Last week I hinted on my Instagram (you can find me here: @rhamiltonbyline) that I was taking some new steps for my mental health. This post is one of them. Consider that your warning for some raw, open, ugly emotions.
I finally have come to understand that I suffer from dermatillomania (or excoriation disorder, it’s your choice). Better yet, in layman's terms, I obsessively pick at my skin. I have had acne since I was about 10. We always shoved off my acne “it’s just puberty”. Around high school I started to pick at my acne. Typical normal teenager behaviour, even typical adult behaviour.
Thing is around age 10, I also started to experience anxiety and depression. Mostly depression, I was bullied about many things. Sure, kids will be kids, bullying is a natural part of life in my opinion, doesn’t mean it was easy. Nor am I placing my mental health struggles on those people who bullied me. They too need love. But it’s a factor that builds my story. It’s a piece of me I have to be open about it in order to accept it. Acne is ugly to begin with, but scabs are just as nasty. I can’t blame them for calling me Scabby, but it still hurts knowing they carved it into the walls of our high school.
There are several other factors that lead me to here. I struggled for decades with my dermatillomania as I am now into my 30s. The chapter before this new discovery of acceptance was denial, I blamed my acne. “Well, if I clear up my acne I won’t skin pick anymore” was my theory. I tried pro-active, masks, exfoliating, anything that didn’t cost too much nor required me to go to a specialist. I even tried that over the years. I saw a dermatologist twice. First did nothing for me, the second even less. My family doctor even tried different creams and medications to try. They either hurt my stomach too much or were ineffective.
I gave up on many of those remedies. What I didn’t really connect was why I gave up. I still haven’t figured that out yet. Was I so addicted to picking that I didn’t want to stop? Was it my unhealthy mental state that having ugly skin matched how I deeply perceived myself? Was I just too lazy?
I don’t know why.
I knew the desires were there and they aren't good desires. I can sense every bump that needs to be attacked with my finger nails. I saw the side looks and glances at my scars. I often wear long sleeves, and stay away from shorts, to cover it up. The words of “the popular ones” in university saying how unattractive girls with acne are pounded in my head. Or the stern words of my mother telling me to stop. I don’t know why I denied it for so long. Perhaps because every treatment failed, or lacked compassion and love. I will never know for certain.
Somewhere in my 20s did things get worse for me. My picking frequency increased. I could spend minutes without realizing it in front of a mirror examining my skin. It escalated to picking pimples, black heads, ingrown hairs, scabs and any bump my fingers found on my skin. I would often find myself unable to be satisfied with my picking, I always need to do more. This is the hardest thing I have typed out in a long time, I would often pick my skin beyond the actual contents of the blemish, beyond little drops of blood. Some of the bumps were imaginary, some would result in purple bruises. This is when I figured I needed to try something else.
The second treatment I tried was self management, something with a little more understanding. With a large knowledge base in behaviour and behaviour change I thought I could create and follow my own plan. Yeah. That wasn’t strong enough to compete with my long standing habit. No replacement behaviour gave me the same feeling, I wasn’t committed, or maybe I wasn’t motivated. You could ask all the same questions I listed above. So I finally decided to reach out once more.
My next chapter is blank. It started with the decision to speak to my (new) doctor about it. The seed for healing and moving forward has been planted. She spoke with me via phone (thanks COVID) for a total of 3 minutes. She quickly prescribed me a supplemental anti-psychotic to go along with my current prescription. She didn’t even mention other options or seeking diagnosis. Just like my anxiety, I sit without a formal diagnosis and yet am being treated for it. A thought for future posts.
My current plan is to give the medication time to find a good place and continue to try to practice self-management, replacement behaviours, mindfulness and work on some soul searching. Thank you for being a part of this journey with me. Words are my thing, writing is my therapy, who knows maybe someone will come across this post and relate. I will likely continue to write about my future adventures with my excoriation disorder.
So there you have it. The first couple paragraphs into my new journey of healing. Of health. Of well being. Of balance and self compassion.
I live with dermatillomania. One day I’ll be okay with it. For now. I’m just trying to figure out how to pronounce it!