I will be the first to admit it -- I compulsively pick my skin. Chances are you pick at your skin too, but please don't tell me about it in a response to learning about my story unless you understand what a confession of "I can't stop picking my skin" really means.
I have a condition called Dermatillomania, although it just entered the DSM-5 this year under the name "Excoriation Disorder". While the main criteria of this disorder is repetitious skin picking, the act of picking does not in itself define the disorder. You must meet four other distinct criteria to be medically diagnosed with this disorder:
- Repeated attempts to stop the behaviour
- The symptoms cause clinically significant distress or impairment
- The symptoms are not caused by a substance or medical condition (including dermatological)
- The symptoms are not better explained by another psychiatric disorder
With being a prominent mental health advocate in the Body-Focused Repetitive Behavior (BFRB) community, I come across many people who tell me that they too have Dermatillomania. Through each confession, I gain a glimmer of hope that I will find someone else much like myself who has experienced the shame, guilt, discrimination, and embarrassment I have in not being able to escape this vicious cycle. I cling to my desire of connecting to someone who truly understands by sharing my struggles and seeing if they are mirrored in another person's experiences.
It is not until I ask one simple question do I learn if someone's skin picking transcends into a considerably problematic behavior: "How does your skin picking affect your life?" Most of the time, I get responses such as "Well, I have to put makeup on a mark once in awhile" or " It's just annoying" and I learn that a few of the scarce supporters we have on our side still don't quite understand what this disorder entails.
In these situations, I end up feeling more alone than ever. I feel like the misconceptions about this disorder will triumph its true definition and some people will pursue a diagnostic manhunt to pin this to their chest with a collage of other diagnoses. Telling me you know what life is like with Dermatillomania when you do not pick to excess is equal to telling someone with an eating disorder that you understand those hurdles because you diet every now and then.
"I never knew this was a problem until I read that skin picking is a disorder- so there's something wrong with me?" The answer to this is no. If you have went through life unscathed by your skin picking until an article brought it to your attention, then you addressing it as an issue will only undermine those of us who face scrutiny, even by the mental health community. Before the literature was readily available, sufferers already knew they had a problem were unaware that anyone else in the world had this or that a term was coined to describe this affliction. To a sufferer, there is never a question of "Do I have this?" We know because we feel like we created the disorder for ourselves out of thin air.
Unless your excessive grooming is destroying your life, preventing you from engaging in social activities, or even keeping you celibate in fear that your marks will be exposed to another person, please do not mention in passing that you also pick your skin. It minimizes the despair we feel and has the power to push us into further isolation, even if your intent is to reach out to let us know we aren't alone.
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