Let’s jump right in. I have four comorbid disorders – generalized anxiety, depression, ADHD and dermatillomania, aka excoriation disorder, aka chronic skin picking.
These diagnoses were pinned to me at different times of my life. The one that has caused me the most stress, anxiety, self loathing is the skin picking. I was diagnosed with that in my 40s. Dermatologists called it contact dermatitis. Whatever, cowards. If you see it, know what it is, and help treat it, call it out. Nope they’re too afraid to diagnose a patient because they don’t have the proper degree focus. At least talk to patients about seeing a therapist about it.
My ADHD, anxiety and depression have been pretty well treated with acceptance and commitment therapy. I swear by it because I rarely get anxious, my depression is well treated and I successfully managed ADHD without knowing I had it until just a few months ago. What the ADHD diagnosis helped with was bringing my life full circle. I spent the past eight years doing heavy lifting in the self actualization category, so uncovering my neurodiverse brain has created a lot of joy for me. I can easily identify when the poor underdeveloped thing isn’t working quite right, I call it out and celebrate.
“The skin picking, on the other hand, has remained the bane of my human existence. It’s a specter that lives on the OCD spectrum. It’s tricky particularly because of my ADHD. People who pick get a little dopamine and norepinephrine uptake which when you have ADHD is solid gold. And ADHD hyperfocus makes picking really challenging because breaking out of hyperfocus is tough to do for an ADHDer. Not exactly a recipe for success.”
I’ve tried fidget toys, taping my fingertips with scotch tape, mindfulness, etc. The only time I stop picking is when I really, REALLY want to get rid of wounds, because I’m tired of seeing the same damn open wound on my skin. I hyperfocus on wound care/treatment – ADHD takes over as does the little willpower I have.
I’ve tried ACT, fidgets, taping my fingers and any method I can think of to keep myself from picking. Sometimes it works, others it doesn’t.
My arms and legs are scarred to the point of needing laser therapy to correct the damage. My self esteem suffers when I see my marred skin next to someone with beautifully smooth skin. I feel less than because I am unable to control the urges my brain pumps out. Just a fact.
The worst is when well-meaning people tell me, “just stop picking.” Not that simple, dumbass. Once a boyfriend held me down and forced band-aids on my wounds. It was humiliating and frustrating. I broke up with him later.
When I thought I might be an alcoholic (I was self medicating the ADHD), I remember the toxic environment in the rooms of AA when people would talk behind my back and assume I was using meth because of my wounds and scars. I scoff when people laud AA as a great support group. But that’s another blog post.
The good news is – good news being relative – that I’m really good at wound care. If anyone I know has an open wound, I know how to treat it, I even can call out when someone will need stitches. First-aid is my jam. So there’s that ray of light.
For neurotypical folks who think they’re helping by making suggestions… please don’t. Don’t ask how we hurt ourselves, don’t suggest we, “just stop,” don’t provide what you believe is help. It’s painful for us and it makes us feel bad about ourselves.
“To my fellow trichs and derms. I get it. I know it’s hard and can be debilitating. What I would suggest is that you are more than your pulling/picking. You are a beautiful, different thinking individual with a lot to offer who happens to like to pull at things.”
Mostly, I want each and every one of you to remember you are not alone.
