I always knew I was a little weird to some extent. OK, I take that back. I was a jumbled ball of weird growing up. I always thought it was just a quirk, but then it began to impact my life, little by little. It would happen a little bit here, but then I would stop myself. But then it would happen again, and much worse next time around. I wasted so much time on it, often doing it mindlessly, but I just couldn't help myself. And that continued for years before I came to the realization that it was actually a problem and that I needed to get help for. But then again, I thought that no one would even get this. No one would be able to help me with my picking.
From the time I was a child, I had always picked at my skin. Fell off my bike and got a scab? Couldn't wait to pick that scab off. Put Elmer's glue on my hand like all children? Felt so relieved to pick it off, even if it wasn't real skin. Got a sunburn? Peeling skin would be extremely entertaining for me. And at first glance, these activities, though pretty disgusting, seem pretty normal for children. I mean most children, most people in general, pick at their skin for some reason or another, whether it's a peeling sunburn or popping a pimple. At some point, however, it's not just your regular pick anymore. At some point, the picking begins to interfere with your life, and that's where my story begins.
As I got older, I started picking even more. But it went beyond scabs that were healed and sunburns and peeling glue. I started to pick at things that others don't typically pick at. I had really bad cystic acne (and still have it today, though it's calmed down greatly), and picked at those bumps even though there wasn't dry skin to pick at. I picked at scabs that clearly weren't healed yet. And then it really began to get worse. It got to the point where I would begin to pick at my skin where there were no "imperfections" and essentially create something to pick at. For me, this took the place of my scalp. When I picked too much, I would accidentally pick deep enough to make my scalp bleed, and then this would cause a scab, and then I would pick the scab and the cycle would continue. It got so bad that I couldn't always hide it with my long hair. When people would ask, I would say my cats liked to play with my hair, sometimes a little too much. This wasn't a lie. My cats did like to play with my hair. But they didn't cause those wounds. No way was I going to admit that I did that. What would others think?
During my sophomore year of college, something happened that led me to figure out what the hell was going on. One morning, I physically could not get out of my bed, and experienced some terrifying rapid heartbeats. I could not move, so I stayed in my bed, paralyzed, scared, trying to figure out what was going on. When the paralysis finally passed, I was so terrified and decided to make an appointment with the university's health and counseling center. Obviously, something was going on, and maybe that episode had something to do with my picking. During that year, I had spent so much time picking. Over the years, my picking had increasingly become worse, to the point that I could not stop, even if I was actively trying to.
Turns out, it did. After a consultation with a psychologist, I was referred to a psychiatrist who diagnosed me with Generalized Anxiety Disorder, and working with my psychologist, we uncovered that my picking had often stemmed from the severity of my anxiety disorder, and from the experiences that were likely the root causes of it. I never received a formal diagnosis for my picking, because very few psychologists study this type behavior, but after much research and several sessions a clinical psychologist, I discovered that my picking was actually a disorder itself and had a name: Dermatillomania.
If you've ever taken an abnormal psychology class, you most likely have heard about dermatillomania by the name it is listed as in the DSM-5, Excoriation Disorder, though you likely defined it, lumping it in with OCD spectrum disorders, and moved on, if your class was anything like mine. People with dermatillomania repeatedly touch, rub, scratch, pick at, and/or dig into their skin. The disorder is classified as a Body-Focused Repetitive Behavior (BFRB), falling into the same family of disorders with the most commonly referred to BFRB, trichotillomania. Dermatillomania affects nearly 2-3 percent of the general population, though because it often goes undiagnosed, the prevalence could be much higher.
The causes of dermatillomania remain unclear. However, studies have shown that it may be both hereditary and a learned, maladaptive behavior, and it is often associated and seen in conjunction with Body Dysmorphic Disorder, anxiety, and depression. Causes that have been and currently are being looked at include dermatillomania as an impaired stress response and growing up in a stressful environment. One thing that scientists do agree on is that skin picking as a result of the use of drugs like methamphetamine and cocaine is unrelated, and caused by different factors than what causes dermatillomania.
Dermatillomana involves the compulsive picking of one's skin. The uncontrollable urge to pick usually is strong during times of tension, stress, and anxiety, and picking takes place in a primary area of the body, rather than everywhere. The most common area is the face, but I personally pick my scalp, and I've met others who pick at their arms, legs, and feet. Skin picking can have drastic effects on those areas of the body, leading to infection, tissue damage, and permanent scarring in some cases. Besides physical damage, dermatillomania has mental effects as well, creating a compulsion to pick and inability to stop, causing feelings of guilt, shame, and embarrassment, and by increasing the likelihood of self-harm. In fact, dermatillomania might increase the likelihood of attempting suicide. Studies have shown that approximately 11.5 percent of those with dermatillomania make suicide attempts.
The reason I share my story, and the information about dermatillomania, is to help in the fight in ending stigma against mental illness. In order to stop the stigma, we must educate us those around us and spread awareness. Ending the stigma starts with us. The other reason is to show others that they are not alone. There are others out there facing similar experiences on a daily basis, and by reaching out to people you trust, you can create a heavy support system of allies around you, and it makes coping a lot less lonely. By standing together, both folks with a mental illness and allies, we can help end the stigma around mental illness. The more we know about mental illness, the more we will understand why we do not necessarily know what others are going through if we are stressed or sad versus someone who is battling an anxiety disorder or depression, why we just can't stop picking despite the many times you yell at us to do so.
Now, over a year has passed, and I have learned more about the disorder. I had told no one about this battle for years, not even my best friends, who I tell everything to, and the number one reason why is fear of judgement. I was even a little hesitant writing this article and sharing it with the public, though I'm very much open with others about my mental health. Anytime you come across someone who has a mental illness, there is an automatic stigma and judgment attached to it. But after about a year, I've finally become okay with it, and have come to terms with the fact that nothing is wrong with me because I have dermatillomania and there is no reason for people to judge me for it. But that's not the case for everyone. There is a stigma still attached to discussing mental illness and mental health. By educating ourselves and spreading the word, we can provide important support networks for those with mental illnesses, we can stop trivializing the effects and impacts of those with mental illnesses, and ultimately, we can stop the stigma and judgment that surrounds the topic of mental illness.
You can learn more about dermatillomania here. To learn more about other mental health topics, I'd recommend checking out the National Alliance on Mental Illness (NAMI).
