Dermatillomania can make social situations difficult. I’ve never talked about my experience of it before, mainly through shame and embarrassment, but also because I didn’t realise it actually existed until a few months ago. Dermatillomania is a condition few people will have heard of and by writing this I hope to draw awareness to this demoralising illness. After suffering from clinical depression and generalised anxiety disorder for the best part of 13 years I am clearly aware of the physical symptoms of anxiety and depression, having suffered weight loss, insomnia, and various aches and pains due to my condition. However, I didn’t realise that a ‘bad habit’ I have is actually a diagnosed medical condition closely linked to anxiety. I had never heard of Dermatillomania before but as soon as I started reading about it I realised I probably have it – just another thing to add to the list then! Dermatillomania, or in laymen terms skin picking, has received little public acknowledgement and most sufferers are simply told to ‘stop picking’, which is akin to telling an anxiety sufferer to stop worrying. Dermatillomania is an example of a Body-Focused Repetitive Behaviour (BRFB) and is heavily linked to Obsessive Compulsive Disorder with many sufferers being unable to resist the urge to pick. It is also linked to Body Dysmorphic Disorder (BDD) as the compulsion to pick stems from a desire to ‘fix’ an imperfection, which may or may not be physically real, but actually ends up making the situation worse and turning into (yes you guessed it!) a vicious circle.
My picking is initiated by acne, so the imperfection is real, but the ‘normal’ imperfection of a spot on my face becomes abnormal as I pick it so much it turns into a scab which often looks like someone has used me as an ashtray. I’m ashamed to say that when my fingernails aren’t up to scratch (pun intended) I find myself reaching for tweezers, and, more ironically, my nail scissors. Although I’ll admit to my family, partner, and friends that I pick my spots I’ve never really told them I can spend over an hour leant over my mirror picking and examining my face whilst the posture makes my back ache.
The hangover effect
We’ve all done it. Gone out intending just to have a couple of drinks then got carried away, ended up blind drunk and woke up the next day with that mix of shame and nausea. The garden path perhaps displaying the lovely rainbow of regurgitated cocktails as the urge to vomit wouldn’t subside enough to let us make it through the door, up the stairs and to the bathroom. No sympathy can be sought though as you’ve done it to yourself, no one forced those drinks down you – just as no one passed me the nail scissors. There’s no nausea when I wake up from a pickathon but the shame definitely makes up for it. I dread looking in the mirror to see the damage I’ve inflicted on myself and hope the open sore has dried up enough to try and disguise it with make-up. There’s been the odd occasion when I’ve felt so bad and self-conscious that I’ve not gone to work or to meet a friend, which just adds to my social anxiety. Most of the time, though, I know it is my own fault I look how I do so I carry on, feeling even more uncomfortable in social situations struggling with embarrassment and low self-esteem.
Admitting I have Dermatillomania, and publishing the picture of my scarred face, has probably been one of the hardest aspects of my mental illness to open up about. Not only do I worry that people I know will be sick of hearing about my long list of ailments, I also think they will simply believe that I’ve done it to myself so I don’t deserve any sympathy. That is fair enough – I’ve often thought the same myself about alcoholism. By writing this I don’t want sympathy, I want to raise awareness. For me, Dermatillomania has caused anguish and shame but for others it is so much worse than that. My case is mild compared to many and that is maybe why I feel able to write about it. There is growing awareness of the condition with campaigns such as #BRFB week and online resources which offer advice and treatment options, but in a world so obsessed with image and saturated with media ideals of beauty it can be hard to open up about issues such as Dermatillomania.