Mental Health Adventures: Confessions of a Dermatillomaniac

I’m writing this post on the back of a very shitty sleepless night, borne by a downward spiral of anxiety from somewhere deep within the pit of my brain. I’ve had a rough couple of weeks dealing with what for me is one of the biggest, and most visible, symptoms of my anxiety disorder.

My core diagnosis is Clinical Depression along with Generalised Anxiety Disorder (don’t be fooled by the innocuous nature of the word ‘generalised’; it’s anything but). While that in itself is constantly humming away in the background telling me I’m a useless waste of space & that my best years are behind me and other such joyful thoughts; at the moment I’m currently dealing with a physical manifestation of the worry and restlessness going on in my mind and body.

Raise your hand if you know what Dermatillomania is? Or Compulsive Skin Picking (CSP) as it’s more commonly known. This website (click here) gives the medical definition and a more objective explanation. As symptoms of anxiety go, it’s an utter bastard. The most vicious of circles. You’re drawn to tackle imperfections on the skin (be they the odd normal kind of spot we’re all prone to get at any age, or those teeny tiny blemishes only visible to you). Armed with a sharp tweezers and a magnifying mirror that would find an ingrown hair on the arse of an ant in the dark, you set upon said blemish with the furrowed brow and concentration of a neurosurgeon. After a half-hour, you give up. But it’s not over; not by a long shot.

A while later, you come back to it, noticing that now it has a tiny scab resulting from your previous effort. Lord knows, we can’t have a scab on our face, better pick it and get a smooth face once more. Ah shit, a little bit of blood. Tiny dab of tea tree oil on the now slightly bigger mark, you swear you’ll leave it alone now to heal. You didn’t need the magnifying side of your mirror that time.

Next morning before you’ve even fully woken up your nervous hands are right up to your face checking for any lumps or bumps. You think you find one, so you scratch and dig. While you’re at it, you attack the self-inflicted wound you gave yourself, which is now quite sore and bruised. By the end of the day, it will look like someone stubbed a cigarette out on your face.

Click on the pic to read a fantastic & honest piece from a teenager suffering with the same condition.
                    (pic courtesy of Teen Vogue)

After an evening of constant scratching, pulling, digging (either with your nails or a tweezer), your face is raw, scabby and weeping at various points, smothered in small patches of pure white soothing Sudocrem like some sort of reverse Dalmation pattern. Your hands and nail beds are tender and sore as hell from working non-stop to sort out those pesky ugly blemishes. You caused these all by yourself, ironically enough, in an attempt to not have any marks or imperfections on your face in the first place. Good luck making any sense of that. But there you go.

It doesn’t stop there. My chest, shoulders and back are scarred to fuckery from at least twenty years of me clawing desperately at my body looking for something to dig at. It’s a sick form of occupational therapy, I guess. But it’s no fun. I remember being in sixth class sitting at my desk trying to concentrate on what was going on, but on my forehead was a great big scab from my efforts the night before, so all focus turned on to getting rid of this unsightly wound. Unfortunately, I picked a bit of a gusher, and before long, the two cuffs of my school shirt were dotted all round with dried blood, and my forehead was so sore and becoming infected from being got at in the open, surrounded by germ-ridden pre-adolescents at every corner.

Because my anxiety and compulsive nature clearly don’t do things by halves, and I’m clearly hell-bent on self-destruction and defacing myself for others to see and judge, about 90% of all my skin-picking is done on exposed parts of my body. Has been since it all started. I know if there’s something in that, but frankly I’m at an age where I really don’t have time to spend dwelling on what went on in my past or whatever or forgiving my inner child – I just want to know what I can do to retrain my brain into not wanting to literally flay myself every time my idle hands summon the devil.

Nothing sets you up for the day like lying in your bed for two hours, pretty much rendered immobile while your anxiety and dread rages on. Your fingers begin excavating your face, back, and shoulders until you eventually emerge from your bedroom almost in tears, stopping only to wash the blood off your hands and the skin and gore from under your nails. Any makeup you wear stings like a bitch, but if you don’t want people staring at your cigarette-burned face (because they’re long past looking like normal spots) it’s got to be done. As you can imagine, it only works for a limited time, because when you’re sitting quietly alone, you’ll do it all again, attacking yourself layer by layer, whether you’re in public or not.

Before I found out this carry-on had a name. I had been familiar with people tearing their hair out as a compulsive habit, and the torment it caused people who suffered from it. I saw pictures of poor souls with entirely bald patches of scalp dotted throughout their once crowning glory, and completely understood where they were coming from. My doctor started remarking on the marks a few years ago, so I knew I was probably becoming worse. I was told it was almost like a passive version of self-harm, which made sense as I’ve been down that road at quite a few points on my journey through mental health issues.  At my most mentally unwell, my upper body and face would provide a bloodied, scabby illustration to accompany the chaos inside. At the very least, it’s Minus Craic. At it’s worst, I’m in danger of permanent scarring, painful skin infections, and a return to more active forms of self-harm.

Treatments vary depending on what the root cause may be. Skin-picking is quite common in chronic drug addicts who, while in a psychotic state or in the midst of hallucinating, believe that there are creepy crawlies or microchips under their skin and they desperately feel the need to cut them out, but that isn’t classed as Compulsive Skin Picking, more the consequence of a serious addiction. It’s those of use who do it constantly every single day while functioning and sober in our regular lives – be it from nervous energy, boredom, anxiety disorders, or possibly from Body Dysmorphic Disorder.

As a result, the treatment can be fairly flexible. Medication such as anti-anxiety or antidepressants may be prescribed to help in extreme situations, but speaking as someone who has been on regular antidepressant medication for a number of years and is still dealing with CSP on a regular basis, I’m starting to do some research into Cognitive Behavioural Therapy as a viable option. Having done an introductory course with the fantastic (and life-saving) organisation Aware (click here for their website), I’ve experienced fantastic results in other areas of my life when I apply what I’ve learned to various triggering situations which in the past may have sent me into a downward depressive spiral. So one of my goals for this year (not a resolution, that word just screams ‘FAIL’ to me) is to make a wee plan for myself on how to retrain my brain and somehow break the habit of a lifetime. I’ve got high hopes for this; because as dodgy as my mental health state can get at times, I’m really quite fond of my brain. It’s just a bit poorly, so it needs a bit of help re-setting some parameters so it can function better. This whole ‘wellness’ thing is a lifelong process, so constant upkeep is required. This is just one of those parts of my life that needs a bit of tender loving care at the moment. We’re all in this together. BE GRAND.

<3

Helpful Links:

Aware: http://www.aware.ie/

Help for Hair Pulling and Skin Picking : http://www.trich.org/about/skin-picking.html

How I’m Living With A Skin Picking Disorder: Click here to read a brave & painfully honest account from a teenage perspective..