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MKM , 03 Mar 2019

Anyone have success with a particular medication?

Hi There,
I’m a lip picker. Started about 20-yrs-ago. At first I thought it was just dry lips, but it definitely is some type of anxiety and OCD issue. I had issues with depression, anxiety, and even eating disorders, (worse in my twenties). I’ve had a lot of individual and group counseling that has been extremely helpful, but still can’t seem to shake the lip picking. I’ve stopped other bad coping habits like nail biting, bulimia, and smoking successfully. Lexapro and counseling has helped tremendously with the depression. Anxiety is still an issue, but not severe. I find exercise and meditation helps manage anxiety quite a bit. However, Sometimes I think there may be more underlying anxiety than I really perceive, because I find I lip pick during stress. Though I pick when concentrating on something too. I was reading something about gaba receptor issues in the brain causing obsessive compulsive issues. Namenda may help with this. Does anyone have any feedback regarding their experience with meds?

7 Answers
serene
March 03, 2019

How many years did you struggle with bulimia and nail biting? How many years did you smoke? I never heard of Namenda....is it a new medication?

serene
March 03, 2019

I also read about a study which compared body focused repetitive compulsions to obsessive compulsive disorder. In body focused compulsions, there are only select areas of the brain which do not work properly, while in regular OCD the whole brain seems to be affected. Having had multiple types of OCD over the years and having overcome that, I would say that there is a difference in how these disorders feel. Do you agree? When I had other types of OCD, my mind seemed to be always on fire, always contemplating the obsession. But with the skin picking it comes and goes in severity. I would say it is influenced by hormones to an extent, and I guess by the look of my skin. But there is a difference in how the mind is affected, and I would say that the regular OCD was much more painful for me. It often felt unbearable, and the skin picking feels less painful in it's emotional anguish...it's just the physical effect of the picking that brings on guilt and sadness.

MKM
March 03, 2019

Hi Serene,
You know what? Come to think of it, embarrassingly, I sucked my thumb until 11y.o., bit my nails when I was younger, then stopped when a teenager. I smoked off and on from teenager to mid 30’s, then finally stopped for good. I started bulimic behaviors around mid-20’s until early 30’s. Group therapy, counseling, and starting Lexapro in my late 20’s helped with bulimia. I struggled with the behavior for awhile, then finally stopped for good about 10-yrs-ago. The bulimia was very stressful and emotionally painful. There was a lot of shame with the eating disorder and a lot of emotional issues, self esteem issues, and body image issues. I agree the lip picking is not particularly emotionally painful, except for the fact, I can’t seem to control the behavior. It feels like a whole different entity. I do it when stressed, but I do it absentmindedly, and when concentrating on something too. I battled with depression and anxiety since adolescence, but don’t feel particularly depressed anymore. I do notice an underlying anxiety and wonder if that is contributing? Overall though, I feel so much more healed than in the past. How about you? What is your history?

MKM
March 03, 2019

I agree it seems like a totally different part of the brain. Apparently, Namenda affects the gaba levels which is thought to be a factor in excoriation disorders. I also just read n-acetyl cysteine May reduce the behavior. I just bought some on Amazon. I’ll let you know. What have you tried that helps?

serene
March 11, 2019

To sum up my history....I began nail biting at the age of 5. Looking back, I suspect that my parent's unhappy marriage dynamic might have been the reason. I remember feeling scared and stressed out whenever they would argue/threaten divorce. This most likely prompted me to start biting my nails as a form of self soothing ritual. Then at around the ages of 7, my family moved to the states from Russia and things sort of escalated for me in terms of new mental issues. I had my first extreme case of OCD at age 8. From then on it tormented me severely until the end of high school. All types of varieties of OCD, they would constantly change and morph into new versions. And then something odd happened, the OCD began to come and go, with breaks of time in between the episodes. Over time the breaks began to be longer and it gradually faded away. So, OCD began at 8 and disappeared by early twenties. I still at times get false memory OCD and other very slight nuances of it...but nothing soul crushing as it was before. I can easily live and not worry about that issue.
The skin picking began at around 15 and is still ongoing by age 30. What I notice with the skin picking is that it also fluctuates. I had two years of extreme picking after getting married, and now im monitoring it and taking care of my skin as best as I can...so now its moderate to minimal. Miraculously, my nail biting stopped at 27 years of age....something I attribute to getting married and moving away from my family. I did battle that habit for a long time as well. I would always make sure to paint my nails and take good care of them in an effort to break the habit. Every week I would paint them a different color just as a distraction measure. I noticed that when my nails looked good I was less likely to bite them. This is the same way I feel about my skin. Yet for some reason I think the stress of getting married and moving away from family actually helped to eradicate that compulsion. The subconscious process of the habit being tied to an unstable parental dynamic might have been the real culprit.
Anyway, the skin picking has lasted 15 years so far. I have never had an eating disorder, maybe because I was always naturally very thin to begin with. I was actually hounded by my dad that I was too thin, and I felt shame in being too thin ...so I actually did the opposite and tried to eat more at one point. As of now I am of a good weight and it doesn't bother me. If I gain extra pounds, I know that I can control it and lose weight through exercise, so I dont get hung up on my body. Yet I do have very low self esteem and looking in the mirror almost always makes me sad. Less sad when I have makeup on, but overall I'm not a fan of my looks. For me, everything is centered around the face, particularly the skin. I never liked my hair either, but thankfully I never developed a hair pulling habit.
As for smoking, I did smoke cannabis and at times cigarettes during my late teens to mid twenties. I would say that I became psychologically dependent on the cannabis, but never addicted to cigarettes.
I have always had depression and anxiety, its part of who I am and it has had a major impact upon my personality. Since I had these issues from such a young age, and at the extreme severity at which I felt them... it definitely had a drastic effect upon me.
The underlying anxiety you feel would probably be described as an inner tension? I think its when we internalize the anxiety...as a means to somehow handle it. And when the mind chooses to detach from it, to deny it to some extent, the body keeps the score. We start to feel the anxiety within us, as an inner tension.
I still get depressed but have come to think of it as my norm now. I stopped fighting it. There is no point to fight it when it will keep on happening. Sometimes I get severe depression for about 2-3 days, to the point where I have no desire to do anything but lay in bed.
I do feel healed in certain aspects. I am thankful that I do not have the OCD anymore. It was worse than skin picking, worse than depression, worse than anything because it feels like mental torture. Comparing OCD to depression, I would say that OCD feels tormenting and unsettling, while depression is a complete shut down of the mind. Yet, im also not thrilled with the physical manifestation of the skin picking. I cannot hide it, while the OCD I could hide and look normal from the outside. The skin picking causes shame and I hate having to hide on bad days. Hopefully this issue will dissipate in time, im just waiting it out and doing as best as I can to minimize it while its occurring.

akaztkl
March 16, 2019

Luvox and Prozac are supposed to minimize skin picking compulsions. Unfortunately, there is not a lot of research on medication for skin picking. I have been taking Luvox (fluvoxamine) 200mg and this has helped subside it. I still suffer from relapses though, particularly when I first started I found my picking got worse but once I reached the 200mg I stopped pretty much completely. Be careful though, I changed generics and this made me much worse (Movox does not agree with me) because the medication has different fillers they can sometimes be less effective on certain people. I've had a very similar mental health history to you and found that Prozac really helps with anxiety but didn't do much for the picking. Luvox (on a high dosage) is the most effective for picking.

amythor6
December 05, 2023

I’ve been using sertraline for the past year; that worked for me and I have stopped picking completely. It might work for you or it might not. See what you prefer. 

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