friend told her that she needed to stop. But the advice ended there. Not long after, she told her mom, who said she was worried and to always let her know when the razor was used. Sometimes she did tell. Then Horan told her therapist, who told her to hold ice in her hand when she got the urge to cut.

Talking about it didn’t seem to help much. Horan still made sure she had access to her Bic razors. They came in a pack with different colors – she would only cut with the green ones. The others would be used for regular shaving. She kept two green ones at hand. One was hidden in her bedroom, the other in the bathroom.

“They were strategically planted,” she said. “If I needed to cut, then I could.”

Cutting became a need to get through the day or to sleep at night. The pressures of school and life were often too much to handle, so she would cut before she left for class. If she didn’t have to cut in the morning, Horan cut before bed to survive her dreams.

When Horan’s eating disorder started, just before the cutting, she was searching some “pro-ana” (pro-anorexia) Web sites. She learned that by wearing a red bracelet on your wrist, you support starving yourself. For more than a year, she wore a red bracelet on her right wrist. Now, a purple beaded one replaces it.

“It is the color of recovery,” she said, fiddling with the stringed beads. Horan wears it every day.

Pat Ferden, director of the WSU Counseling Center, said she sees a few people a month who admit to self-mutilation, but it is always the manifestation of another problem like depression. Because of that, the center does not keep track of the exact number of people who perform the practice.

Horan reached a breaking point in May 2009.

“I knew if I didn’t get out altogether, I wouldn’t be able to go to college and do what I want to with my life,” she said.

Horan took the next few months minute by minute. She kept telling herself she wouldn’t cut.

“OK, I’m not going to cut right now,” she remembers saying. Then it moved to, “I’m not going to cut in five minutes, either.”

But Horan couldn’t put down the razor alone. It took a renewed faith in God, she said.

“Jesus saved my life,” she said. “I’m not the person I was six months ago.”

Horan is still figuring out what she wants to do in life. She knows she wants to continue talking about self-mutilation. It needs to be talked about, she said, and maybe with her story, someone else can be saved.