More than just a bad habit
HOW A HABIT CAN BE A SIGN OF SOMETHING MORE SERIOUS
(Annie Spratt / Unsplash)
Brush, brush, brush.
Once I start picking, there’s no going back. At least, not until I wash my hands to reset my mind. So, I brush and brush and brush. Did I get all the flakes, all the white pieces of my scalp littered throughout my coarse, curly, dark hair?
Until 2021, I thought I just had a lifelong bad habit.
When I was little, I constantly bit my nails and picked my cuticles. My family tried to get me to stop for over a decade. One time, my babysitter painted my nails with a clear coat, which turned out to be a no-bite nail treatment. The taste was awful, but I became tolerant of it because I physically could not stop biting.
In high school, I moved from my nails to my scalp. Little by little, the slight picking at small pieces of dandruff turned to hours of digging and digging into the layers of my scalp. I was having a hard time focusing in class and keeping my hair clean because I was always picking. I was embarrassed, but what else could I do to relieve the itch?
At first, I thought I just had a really bad case of dandruff. My hair is naturally very thick and curly, so it takes forever to dry. My mom thought maybe I just wasn’t rinsing out my conditioner well enough. Both options made sense, but how was I to know what was really going on? I finally went to a dermatologist who prescribed me ketoconazole shampoo. I guess she thought it was just bad dandruff too. Needless to say, the shampoo didn’t stop the picking, so was it just a bad habit? Or was there another issue?
To some people, a bad habit is what my constant picking will always look like. I now know that I live with dermatillomania — a skin-picking disorder that affects one in 20 people. Some people confuse it with trichotillomania, a hair pulling disorder. Except, I don’t pull my hair. I pick my skin, my nails, and my scalp. Not in the usual way that one would pick a piece of dandruff from their hair or a hangnail from their cuticle. I pick a flake or scab until I’ve managed to dig so deeply that I start to notice the soft, bloody bits of skin appearing under my fingernails. Or, I try to pick a hangnail or piece of loose skin around my nail, and before I know it, I’ve managed to pick and pull at my cuticles until there is blood and searing pain under my knuckle. Sometimes, I don’t have the patience to pick. So, I use my teeth. I bite and tear at my nails and skin until they are bleeding and sore.
For years, I thought this constant picking was somehow a weakness on my part — that if I just put my mind to it, I could stop. I could be free of the guilt and shame. Then, I learned the real reason I constantly pick.
During my sophomore year of college, I read through the DSM-V. “It’s just for fun,” I thought. Little did I know, I would find that my skin picking is a symptom of mental illness.
Dermatillomania is a body-focused repetitive behavior (BFRB) often associated with conditions like OCD, anxiety and ADHD. As someone who also struggles with self-harm as a coping mechanism, I can tell you that dermatillomania is NOT a form of self-harm. And, it is difficult to treat as it usually requires behavioral therapy, not just medication. For a while, I thought my skin-picking behaviors related to my General Anxiety Disorder. Except, I pick when I’m both bored and anxious. Does that mean I have underlying anxiety all the time?
Recently, I learned I have borderline clinical ADHD as well. I’m still coming to terms with the diagnosis. It’s clarifying the reasons for my behaviors, but it’s also complicating my understanding of what I’d already decided was the problem. What I once thought was anxiety-induced is now also ADHD-induced. But when is it anxiety, and when is it ADHD? Does any level of OCD factor in? I have no idea.
The big question was, and still is, why do I do it? Why have I picked at my skin since I was a child, and why did I have to read the DSM-V before I had a reason to validate my picking as something beyond my control? Couldn’t someone have just told me?
I’d known for years that I was living with anxiety. But dermatillomania is not well known in the mental health community, and definitely not in the everyday world. Even today, Microsoft Word doesn’t recognize dermatillomania as a word.
Though mental health stigma is being broken slowly each day, it is still hard to convince people that mental health conditions affect the physical body in one way or another. I pick not because I just have a bad habit, but because my brain recognizes it as a coping mechanism for a mental illness.
I’m realizing now that I pick when I’m bored and restless, when I’m anxious and stressed, and even to keep my hands busy so my mind can focus. On top of that, I pick whenever and wherever to appease the perfectionist within me. There is no limit to where, how long or how violently I pick my skin. Though I’m getting a lot better at fighting the urge.
I don’t know that I’ll ever be able to stop, to be rid of this “bad habit,” or if I’ll ever even truly understand it. But I can bring awareness to the condition - I can research, write, speak up and support others who struggle. And I can still live a life worth living, even with dermatillomania.
If you struggle with constant picking or have another “bad habit,” I hope my story encourages you to seek help and realize that maybe your habit is a sign of something bigger.
This piece was written and shared during the IDONTMIND Writing Workshop. Learn more about our free, nine-week course and be the first to know about the next workshop here. Visit Mental Health Connecticut’s YouTube channel for a video version of Rebekah’s story.
Rebekah is a senior Mass Communications major at Toccoa Falls College. When she's not writing for school or leisure, she's probably sipping iced coffee, lifting weights, hanging out with friends, or editing her school newspaper. She hopes to use her writing to share truth and encourage others that they are not alone.
