Dermatillomania (Excoriation) in a Bikini

Founder of Millennial Girl, Interrupted, a senior in a small Connecticut high school. I've been through many treatments and recoveries and am eager to share the lessons I've learned!
Latest posts by Olivia (see all)

I have a condition called dermatillomania, an anxiety (and usually OCD) based disorder that is characterized by the inability to stop picking, prodding, scraping one’s own skin. I’ve talked about it before, but here’s a quick recap of it.

I’ve gone through periods of my life where hours, meaning 4 or 5, were spent on the floor of my bathroom, shower running but eventually ice cold while the mirrors are fogged up and I’m curled up and naked, picking at every visible surface of my skin. This would take up the time that I’d possibly spend doing anything else, like seeing friends, doing homework, seeing family, going to activities. My skin would be bright red and bleeding all over clothing and surfaces, and in order to go out I’d wear a smattering of thick foundation and band aids all over my body, if I went out at all. That’s what dermatillomania is.

Now, I’m much improved. I still spend some time in the bathroom, but it’s usually under an hour and the scraping and picking is much less severe. Still, I have spots on my body, as you’ll see in the pictures, particularly scarring on my back and some recent spots on my chest.

I haven’t been as body positive about not Facetuning the spots, and I regret that. I regret even downloading the app facetune at all given its horrible thinning features, but I use it for skin smoothing and spot nixing and for me, that’s nearly as much of a deception as taking three inches off of a waistline. The spots are an inextricable part of who I am.

But it’s embarrassing. I won a Scholastic award for writing about my picking experience and the shame comes with it, and even writing for the judges was humiliating, but that discomfort clued me into the idea that I should write about it, much like my instincts with this entire blog.

The spots are impossible to hide if one wants to be like any other summer beach-goer, ice cream eater, swimmer, vacationer. They’re also impossible not to make. I haven’t shaken the compulsion in the 7 years I’ve been doing it. I wear those 7 years all over my chest, arms, neck, face, back, hips, and thighs. Sun exposure smooths over the red but technically, none of my spots have ever gone away.

If I don’t want to cover up, I have to wear the spots proudly. What does that mean, exactly?

unedited photo #1

It means I’m wearing my anxiety proudly. It means I’m wearing OCD, PTSD. It means I’m wearing a mountain of homework, a dispute with friends, a bad relationship, lack of relationship, loneliness, fear, anger, fear of anger, on my body for all to see. I’m wearing my trauma. Most importantly, I’m wearing my failed attempt to deal with it all.

Picking feels like a failure. It’s called a maladaptive coping mechanism because it does alleviate those pathological feelings, but it does so in a way that ultimately results in more harm than relief.

In the summertime, I feel the most weird, the most alone.

unedited photo #2

It seems as if the bodies of everyone around me are unscathed, on every level. I feel separate from the people around me by virtue of the fact that their pain isn’t visible, so they may as well not have it, because mine is ugly, and gross, and worn proud on my surfaces. I can’t hide that I suffer, with this skin. Others can.

That feeling of exposure is what I wrote about for Scholastic. I don’t have a choice as to whether or not I want to expose my pain. I compulsively pick. I can’t stop. I can make different choices, such as showering at certain times, showering in the dark, avoiding mirrors, and others, but I can’t fully stop the compulsion. At least, not yet!

This blog is part of embracing how bare my dermatillomania renders me. It embraces the part of me that couldn’t be hidden anyway, and exposes the parts that I’d otherwise try to hide. That’s the goal, anyway. I hope to be the person that talks about the otherwise hide-able stuff so others can see it and think hey, I didn’t know that some people don’t hide that, I didn’t know that other people had that at all!

If you see me this summer, please forgive the spots. A lot of effort went into not having them, and they represent everything I’ve written about, here, so there’s much history to them. I’d prefer you not ask. In turn, I’ll try my best not to Facetune them out.
Advertisements

I’m so OCD: Sitting in Uncertainty

Founder of Millennial Girl, Interrupted, a senior in a small Connecticut high school. I've been through many treatments and recoveries and am eager to share the lessons I've learned!
Latest posts by Olivia (see all)

I am absolutely intolerant of uncertainty.

This statement applies to me when I’m gripped by Obsessive Compulsive Disorder. It’s at the crux of the disorder, but it affects every sufferer differently. OCD, particularly of the checking variety, is all about creating a certain outcome with the same compulsion, a compulsion that is alleviating the same obsession.

In particular, a subsection of OCD is a checking variety. Anything can be checked, from stove activity to a partner’s fidelity, and once the fear/worry has presented itself, the check is the path to relief. In an OCD brain, chemical signals disproportionately, frequently fire off that alert the brain that something is wrong! Something is terribly wrong, there is a threat. This threat must be neutralized. The act of the check is really neutralization. I have always commented that once a thought has burst onto the scene of my brain, it’s already over. This is a cynical view of OCD that I no longer subscribe to, but it speaks not only to the necessity of checking but also the difficulty, if not futility, of the process.

I experience two categories of checks. The first I’ll call learned checks, either through upbringing or trauma (the following can be either; I don’t want to disclose trauma just yet). I obsessively check where my parents are at any given moment. I obsessively ask my mother who she’s texting. I used to obsessively check my armpits to see if I’d brushed powder deodorant under them (this could happen many dozens of times a day). I obsessively check if people want to be friends with me, want to be in a relationship with me. I obsessively check to see if I’m bothering, hurting someone. I obsessively check the eyes and habits of others, particularly men, to assess threat levels. I obsessively check my clothing to ensure that it’s situated just so, that nothing is constricted.

An example of a common text exchange between my mother and I. She usually indulges me and responds.

I could go on and on, but my point in sharing this laundry list is to double back and name the corresponding obsession that results in that compulsion. Respectively, I am constantly terrified that my parents are delayed, in car accidents, otherwise hurt, or upset with me, therefore rendering them unable to respond. I am terrified that my mother is texting with someone she used to text with that hurt me, or that she’s texting with someone who will get me in trouble, somehow. I am scared of my armpits being the wrong texture, scared of that feeling of dry skin rubbing against itself. I am terrified that my friends are burdened by me- that anyone is- or that I’m inadvertently hurting someone. I am terrified of being hunted. I am scared of constriction, of appearing disheveled.

Obsession, compulsion. Obsession, compulsion. Round and round it goes. There are two ways to confront the cycle. The first, and the healthiest, is to face it head on, a tactic titled Exposure Response Prevention Therapy. It’s at the helm of anxiety treatment, making it also at the helm of OCD treatment. It’s effective at treating intolerance from uncertainty.

The other method for confronting the cycle is, of course, avoidance.

I employ this tactic when the cycle is simply too overwhelming for me to deal with. I’m known for entirely shutting off my phone for hours at a time to take a pause on what is basically a compulsion machine for me, rife with checking capabilities that escalate exponentially until I explode. My brain starts to buzz and crackle and I need to give it room to calm down and clear out. I shut off my phone and engage in something sensory, like eating, drinking, exercising, bathing. I also use these sensory activities to procrastinate doing things that I know will result in intense OCD-based anxiety, most commonly interpersonal interactions.

The cycle makes interpersonal life exhausting. For a social extrovert like me, such heightened anxiety and need for compulsion performance is a major barrier in the way of my actualizing my desires for socialization, connection and meaningful relationships. I know ahead of time that my terror over whether or not someone likes me, is annoyed by me, burdened by me, will be absolutely sapping. I either jump into the world anyways and become extremely sensorily distressed or I avoid, shutting myself in my room. I am diagnosed with Major Depressive Disorder, but only mild to moderate, and sometimes my OCD symptoms appear to be depressive symptoms because they include barricading myself in my room, under my covers, to neutralize my body and mind and shield myself from certain uncertainty. In these times in my life, I would have been motivated to get out of bed if I hadn’t been so terrified of what awaited me.

As I’ve grown older and experienced more of my fears, it’s been harder to justify avoidance, shutting myself down. I’ve seen the consequences of remaining a room-based recluse: missing a year of school and everything that accompanies that. Been there, done that. I don’t want it. There’s nowhere to go but out, so out I go, forcing exposure that once initiated, is never as bad as the terrorization that my mind made it out to be.

The real solution to fear of the unknown? Experiencing the unknown. Only by forcing yourself to enter into situations that are giant question marks will you understand that question marks aren’t so bad. I was talking to a co-worker the other day, and he asked me if I found that hard, mental illness related situations become easier the more they happen. Oh boy, do I. This summer, I spent a long time sitting in agonal uncertainty that my OCD turned into torture. My brain was “on fire” for weeks, as I put it. As horrifying as that experience was, I’m now more able to cope with others’ delayed response times, among other things, because forcing me into a situation that I was scared of, that presented as the end of the world at the time, showed me that I could live through the things that frighten me the most, the things that I perform compulsions to avoid sitting in.

Maybe my parents are hurt, but they’re probably fine. I should wait a while before checking up on them. Maybe my friends do secretly hate me, but they probably mean it when they say they adore me. I should trust in their assurances and limit asking for reassurance. Maybe deodorant application hasn’t happened in an hour, but nothing bad will come from waiting a bit longer to re-apply. Maybe there is a threatening man around, but the odds are low and I’m safe. I can relax.

Dive right into the things that terrify you, within reason. If you don’t, they’ll continue to terrorize you. The best way to neutralize a threat is to allow it to be, and to know that life will go on if you do.

I’m so OCD: Tics and Tourettic OCD

Founder of Millennial Girl, Interrupted, a senior in a small Connecticut high school. I've been through many treatments and recoveries and am eager to share the lessons I've learned!
Latest posts by Olivia (see all)

A twitch, a bark, a swear, a jerk, a hum. Unprompted. Sounds like crazy behavior, doesn’t it? I used to be disturbed, as a young, reactive child, by such bodily functions. Why are these big, scary people humming, muttering, distorting their faces for no perceptible reason? The unknown was looming and terrifying. I stuck to my mom and twin.

My twin actually developed a tic before I ever did. We went away to an Appalachian girls’ summer camp for a few weeks as preteens and were placed in different cabins. I’d slept in the same bedroom as my sister since birth; I knew well what it was like. I was aware that she hummed inadvertently when stressed. A quick, soft, spurting hum, like a mouse clearing its throat. It could happen in clusters or just once, softly in the night. I overhead, one mid-afternoon, a group of girls gossiping about my sister’s humming, how “annoying” it was. I burst onto the scene, arms crossed. “She can’t help it guys, it’s a vocal tic!”

I was right, even if I was just verbatim repeating something my mom had said. Tic disorder, most commonly comorbid with Tourette’s Syndrome, is defined by repetitive, spasmodic motions or sounds that sufferers unwittingly and/or helplessly engage in to relieve stress. They’re most common, overwhelmingly so, in children and teens. Most adults kick the habit (can’t wait!). There is a distinction between OCD and Tourette’s Syndrome, but the overlap is considerable and there is a diagnosis in the new DSM-5 titled tic-related OCD.

IMG-2128

Though also destructive, this is not the type of tic I’m referring to!

I have a lifelong set of tics that have come and gone, swapped between themselves, and varied in severity. When my PTSD symptoms were most acute, I developed a twitch and need to flex my muscles in my thighs, shoulders and neck. I’d do this several times an hour; it was as if an egg cracked down my body in the way the flexing would travel through my muscles, mildly disturbing to anyone who happened to be watching in those brief moments. Eventually, those muscles would become so sore I’d hardly be able to move them, and I’d move onto my wrists and hands, flexing and writhing them. Once those were too sore, I’d switch back to my more central muscles. Back and forth, always something.

More lifelong tics of mine, and ones that overlap most with OCD, are my facial tics. A common element of OCD is performing a compulsion that needs to be done “just right” in order for it to cease. My picking disorder and symmetry related symptoms are like this, most acutely. Physical tics are like this, too: performed to satisfaction. My facial tics are definitely the most perturbing and sometimes grotesque, and they aren’t commonly activated but when they are (once every few days, or so) they’re hard to stop.

My nose. I crinkle my nose as hard as I can, over and over. It appears as if I’m attempting to pinpoint all of my facial features down to just my nose, squeezing them all towards the central point of my face. My ankle. I twist and turn my ankles until they’ve been twisted and turned just so. My eyes. I slam my eyes shut harder, harder, harder still, until I release them, tearful and sore. My brow. When it occurs to me that I need to crinkle my brow, I do so dozens of times in a matter of minutes, each time more forcefully until I’m finally so desperate to most forcefully and satisfactorily crinkle it that I press the palms of my hands, hard, into my eyebrows to stop them from moving and to apply the pressure I hope will alleviate the desire. It usually does, but not without the accompanying distress of feeling out of control of one’s own facial features. It’s a scary, helpless sensation, and when you add the embarrassment when it’s performed in public, having facial tics, or any tic, is a destructive ordeal.

I actually know an abundance of people with tics (I naturally would; it affects around 1% of the population). A guy I know barks at unexpected, stressful moments. A girl I met in treatment hummed, like my sister. A close friend of mine has Tourette’s, and she bounces and kicks, among a plentiful list of things. Recently, this friend and I were seated at an event behind an older man and his son. My friend, try as she might, could not stop herself from bouncing in her seat. The man apparently detected this movement, turned in his seat, grabbed her ankle, and exclaimed “stop kicking my seat!”

If I’d been there (I was off getting drinks), I would have vehemently launched into a tirade about accepting those with Tourette’s at this man, but as it was, she apologized profusely and she and I swapped seats when I returned. What this occurrence, and the youth camp incident, exemplify to me is that watching others in distress, unable to control their own movements, is inherently scary to most. As a result, “most” lash out or are repulsed by those who can’t control their bodily functions. This extends even further into the very concept of the perception of mental illness at large; seeing folks helpless induces secondhand fear and disgust in others, naturally, others who don’t or can’t understand what it’s like to be the sufferer.

As is the case with most of my explanations of more obscure mental disorders, I would encourage you to try to imagine what your life might be like if you, with all else being equal, sometimes couldn’t control your facial movements when you got a bit stressed. Imagine the humiliation and helplessness that comes with that. Next time you see someone going through what you suspect may be tics, keep such a projection in mind.

I’m so OCD: Obsessive Moral Scrupulosity

Founder of Millennial Girl, Interrupted, a senior in a small Connecticut high school. I've been through many treatments and recoveries and am eager to share the lessons I've learned!
Latest posts by Olivia (see all)

I’m so OCD is a recurring theme. Obsessive Compulsive Disorder is my primary diagnosis and I’ve noticed that there are many circulating misconceptions and misunderstandings of the disorder. I’ll be writing about different compulsions and areas within OCD’s jurisdiction, in the hopes that discussion of it will help foster understanding and compassion.

Severe OCD is my primary diagnosis. It took time for my doctors to understand the role that OCD played in my overall pathology, for while my picking and various other classic compulsions indicated that I did have the disorder, some digging by skilled psychologists and uncomfortable honesty on my part was required to reveal the festering underbelly of my mental experience. I’d been previously both under-diagnosed and incorrectly diagnosed, for OCD is often mistaken for other disorders or unrecognized. Now, I live in the classically frustrating state of understanding my disorder perfectly while having a long road ahead of me to actually change the way my brain works. Understanding is just the beginning step.

The biggest battle I face is the confrontation between my true self and my obsessive/intrusive thoughts. OCD is now understood to be a chemically disproportionate dance between three sections of the brain: the basal ganglia, the orbitofrontal cortex (OFC), and the anterior cingulate gyrus (ACG). In the OCD brain, the OFC and ACG become overstimulated and send hyper-excited messages to the basal ganglia, messages that essentially scream “there is a problem!” While the properly functioning parts of the brain can sense that there is no problem, there remains a system that traps the OCD sufferer within a loop of irrational fear. Though OCD is chronic, and PTSD is also theorized to play a substantial role in these obsessive brain locks, medication and therapy are/will be able to coax my brain out of these loops.

My obsessions fall into a few categories. There are many more categories out there and their scope is impressive. Some folks obsess over things that fall into just one category but to an extreme extent, but while most of my obsessions could be described as extreme, my range is generous. An unanticipated (and ultimately minimally consoling) plus side of this is my ability to speak to so many areas of OCD. In writing this piece, I discovered that if I shoved every category into one post, y’all would be reading for far too long. I figured I should start with my obsessive compulsive relationship with moral scrupulosity, for it’s probably my most functionally interfering.

——————–

A common type of OCD is religious scrupulosity, wherein sufferers experience normal thoughts and desires that they punish themselves for out of fear that they’ve broken their religious code of ethics (sinning, church traditions, etc). Being genetically predisposed to this obsession while also being raised in a non-religious household, I have developed my own set of moral rules that are not to be broken, lest I become a bad or selfish person. I developed this set of rules through childhood influences, for without a religious book or spiritual leader, I had to start from scratch. The difference between this rule set and a general ethical code that folks live by is its reasonability and the consequences of deviation. I’ll let you judge for yourself whether or not you think these rules are justified (I sure don’t!).

Three days ago I burst into tears because a piece of paperwork I needed to fill out for my job asked for my last three addresses and the dates I lived at them, and my father insisted they would only need my current one (he would know, he’s been a member of the workforce for a hundred years, or however old millenial parents are these days…). I immediately launched into an explanation that not filling out the paperwork exactly and extensively would be akin to a crime, and it didn’t matter that they reasonably wouldn’t need all of my addresses since birth to run a background check on me, I couldn’t convey incomplete or mis-information or else I would be a bad person.

When I was in my eating disorder treatment center, I was given a 4 inch binder full of the rules of the house, the legalities of the program, and endless pages of technicalities. I read it over four times, which took me many hours, three nights in a row, only to discover that nobody followed most of the rules in the binder; it was a formality. When I discovered that, rather than shrugging it off and going with the flow, I became extremely, physically distressed. I knew I’d be the weird one now if I tried to stick to all of the rules in the obsolete binder, but I had to! No one else was reporting to the nursing staff if they saw someone else online shopping for clothes. I didn’t want to be seen as a snitch, and I didn’t genuinely morally judge the people who were doing it, but I could not possibly imagine breaking one of the written rules.

Those are recent examples, but I have hundreds of them dating back to my early childhood. I despise jaywalking and will snap at my family and friends for doing it (only because I’m then expected to do it, too). I feel extremely uncomfortable when I swear, and really only do it when it would help me in the social environment I’m in (i.e. when my friends in the moment would think I was weird if I didn’t). I don’t judge others for swearing, but it feels like I’m breaking rules when I do and it makes my body itch and brain buzz. Raising my voice in public, being loud when walking, pointing, are all held by my OCD brain as socially unacceptable, morally unacceptable, offenses that I cannot commit.

Most painfully, I punish myself if I do anything that I have determined to be a selfish thing. Selfishness is my ultimate moral infraction. Accidentally interrupting someone, raising my hand too much, walking in front of someone, failing to tip at least 25%, neglecting to give at least ten dollars to any homeless person I encounter, failing to hold the door open for the next person, making someone jealous, getting something that I know others wanted, receiving specific praise, being praised at all, asking for anything from a piece of gum to a birthday present, a phone call to a hug, “making” people listen to me or talk with me, even be in my presence, all elicit intense internal self-berating and the corresponding compulsion, “sorry!”

Processed with VSCO with c9 preset

A mask I made while in my ED treatment center.  The assignment was to create a mask portraying what we let others see of ourselves. “Sorry” is glued over my lips.


“Sorry” is a bit of a buzzword in my treatment, for it’s a pure compulsion of mine, meant to “neutralize” a perceived infraction that I have committed. I say it when I enter a room, when I start speaking, when I finish speaking, when I request anything from anyone. When in ED treatment, I was given a ticker to count the number of times I said it in a day; I averaged around forty. It is genuine, but I am not attempting to craft a heartfelt apology with it (when I am trying to do so, I’ll say “I am so sorry” or “I apologize”). When I commit an aforementioned infraction, my brain’s OFC and ACG send frantic messages to my basal ganglia that something is very, urgently wrong, and I must fix it! That’s where the compulsive “sorry!” comes in, and I shrink into myself.  When I “commit an infraction,” my brain loses its mind, to put it academically. I panic, I repeat “sorry!” over and over while becoming visibly distressed, which has the effect of both scaring those who observe it and, unfortunately, making them feel guilty for reasons they don’t understand. Why is Olivia tearing up and saying sorry for the seventeenth time? She literally just ran out of paper and had to tell me she didn’t have any to give me. Did I do something wrong? This doesn’t seem right.

That, generic observer, is because it isn’t! I know it isn’t. The logical, rational and intelligent part of my brain knows that my compulsions are unjustified, but the chemically imbalanced part does them anyway. The chemical imbalance is created by OCD (and sometimes PTSD), but knowing where it comes from doesn’t make it go away. That’s the trickiest part of Obsessive Compulsive Disorder. Knowing simply empowers me to go down the right path towards ridding myself of it. That path involves internally challenging my self-punishing thoughts and doing the things that I fear would be selfish. I raise my hand anyway, I make my opinion known. I tip 20%, I give only what I have. I let myself be proud of accomplishments and praise. I stop myself before I say sorry, and substitute in a thank you, instead.

The most harmful effect of my experience with moral scrupulosity is the degree to which it stops me from living freely. A large percentage of my days are consumed by either fearfully avoiding potential infractions or fearfully neutralizing ones already committed. Underneath my OCD, I’m an assertive, vivacious, even confident (sometimes!) person. My true self has a lot of trouble clawing to the surface, and when it does, the backlash my OCD reflects onto it makes exposure seem not worth it.

Even now, I’m sitting at my laptop questioning whether or not I’ve spent too long in this piece talking about myself. What if I didn’t include enough references to objective OCD experiences? Will I be perceived as self absorbed, selfish?

This is literally titled I’M so OCD.

So no, I’m not sorry for writing about myself. Not one bit!

I’m so OCD: Excoriation

Founder of Millennial Girl, Interrupted, a senior in a small Connecticut high school. I've been through many treatments and recoveries and am eager to share the lessons I've learned!
Latest posts by Olivia (see all)

I’m so OCD is going to be a recurring article theme. Obsessive Compulsive Disorder is my primary diagnosis and I’ve noticed that there are many circulating misconceptions and misunderstandings of the disorder. I’ll be writing about different compulsions and areas within OCD’s jurisdiction, in the hopes that discussion of it will help foster understanding and compassion.

“Oh, I have that too! I pick at my nails all the time.”

There’s nothing unforgivable about those sentences. The people who say that to me are usually just trying to forge a connection through a shared quirk, or make me feel at ease in a moment I likely appear to be uncomfortable, or validate their own understandable frustration with a bad habit of theirs. I’m guilty of those things, myself, in other ways. Despite my understanding of it, those sentences nip at me every time I hear them. I wish I knew more people who had Excoriation disorder. Excoriation, or picking as I usually call it, is rare and uncomfortable, and by nature it alienates the sufferer from their non-picking contemporaries.

Excoriation disorder, or dermatillomania, is characterized by the sufferer’s inability to stop picking at their own skin. A few key elements of the disorder separate it from a layperson’s nail habit (and other body-focussed repetitive behaviors). Among other things, the picking must cause significant, function-impairing distress and persist despite repeated attempts to stop. Like any disorder, the thing that really sets it apart from a slump, bad habit, or personality trait is the degree to which it hurts and the degree of helplessness that’s involved. There is a suspected strong relationship between OCD and dermatillomania, with picking often conceptualized as a compulsion.

I’ve suffered from dermatillomania since eighth grade. In the two years preceding the dawn of my disorder, I suffered from trichotillomania, which describes the inability to stop pulling one’s hair out.  My hair part- split down the middle- was almost two inches wide, for I’d pulled out nearly every strand of hair along it. I’d sit for hours atop my bed, plucking blonde strand after blonde strand from my scalp before glancing briefly at it and tossing it behind my bed. Balls of hair accumulated under my bed, and my dog was once spotted munching on one, much to my humiliation (and his delight). There was little to no pain involved, and with each pluck! came the most brief, intimate sense of relief that was quickly replaced by an insatiable desire to do it again. My eyes would glaze over and I would pluck deep into the night, every night. I was twelve. This is the glamor of OCD.

Come the end of seventh grade, my interest in maintaining my looks spiked and I was too ashamed of my bald patch to continue the habit. I bought droves of makeup, begged my mother to take me shopping at Hollister and Forever 21, and renounced trichotillomania! I wish it had been that simple. My OCD didn’t stop, or even lessen. I immediately replaced my hair plucking with something more concealable and insidious. It started with my upper arms, outward facing. I’d keep my nails long and sharp so I could dig them into my skin, forming perfect circles, making just the right scratch, achieving just the right pick. Come the middle of eighth grade, I was glancing down to my arms dozens of times a day, sneaking in a quick pick to tide me over, and when night fell, I’d almost always be found huddled on my bathroom floor, lights bright and blaring overhead, scratching and picking away. I didn’t wear tank tops, and if I did, I’d apply face concealer to my most obvious, often still raw, picked spots. I was fourteen. This is the glamor of OCD.

New Note.jpg
Winter 2017. My mother photographed me with picking spots painted inside of hearts.

My picking quickly spiraled into something worse than just spots on my upper arms. As I entered high school, nearly every spot on my body was fair game. The most popular locations were my upper chest, outer arms, face, shoulders, and knees. Some days I’d be able to limit my quick picks to a dozen or so occasions and simply an hour spent in the bathroom nightly, but if I had a lot of homework, had a nasty fight with my parents or sister, was particularly worried about a social event or relationship, I could spend up to four hours in the bathroom, my shirt spotting with blood, eyes glazed over, music playing and the shower’s steam clouding the mirror over the counter. My bathroom “sessions” stole away time that would otherwise have been spent sleeping or doing schoolwork. These sessions would end deep into the night, and I’d be exhausted and miserable, but I’d be satisfied in a way I didn’t understand. If I didn’t pick for long enough, my body would begin to buzz, so to speak, and the itch would grow until I satisfied it. After “snapping out of it,” I’d douse myself under the showerhead for ten minutes or so before dashing to bed, able to sleep soundly only then. This is the glamor of OCD.

Throughout my high school years, the amount of time I’ve poured into stopping myself from picking and into concealing my picking would be astronomical, if a tally was kept. I’ve bought nearly a dozen bottles of body makeup, many dozens of cheap, CVS stockings, boxes upon boxes of one-inch-by-one-inch band aids. I bought the paid version of the app Facetune to blur out my spots from any picture I would post on Facebook or Instagram. I’ve spent hours perusing the internet for a fashionable, long sleeved swim shirt to conceal my upper body from others in the summer. I’ve basked for many dozens of hours in the hot summer sun, not a drop of sunscreen on me, in an effort to “burn off” my picking spots. Nothing stuck. I’m perpetually scared of the judgement of people around me, especially in the warmer months. I’ve fielded questions like “are those bugbites?” (yes, damn mosquitoes! I’d eagerly say) and “eww, is that some kind of disease?” (yes, damn spattergroit! I should have said). This is the glamor of OCD.

I’ve tried nearly every method I or anyone around me can think of. I wore gloves, taped my fingernails, clutched onto hand-held games (none worked; I’d put the game down, take the gloves and tape off). My parents took me to a specialist at Yale who couldn’t make a dent in it. My psychiatrist put me on a fringe medication that had been shown in a study or two to possibly reduce picking urges. I kept my bathroom door cracked while my parents timed me- fifteen minutes maximum- in the shower, at night. I recruited my friends and family to exclaim “picking!” when they noticed me doing it. One year, I religiously got a very mild spray tan every three weeks based on a theory that if I just wanted clean skin more, as I might when I’d spent good money on a flawless glow, I would be less likely to engage. I didn’t understand that my behavior had nothing to do with what I wanted. If it did, I’d never have started it. I was powerless.

In his book Brain Lock, author Jeffrey M. Schwartz presents a few dozen cases of OCD patients he has treated throughout his career. Each case was different, but one of the threads that ran through them all was a deep sense of shame. The OCD sufferer knows full well that their behavior is ridiculous, unnecessary, a distraction, that it is unsettling for others to watch. Though they desperately want to, they can’t stop performing their rituals. The brain composition of the OCD sufferer is chemically different than that of a neurotypical brain. OCD is not a lost cause, and therapy and medication have been proven to have profound healing effects upon it. It is, however, far more complex than “just stop!” It, and both of the “mania”s, are so much more than just a bad nail habit.

I still struggle with dermatillomania. It’s much less severe than it has been at multiple points in my life, and I understand it far better than I ever have. However, it’s a chronic disorder, and there is a chance I’ll be struggling with this compulsion, to varying degrees and perhaps in different capacities, for the rest of my life.

For me, recognition of what my disorder is goes a long way. I’ve only ever met two other dermatillomaniacs, which speaks to how rare it is. As goes for the other criticisms of the trivialization of OCD, the simple acknowledgement that the disorder exists and is extremely difficult- compassion, in essence- goes a long way. As weird as it seems to you, compulsions are many times more scary for the person who’s chained to them. If you couldn’t relate to my story, I hope it at least helps you reach a better understanding of the various futilities that the people around you engage with. We all want to feel as if we’re in the driver’s seat of our actions, and some people’s brains aren’t wired to feel that way.

We all want to feel as if we’re in the driver’s seat of our actions, and some people’s brains aren’t wired to feel that way.

If some part of my story resonates with you, and/or you suspect you may suffer from a “mania” or OCD, bring up your concerns to your doctor! Social media, socialization and general insecurity make this disorder particularly difficult to speak up about, but doing so is the first step towards ridding yourself of it. Unlike some disorders, OCD is very treatable, or at least manageable.

One way I’m taking control back is by eliminating my habitual Facetune blurring of the pictures I post. It’s a scary leap for me, but it says to my followers, and most importantly to myself, that I’m not ashamed. I used to be, and I may be in the future, but right now I know I’m doing the best that I can. I’m tackling my picking compulsion with my doctors, a medication targeted towards OCD. I’m experimenting with replacement behaviors and reading as far deep into my ailment as possible. As I do those things, I slowly but surely wrestle back control from OCD. If there’s any physical ailment, disfigurement, or similar that you wear, give posting it, unedited, a try! You can always take it down, but I’m willing to bet you’d feel a bit more powerful if you let it out.