Tuesday, April 7, 2015

Mental Disorder Conclusion - Dermatillomania

Whelp. One problem of my various disorders is I randomly vanish from time to time. Just a lot of stuff to handle. (A lot of car stuff being part of it.) Plus, I have mild avoidance issues. I like to just go "ugh" and fall asleep. So that's what I did this weekend. That and playing Catherine, which is a puzzle platformer style game with a great story line complete with alternative endings. I got the best possible one.

Taking a break now and then isn't a bad thing. It's just really difficult for me to get back on track. 2-3 days is actually on the lower end of how long I vanish.

And now it's time to talk about a problem that doesn't contribute to my vanishing! Although, it does take up a lot of time. And it can trigger (or is triggered by) my depression and anxiety. This mysterious little disorder is called Dermatillomania.

What is Dermatillomania?

Dermatillomania is not widely heard of. In fact, not even spell check knows what it is, so I will probably have a hundred red squigglies by the end of this. It thinks I'm trying to spell dermatological, which is related in subject, but not what I'm trying to type.

Dermatillomania, also known as Skin Picking Disorder (SPD) is sort of an OCD cousin. The person with dermatillomania picks at their skin compulsively. It can become a pretty big problem leading to an excess of scabs and tissue damage. It also takes a big chunk of time out of your life, with serious sufferers spending hours per day. Luckily mine isn't that bad.

People with dermatillomania exhibit a wide range of behaviors. Some people only pick briefly a couple times a day without even realizing it. Others spend hours picking at a single spot. Most people use their fingernails to pick, but a lot of people also use various instruments such as tweezers or nail clippers. Some people even injest the skin that they pick.

There are two main time periods when dermatillomania starts happening. Puberty, when pimples first start appearing, and around age 30-45, which is when a lot of life stresses tend to come up. As for me, it started during the puberty time. What happens is a person starts picking at the perceived imperfections (I have keratosis, too, which means I get random excess skin bumps.) It becomes a habit and is usually tied to anxiety or boredom.

A shocking figure is that about 11.5% of pickers make suicide attempts. Also, people with dermatillomania are very likely to do other types of self-harm like cutting and banging their heads on things.

There is a controversy over whether dermatillomania is a disorder of its own or a symptom of another. As the primary issue with dermatillomania is the picking, and not something else, I stand by the opinion of the DSM-5 which puts it in its own category.

What treatment options are available to somebody with Dermatillomania?

There isn't exactly a specific cure for dermatillomania. There are some treatments that may help such as behavioral therapy similar to people with OCD, as well as trying to address potential root causes. There are not always root problems. If the person experiencing dermatillomania found a way to stop chewing their fingernails when they were younger, using a similar method may help get rid of or at least reduce their dermatillomanic behaviors.

Also, some doctors provide SSRI's, which do help some individuals.

What you shouldn't say to someone with Dermatillomania.
  • You're crazy/psychotic.
    • We're only as crazy as people who bite their nails, stay up too late, drink too much, or smoke. Our behavior is just less socially normal.
    • If we were psychotic, a treatment of the psychosis would stop the behavior. For a majority of us, it doesn't.
  • Why don't you just stop picking?
    • If we could, we would. Do you think we enjoy the scars left on our arms and face? The pain and irritation? High risk of infection? Ridicule? Not really.
    • Our bodies become addicted to the hormones released when we pick, so it's not really a "habit" we can easily break.
  • I don't see how this is a problem, you're making it up.
    • If you can't see a tree fall in a forest, does that mean it never existed? Dermatillomania is a real problem that affects real people. 
    • Just because we're not covered in blemishes, it doesn't mean the problem isn't serious. The other important factors besides how many scabs we have is how much time we spend picking, how the picking has effected our views of ourselves and our bodies, and how much the picking has changed our lives.
  • You must have really bad skin if you're picking all the time.
    • Not all picking starts from having a skin condition. Some people pick at perfect skin that they perceive as imperfect.
    • Also, thanks for the insult.
  • I pick at my scabs sometimes.
    • That's perfectly normal. People with dermatillomania do it more than "sometimes" and it's not always scabs and acne that they pick at. 
  • I used to cut, so I get what you're going through.
    • Skin picking and cutting are two totally different things, started for completely different reasons. 
    • Cutting usually relates to depression and, though it can be compulsive, it usually isn't a life-long uncontrollable compulsion. 
    • Skin pickers do not pick their skin for the purpose of hurting themselves. Often they don't even realize they are picking until after they've done it.
  • You're leaving marks on your skin for attention.
    • Actually, the marks are our least favorite part of picking. Many people with dermatillomania use make-up or clothing to cover the marks. They reduce our quality of life. 
    • Also, giving attention to them is like social suicide, especially because most people don't understand or even know about the existence of the disorder.
  • Stop taking drugs and you'll stop picking.
    • Very, very few people with dermatillomania are on drugs. Dermatillomania is a disorder, not a side effect. This is very damaging stigma.
    • On the other side of things, people with ADD often take stimulant medication which WILL worsen their picking. 
  • If dermatillomania were a real disorder, it would've been in the DSM a long time ago.
    • A lot of "real" disorders were just added to the DSM. The DSM is a lot like the Vatican in terms of stances it takes, they only want to publish what they are absolutely sure of. With more medical advancements comes more information and therefore the realization of what is going on with people.
  • Skin picking is only a superficial disorder because it's only harming your looks.
    • Skin picking also harms your self-esteem, perception, and body-image.
    • It creates a higher risk for infections.
    • Some people pick to the point of needing surgery.
    • It's not just blemishes, it's tissue damage.
How you can help out the Dermatillomanic!
  1. Suggest they seek some help! Less than half of people who suffer dermatillomania go to get treatment for it. 
  2. If they start picking, point it out. A lot of the time they don't realize they are doing it.
  3. Gift them or recommend to them various lotions, loofahs, soaps, and anti-acne things that they can use. Even though people pick with great skin, I at least don't pick as much when I don't notice any bumps or scabs.
  4. Help us keep healthy sleep schedules and keep to other lifestyle things that lessen anxiety and depression. Those are two potential root causes, so helping one helps the other.
  5. Don't comment on how it looks. We try to hide it, bringing up the scabs and blemishes will only make us more self-conscious and therefore more likely to pick.
  6. Hang out and keep us busy! One of the other causes is boredom. The best way to fight boredom is to hang out with somebody. This way we don't become bored and mindlessly find ourselves in a picking session instead of, say, reading a book or going on a walk.
  7. Likewise, if we text you saying we're bored, reminding us of things that we can do like going on a walk or solving a puzzle might stop us from going into a picking session.
My Personal Struggle with Dermatillomania.

I might have technically had dermatillomania for longer than most people because of my keratosis. All I remember from my childhood is when my keratosis would spike, I would scratch at it and then I would get these scabs all over my arms. My peers thought it was chickenpox. Needless to say I was ridiculed for the marks on my skin.

Then came acne. I started to go after my face more than my arms. This did two things. First, my arms had way fewer scabs because I was focusing on my face. Second, my face was battle-ridden from my picking sessions. It still kind of is.

That's the thing, I'm still picking. I go through bad times and good times, but it's still there. Sometimes I make sure to add an extra half hour to my "getting ready for an event" time just so in case I start picking, I'll still be ready on time.

That, by the way, is how you know it's a problem. When you have to maneuver your life around your disorder is when it desperately needs to be managed. It has taken hours out of some of my days. It has decreased my self-esteem. It has increased my anxiety. I'm just glad I have a name for it, really. Nothing like explaining to people why you've been in the bathroom for an hour, picking at your face.

I'm working on trying to take care of it. I've been trying to lessen my anxiety, which I know is a trigger. I've got more than enough things to keep me occupied. And when I go to the bathroom, I set specific rules about what I can and cannot touch on my face. I'm still trying to get into the "wash my face everyday" habit, but I know that will help as well.

Thank you for staying with me until the conclusion of this mental health spotlight! 

It really means a lot to have people listen to all the things that effect you. Making this series is also great because hopefully it's helped spread some awareness on these disorders. At the very least it's put the names out there one more time.

Alex's Journey will continue it's random subject matter as normal, except with an attempt at posting every day. Minus random vanishes, of course. Those are going to happen. But at least now you all know why, right?

Oh, and for those of you interested in helping out with the car situation, here is the paypal button and a fancy progress bar! From what I know of the car, we have definite transmission issues and potential intake problems. And all the cars problems are expensive, so working towards getting a new car would be beneficial.

That $19 is just me saving so far. After one of my debts is wiped out (FRIDAY!!) hopefully I can make that number climb a little higher. Please consider helping out, it would be much appreciated.

New Car Downpayment

Want to donate some Shinies?
Who is this rad giver?
Note: I heard there was trouble with this donation box thingy, so much as I'm going to regret putting my email address out on the net, you can send me paypal monies using the email address bbnewgo @ yahoo . com

In other news, I'm trying to figure out Minnesota ride stuff. The fiance and I have a ride to MN, but not back. I'm hoping we find one because it's kind of a special weekend. You see, on the 20th, he and I will have been in a relationship for a full year. We plan to go to Baker's Square because that's the place where we first met up. We can't stay until the 20th (a Monday) so we'll be going either that Saturday or Sunday. But as you can see, it's relatively important to me.

Hopefully we'll get a ride. And hopefully they'll have pumpkin pie in stock.

As always, Charmed