Riley Butturini is a typical teenager. Her pictures on Facebook show a fun and carefree 17-year-old student at Farragut High School.
But what you don't see in the pictures are the scars that can come with being a typical teenager.
"If you're not like a cheerleader or you don't wear a bunch of makeup caked on, no one gives you the time of day," said Riley.
With every page turn of a fashion magazine or click on a social media site, girls today are bombarded with images of perfection. For Riley, those pressures combined with her parents' divorce and a traumatic relationship with a boyfriend sent her into a tailspin. She dealt with the turmoil by turning on herself.
"At first I would just read a bunch of books. It stopped helping out so I started cutting," said Riley. "It didn't hurt at all. It made me feel better afterwards."
Knoxville psychologist, Dr. Renee Repka says studies show one in five girls engage in some form of self injury. The behavior is called Non-Suicidal Self-Injury.
"This is basically any behavior that is self destructive but not suicidal," said Dr. Repka.
Dr. Repka says girls who cut, burn or hit themselves are ironically trying to cope with emotional pain. So often, they are girls you would least expect in distress.
"They might be in their church group, they might play athletics, they might take honors classes. They are doing all of that. Where that comes from is it comes from our culture. Be everything, do everything, it's in the media. Your hair should look good, flat ironed face is beautiful, all of that," said Dr. Repka.
At its worst, Riley would cut her arms and inner leg up to 30 times a month.
"It's not like I wanted to kill myself. I wasn't cutting deep; it was like a scratch," she said.
All the while, she was trying to hide the scars on the inside and out from her friends and family.
"During the summer I would wear hoodies and be like sweating," she said.
Finally, Riley confessed it all to her father.
"We hid every sharp object in the world. That didn't work. She would take apart disposable razors. She would break light bulbs, anything to cut," describes Riley's father, Jack Butturini.
But it's what a friend who also cuts said to her that ultimately made Riley want to stop harming herself.
"Her doctor was like 'you can't get rid of these scars.' She told me 'I want to walk down the aisle when I get married and people see a bunch of cuts.' So I was like 'I'm going to stop,'" described Riley.
With help from counselors at the Helen Ross McNabb Center, she has stopped. Jack says talking is a must. It's paramount parents pay attention.
"I think it would be similar to whether your child is taking drugs or alcohol. Watch for those signs of being withdrawn, changes in their behavior, and be open to talk to them and most important, let them talk to you," he said.
Riley just celebrated a milestone-- one year free of cutting herself.
"I don't even have the urge to do it anymore," she said.
She's still working on self esteem issues, but now with help, she has hope.
Dr. Repka also urges parents to be aware of their child's behavior. If you suspect a problem, she recommends talking to your child's pediatrician or family doctor as a first step.