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I am a walking contradiction. At times I find life so difficult that I think death is the only answer but then I desperately want to live. I fear ill health and death and yet I fear my fears to the point that I see death as the only way out.
I realised tonight that mental health is just as important as physical health and deserves the same amount of recognition. I have a mental condition and I don’t think I’ll ever be cured from it, the best I can do is learn how to manage the dis-ease. I find that my mental illness also causes physical illness. I feel all kinds of things that I just don’t want to feel but the more I try not to feel the more I end up feeling.
My legs are restless. I am lying in bed but my legs feel so itchy from the inside out that I just wish I could tear them both off. I feel like I need to get up and move around but I am so tired that I just don’t want to move. I’ve just discovered I have a vitamin B12 deficiency so all my symptoms of late can be put down to that – breathlessness, faintness, dizziness, chest pains, rapid heart rate, fatigue, depression, tingling arms and legs, restless legs, etc. At first my doctor just thought I was stressed and anxious, and I could believe that, but it turns out there was an underlying condition. Apparently it can be quite serious if left untreated but I am petrified of the treatment.
You see I fear medication because I fear side effects. Even though an illness makes me ill and could even possibly kill me I never take anything I am prescribed because the medication could make me ill and even possibly kill me. Seriously how fucked is my mind? Like can you even win with me?
And I know I don’t think rationally yet I can recognise my irrational thoughts as irrational. Like I think about ending my life over the most stupidest of things. No seriously it is ridiculous! When I was 13 years old I remember wanting to commit suicide because I thought my wrists were too thin and would snap at any given moment. Lately I’ve been wanting to end it all because I received a dodgy filling months ago and it is still causing me pain even after they were forced to redo it. Now I am too scared to have it replaced a third time so I am just putting up with the pain.
And I know there are people out there right now in excruciating pain. Mental and phsyical. And they would give anything to trade places with me. And here I am complaining. There are people battling cancer right this second. Mothers who have just lost a child. Travellers being beheaded by terrorists. And here I am in a warm comfortable bed. I had a beautiful deliciously healthy dinner and I relaxed to a movie and a new TV series tonight and yet I still can’t feel happy. I just feel… empty, lost, lonely, tired, hopeless and full of regret.
The only thing that helps me is to write. To just get it all out of me. I feel like a failure but at the same time a success. I feel lonely but at the same time I like being alone. I want to be well but at the same time I avoid everything that will make me well. I want more children but I fear I will never be able to have any more. I want to go and check that my fridge door is shut for the hundredth millionth time but I don’t want to keep giving in to my OCD. I want to not suffer with mental illness anymore but at the same time I am grateful that I am not suffering with a serious physical illness. I am so many things that I do not want to be and yet I do not do anything to change into the person that I do want to be. I am a walking contradiction. I don’t even know who I am anymore.
I understand that this blog post probably makes no sense. I haven’t bothered to censor myself. I just wanted to provide you with a snapshot of what goes on inside my head every second of every day. Dermatillomania is not my only disorder. Sometimes my anxiety, depression and OCD overwhelm me and at times like this, it is not at all related to the skin picking. Tonight is just a night for my other mental illnesses to come out and play. Anyone reading this would probably assume I was drunk or off my face on drugs. I know I sure would think so after reading such scattered thoughts. But then again I am a highly rational irrational person and I can assure you that I’m 110% sober but I maybe just maybe am a little bit crazy. Unfortunately.
Self-diagnosis. We are all familiar with it and we have probably all engaged in it at least once or twice. But how does self-diagnosis impact on those who have either been diagnosed with or are clearly suffering from a mental health disorder, such as Dermatillomania? This is a topic I feel compelled to write about, it is a controversial one none the less but I feel that someone has to give this topic a voice.
As a Dermatillomania awareness advocate I come across and converse with many derma sufferers on a daily basis. Mostly what I see is upsetting – people caught in the grips of an illness that is literally tearing their lives and skin apart, then there is the occasional hopeful story – those who say they used to suffer from the illness but now have it beat (I always wish there was photographic proof for these stories though as I am a bit of a sceptic); and finally there are times when what I see confuses and deeply upsets me. By this I mean those who say they are suffering from Dermatillomania and yet I can’t see any scars or marks on them. Then I find myself wishing that my derma could be that mild [edit: as physically mild as theirs] so I too could experience what it’s like to wear tank tops, shorts, go without makeup, or even wear a bikini! In fact I don’t even own said swimwear. The last time I went swimming was 11 years ago when I was 14 years old. I lived in a very hot and humid coastal town, so avoiding the water was near impossible, it just came with a sideline of questions and bullying.
Now as a Dermatillomania sufferer I am well aware of the tips and tricks one can take advantage of to hide the damage we do to our bodies, including Photoshop, taking photographs from certain angles, experimenting with different kinds of lighting, wearing certain types of clothing and picking only in certain areas. I am also well aware that Dermatillomania is a condition similar to physical illness, in that the sufferer can go through periods of remission, a word most commonly associated with cancer but it refers to the period of time during a serious illness when the patient’s health improves. I experienced remission when I was 17 years old to the point I almost considered myself recovered, although I did still pick every day even if it was only at a handful of hidden spots. Then I went through similar incidences of remission again when I was 22 and 24 although I relapsed in both instances within a matter of months. My skin-picking also decreases during winter when I have less opportunity to pick at my skin due to the fact it is always comfortably covered by jeans, jumpers, scarves, etc. And because I am not standing out as the only person wearing pants and long sleeves (as I do in the warmer months of spring and summer) I find that I fit in to the wider community a lot more which lessens my stress, depression and anxiety which in turn decreases how often I pick. So keeping all of this in mind I understand that I may be making judgements on people who are in remission; however if this is the case then it is helpful to state that you are in remission when discussing Dermatillomania with other sufferers so they don’t feel upset or confused by how flawless your skin looks in comparison to theirs. This is something that I learnt when I was in remission interacting with other sufferers and I found myself having to explain that I really did know how it felt to have severe Dermatillomania.
When I was 19-21 years old, my Dermatillomania reached its most severe point and thankfully it hasn’t been back there since. I was that disabled by my condition that I NEVER left my house without assistance and only then it was to force myself to do the grocery shopping in order for me to feed my son. I could not even walk to my letterbox, I could not put my bins out on the verge, I could not even open my front door to put rubbish in the bin, I would not open my front door to anyone and I would not even hang the washing out in my own backyard for fear of being spotted by a neighbour. My curtains and blinds were always drawn shut – I lived in complete darkness for more months than I can count! My only regular interaction with others was with mental health professionals, social workers and family support workers. I was that disabled by Dermatillomania I needed encouragement to walk outside of my own house because I felt as though my legs were going to collapse underneath me from the anxiety of it all; and if someone did manage to convince me to leave my house I would walk with my head faced firmly down, eyes fixated on the pavement, struggling to breathe, on the brink of tears and completely lost for words. During this time of my life I would engage in 7 hour long picking sessions most nights, where I would gouge at my skin with tweezers to the point I felt physically ill. I hardly ever slept, I was constantly infected and I was inundated by suicidal thoughts. I started planning my own death and writing goodbye letters. The next day I ended up as an outpatient at my nearest mental health hospital. This is severe Dermatillomania.
In the DSM-5 it states that: “Excoriation (skin-picking) disorder is characterized by recurrent skin picking resulting in skin lesions. Individuals with excoriation disorder must have made repeated attempts to decrease or stop the skin picking, which must cause clinically significant distress or impairment in social, occupational or other important areas of functioning. The symptoms must not be better explained by symptoms of another mental disorder”.
Apart from the name Excoriation Disorder, I feel that the DSM-5 has it fairly spot on so far. To be diagnosed with the condition one must have skin lesions present on their body, there must have been some desire to want to stop, it must cause clinically significant distress and/or it must cause impairment in social or occupational functioning. It also must not be better explained by symptoms of another mental disorder and I think this is the most important signifier. In some instances there seems to be a fine line between Dermatillomania and Body Dysmorphic Disorder. I say this because if one has flawless skin but believes they have imperfections on their body that are not observable or appear slight to others, then this more accurately fits BDD. With Dermatillomania there is no doubt to oneself or others that the condition very much exists physically! This is backed up in the DSM-5 under the Body Dysmorphic Disorder Diagnostic Criteria which states that a BDD sufferer has a “preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others. At some point during the course of the disorder, the individual has performed repetitive behaviours (e.g., mirror checking, excessive grooming, skin picking) in response to the appearance concerns”. The DSM-5 then goes on to state under the Excoriation Disorder section that although “skin picking may occur in individuals with body dysmorphic disorder who pick their skin solely because of appearance concerns; in such cases, excoriation disorder should not be diagnosed”.
This brings me to my next point however and that is that the DSM-5 should include an assessment criterion which diagnoses Dermatillomania on a sliding scale as it does with depression. When my derma was at its worst I was also diagnosed with severe depression however I can go through stages now where my depression is quite mild. Then there are days when I am just sad. Sadness and depression are two different things as are skin picking and Dermatillomania. One has to be severe enough to negatively impact the sufferer’s mental health and/or their ability to function in social situations in order to be classed as a disorder. Hopefully with more research and more awareness into this disorder a sliding scale for derma might come into existence, one where it can be assessed as mild, moderate or severe. I feel this is important because some people only focus on one area (and it may be an area that one can hide) whereas other sufferers can’t help but pick at numerous areas and in places that can only be hidden when the sufferer takes great extents to do so (e.g. by wearing long sleeves and pants in summer). Also some derma sufferers are still able to maintain friendships, relationships and hold down employment whereas others are unable to function in any social situation. In order for no one person to feel isolated about living with a condition such as Dermatillomania, it is important that there are different ways to describe the severity of the disorder, ones that are backed up by thorough medical and psychological research.
In a world where Dermatillomania is only just starting to be recognised in the medical and psychological field, I understand that many sufferers self-diagnose because they feel that there is no other option for them. I self-diagnosed 5 years ago when I first found information online about this disorder but I then brought that information to my doctor and the psychologist I was seeing at the time in order to receive a proper documented diagnosis – albeit they have spelt Dermatillomania wrong on my file! Whilst self-diagnosis can be helpful, it is only a stepping stone in a greater journey towards clinical diagnosis, treatment and then hopefully recovery. The reason being is that when self-diagnosing ourselves with disorders or illnesses, whether they be physical or mental, we can sometimes get it wrong or be quick to label a habit something more serious than it actually is. To put this in perspective: I often pluck my eyebrows, sometimes I over pluck them in my desire to shape them perfectly, I will also pull stray hairs from my chin or upper lip, and if my hair is done up in a style and I notice some are out of place I will pull them too. I occasionally pull hair but I do not have Trichotillomania or Trich. My hair pulling is nothing out of the ordinary and does not cause me any distress or social embarrassment. Everyone picks at their skin. This is normal. Many people even take pleasure in popping pimples or satisfying an itch. This is also normal. What is not normal is when you do not know how to stop and when you keep going to a point that it causes you significant distress and/or impacts on your ability to function socially. So please keep this in mind when self-diagnosing, as a wrong diagnosis can have a detrimental effect on both yourself and those suffering from the mental health disorder in question. I don’t want Dermatillomania to be misunderstood more than it already is or to be made out less serious than it actually is – this disorder has the potential to put a sufferer in a life threatening situation and this is why I am so passionate about spreading awareness, however controversial it may be.
About three months ago I put a plan in place to stop picking by my 25th birthday. In 1 minute, I will be 25 years old and my picking is the worst it’s been all year.
That photo is of me on Friday night… I spent my night picking for hours on end to the point I felt physically sick to my stomach and that depressed I contemplated suicide.
I feel worse tonight.
My back is on fire. I have a weeping open wound in between my shoulder blades that just won’t heal and I can feel it burning. All the skin around it is red, raised and hot to touch. My face is stinging and my arms and legs are covered in band-aids.
I haven’t felt this sad in a long long time.
I’m 25 tomorrow. That’s 21 years living with Derma and I’m not sure I can do it anymore.
I’m in so much mental and physical pain. I just want to cry but I can’t.
I can’t handle how much this disorder has consumed my life. I feel so ill. A sign I am infected once again.
Happy birthday to me.
Why can’t I just stop?
Why can’t I just stop?
WHY CAN’T I JUST STOP?
The endless commentary that continually runs inside my own head!
I WANT TO STOP SOOO BAD!!!
I’ve had enough of this damn derma!! ENOUGH ENOUGH ENOUGH!!!
I can’t stop picking 😦
I try so damn hard but I JUST CAN’T STOP!!
And it gets me down!
SO SO DOWN!!!
So you know how I was having a bad day… WELL I decided to put my big girl panties on… managed to do the grocery shop just fine and even buy meat! Then when my son suggested we head to the river before dinner I just had to say YES! And boy was it worth it! Check out that sunset:
Then like the BIG KID I am, I just had to have a go on the swings:
And there’s no faking that smile! I had butterflies in my stomach and I couldn’t stop laughing! Plus I didn’t stop there… I played chasey in the playground with my little boy and squealed going down the big “scary slide” with him, I even had sand in my shoes at the end of the evening… always a sign of good times had.
So I guess what I wanted to share with you all, is that even though my day started off plagued with depression, anxiety and all things Dermatillomania, I somehow managed to have the BEST afternoon I have EVER had with my son! And I laughed… I really laughed!!
Sometimes we build these things up inside our head to the point that they seem insurmountable but if we just push ourselves that tiny little bit then the possibilities are endless. Let this be your little push for today…
Having a not-so-great day today. I’ve relapsed since coming on holidays. Most people find holidays relaxing – I, on the other hand, find that having nothing to do actually makes me incredibly anxious and allows my depression to creep back in a little. I didn’t want to get out of bed today. I felt sick (I suffer from medically diagnosed Irritable Bowel Syndrome with the possibility of also having chronic appendicitis) so trying to push past the pain/discomfort barrier was a little difficult this morning. Since then I have spent the last 3 hours picking at my face… mostly while sitting here on the laptop but I’ve also headed into the bathroom a few times to have a session in front of the mirror with my tweezers. This is what my face looks like now, it is the same on the other side:
I’ve been trying to figure out what about today is making me so anxious that I feel the need to pick. I’ve hit on a few things… someone is coming over today to feed the birds so being “skin-ready” for visitors always makes me anxious, I need to go to the shops to get something for dinner & because my OCD also manifests itself in the form of fearing all food is contaminated with bacteria, especially meat, food shopping is really nerve-wracking for me and I then need to cook dinner which is also making me incredibly anxious.
So I’ve since put on some makeup, brushed my hair & changed out of my PJ’s in the hopes it will encourage me to get off my ass and finally face the day:
However even with the makeup on you can still see the pockmarks on my skin 😦
Video Number Two: This was made at the beginning of 2009, a few weeks after I found out that my illness had a name: Dermatillomania. By this stage I’m getting pretty desperate for help… it’s very hard for me to watch back over these but I’m uploading them again in the hope that they will help other sufferers realise that they are not alone in this. Much love to you if you are feeling or have ever felt like I did in this video. x
Yesterday was really triggering for me. I’ve never been triggered by looking at pictures and videos of other people’s derma but rifling through my old footage really got to me. I stayed up until 1:30am picking last night. Angrily picking! Not at my face… but at my arms and legs. They were almost healed but I was so upset by my old footage that I just kind of lost control last night. I sat on the cold tiled bathroom floor, for I don’t know how long because I lost track of time, and gouged and ripped at my flesh until it hurt and bled. It was almost as if I was punishing myself for ever having experienced such a severe bout of Dermatillomania and for letting it rule my life to the extent it did. BUT in my new positive state I am not going to let it get to me. I gave it my energy last night and now I’m moving on from it. I can’t rewind the clock and change my past but I can pave the way for a better future. And that is what I want: A better future for myself and my son that is free from the confines of Dermatillomania.
I could only upload a picture tonight as I wasn’t mentally ready to rifle through anything more again so soon. The thing that troubled me the most last night was that I stumbled across an old goodbye letter that I had written to my son when I was planning suicide. I can’t believe I almost went through with my plan. To think I would have left my son all alone to fend for himself is utterly heartbreaking to me. I need to beat this not only for me but also for him. My boy is the most important thing that has ever happened to me and if it wasn’t for him I know without a doubt that I would not be here today. I only got halfway through writing that letter to him before I realised what I was doing and rung for help. The next day I became an outpatient at a mental hospital and a few weeks after that I did some Googling and stumbled across a name for my condition: Dermatillomania. It’s been years since I wrote that letter and although I’ve considered suicide many times since then – that was without a doubt the darkest year of my life. I am determined now to never let my battle with Dermatillomania or Depression take my life away from me. I’m worth so much more than that!
One of the very first videos I made about my Dermatillomania. Never before has this video been uploaded until now. This was filmed in 2008 when I was 19 years old and before I knew that my condition had a name. You can tell in my video that I have no idea what I suffer from or that there are other sufferers out there as I still refer to my condition as “scratching” which is the only name I knew for it growing up. This is painful for me to watch and intimidating for me to upload but I’m hoping in sharing this it may be able to help others out there. It’s also a way of showing how far I’ve come in this battle over the years. There will be more videos to come over the following days and weeks containing old footage of myself describing my struggles with Dermatillomania – so stay tuned!