I've been a nervous person for as long as remember. Intense perfectionism, a constants sense of responsibility. I have always been terrified of being judged, being wrong, being in trouble. How do you deal with that, so young? I turned to my hands. Thumb-sucking and nail-biting eventually led to skin-picking and skin-biting.

I started picking at my knuckles when I was 12. A small, pink lesion appeared on the joint of my thumb halfway through my 6th grade year. At the time, I wasn't aware of what I was doing; my family and I assumed it was caused by a pencil rubbing against my finger. But it wasn't; by the time I was 14, all of my fingers were reddened with sore, swollen patches of raw skin. I had inflicted these patches on myself.

I think that the skin-picking/biting started off as nothing more than a coping mechanism, a way to quell the anxiety I was feeling so constantly. Seemingly overnight, however, it became so much more. I am constantly aware of "imperfections" on my fingers, bumps and scabs that a person without a BFRB would not be conscious of. Sometimes, these imperfections do not exist at all. If I notice an imperfection, it often becomes all I can think about, until I can "fix" it. As illogical as it may seem, I am striving to achieve what my mind perceives as "perfection". On a good day, my hands are nothing but a part of my body. On a bad day, they have the power to consume me.

The term "body-focused repetitive behaviors" encompasses trichotillomania (compulsive hair-pulling), excoriation disorder (skin picking/biting), and even onychophagia (severe nail biting). Two out of 50 people suffer from a BFRB - that is 4% of the population. Despite the feelings of guilt and isolation that BFRBs can cause, they are not uncommon and not untreatable. For me, a combination of therapy and medication are key to reducing my anxiety and controlling my skin-picking. For others, support groups, holistic treatments, and self-help techniques can help reduce symptoms of BFRBs. Body-focused repetitive behaviors are very real, very debilitating conditions - and there is hope.

I still struggle everyday with anxiety and skin-picking. Somedays, I am successful in channeling my anxiety into healthy and productive coping skills. Somedays, I succumb to the urge to pick at my skin. Somedays, people don't seem to notice my swollen fingers. Somedays, people ask questions or stare. Everyday, I find comfort in my support system and motivation in how far I have come in winning this battle.

If you are the loved one or friend of a person with a BFRB, I ask you to be patient and understanding with us; we don't want to engage in these behaviors, and we cannot "just stop". For all others, I encourage you to live with empathy - don't be quick to judge and don't call attention to things you view as "weird" or "different". If you suffer from a body-focused repetitive behavior - whether it be nail-biting, hair-pulling, or skin-picking - please know that there are resources avaliable to help you learn to manage the condition. I challenge you to reach out to a family member, friend, or medical professional. It is possible to live - to live well - with body-focused repetitive behaviors and other psychological conditions. You are #notalone.

If you or someone you know is in need of immediate assistance, please call 911 or refer to this list of hotline numbers: http://www.teenhealthandwellness.com/static/hotlin...