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My first time in a forum. Quick lowdown: I pick primarily on my face. My case is due to a combo of impulse control disorder, body dismorphic disorder, and depression. I've been on an SSRI antidepressant for 13 years and birth control pills, both of which I think have an effect on this disorder, but I'm not really sure how exactly. I am older, I think, than most people writing- 33, I have been dealing with this problem for about 15 years. Don't let this discourage you though; it has gotten MUCH better over the years and I do believe it can be beaten. When I first started picking on my face I would spend at least four hours every day in front of the mirror attacking microscopic specs and imagined bumps...I spent so much time doing this that my upper thighs became dented from leaning against the bathroom counter to be closer to the mirror. I literally had a horizontal line across my thighs that was two inches wide and a half inch deep. It took nearly two years for the dent to go away once I started beating this disorder. I have no idea why the disorder has gotten better for me- maybe my age (chemical changes), maybe more will power, or better stress coping skills, who knows...it's pretty much at the point where I don't pick at all except for a few days before my period, at which time I seem to have little to no control over it. Has anyone else found it to be linked to their monthly hormonal cycle? Any advice? I feel like if I can figure this part out I might finally have this thing beat. I don't have much advice to give, but thought I'd share some of what I have learned over the years... 1. It's important to find a supportive person or people to talk to about this problem; I know it's really hard, but the more I talked about it the less it became my "shameful secret" and the more I was able to focus on getting better. 2. If you're going to try substituting a healthier behavior be careful what behavior you choose. While I think this could be a great therapy, it backfired for me. I had decided that whenever I got the urge to pick I would instead harmlessly pull out leg hairs by tweezer (sounds ridiculous now)...well that quickly turned into me picking on my legs in addition to my face. I haven't been able to wear shorts in 10 years. I recommend a behavior that is "outside of yourself" such as an artistic or musical hobby. 3. Try not to get discouraged if you relapse. Don't blame yourself. It's important to believe in yourself and your ability to concur this. 4. Try to avoid the "spaced out pick"- ask your trusted friend to gently let you know that you're doing it (and try not to get mad at them when they do- they're doing it because they love you and want to help you) 5. Try writing notes to yourself on your mirror with a dry erase marker- mine say things like, "just walk away" and "remember, red, raw spots are way worse than a microscopic spec" 6. Try keeping a journal of your habits- it might help you figure out a pattern to your behavior and/or the things that trigger it (understanding the times that you're not compelled to do it could be helpful too) 7. I found that simply not turning on the bathroom light (unless absolutely necessary) has been helpful I'm starting to ramble so I'll wrap this up. I recommend watching the documentary Too Ugly to Love. I happened across it on BBC the other day. It follows three people with body dismorphic disorder. It might be a good thing to watch with someone that you want to share your problem with but aren't sure how to explain it. One last question- has anyone tried hypnotherapy and if so did it work? good luck everybody.