This video is from Bethany, a British woman who vlogs as "Freedom, Birdie!" about vegan living and her lifelong struggle with dermatillomania. Also known as "skin picking" or "excoriation disorder" it's a body-focused repetitive behavior classified in the Diagnostic and Statistical Manual (DSM) as related to Obsessive Compulsive Disorder. Patients are unable to resist picking at skin imperfections in an attempt to correct them and often end up causing themselves scarring and damage. Like all body-focused repetitive behaviors it is an impulse disorder - the person is unable to prevent themselves from doing it and may not even be consciously aware of the behavior.
Falling off the wagon
In this video, Bethany talks about having a relapse after being able to keep herself from picking for 180 days - and how she has no clue why she relapsed at this point.
"I've been seduced by the feeling I get, the pay off I get when I pick at my skin."
Some psychiatrists call dermatillomania an "addiction" because it appears that sufferers get a pay off for doing it and may experience withdrawal-like tension when prevented from doing so. And it can be a serious problem - some sufferers may alter their life to avoid anyone knowing about the damage they are doing, by refusing to appear in public without makeup, wearing long-sleeved shirts on hot days, etc. The targeted body areas vary - Bethany's "target area" is her legs, but the face and arms are more common. The fact that it is predominantly experienced by girls and women may hint at a connection between the habit and the pressure women are often under to look "perfect."
It is hard to stop something you do not always know you were doing,
"The sad thing is that on one of my legs I don't even remember creating some of those wounds." In fact, Bethany admits that she even picks at her skin in her sleep - a hard thing to stop.
Bethany has a few more tips. She suggests wearing gloves literally all the time, at least when you first stop trying to change the behavior. She also suggests having your close friends or partner tell you when you are doing it. Keeping your skin in good condition so there are fewer noticeable "imperfections" to pick at may help, although some sufferers will pick at imperfections that are not in fact there. Some of these tips - especially the second - may also help with other body focused disorders. These include nail biting, trichotillomania (pulling out one's own hair) and lip and cheek biting. We all do these things on occasion, but somebody with a body focused disorder simply cannot easily stop. Bethany's channel, thus, may well help other people who suffer from this disease.
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