If you have intermittent explosive disorder you experience uncontrollable bouts of rage that last 10 or 20 minutes, that often result in violence or destruction of property and which are way out of proportion to the situation or the provocation. Your disorder almost surely reduces your quality of life and it may cause you to lose your job or get expelled from school, have trouble maintaining friend or romantic relationships – or it may even land you in jail. Fortunately, for those that seek treatment, help is available and you can learn to get better.

Do you suffer from bouts of rage that lead to violence or the destruction of property? Although you feel your anger is mostly justified, do you realize that your reaction – your spell of rage – is out of proportion to the situation? Do you often feel remorseful or guilty after loosing control and succumbing to your rage?

If you answer yes to the questions above, you may be suffering from an impulse control disorder called intermittent explosive control disorder – a condition that makes it very difficult to resist impulses to react with violence or destruction when angry.

Those that suffer this condition are often perceived by those around them as being angry people, and they may have difficulty with relationships or at school or on the job. They are also, by the nature of the disease, at a greatly increased risk to get in trouble with the law or to get hurt in a violent confrontation.

Uncontrolled bouts of violent or destructive rage can greatly reduce a person’s quality of life – as well as affect the emotional well being of those around him or her. Because of this, it’s important that anyone who experiences this disorder seek an accurate diagnosis and begin treatments that can help a lot to control symptoms of rage.  

Do You Have Intermittent Explosive Disorder?

According to the America Psychiatric Association’s manual of mental disorders, the DSM-IVr, to meet a diagnosis of intermittent explosive disorder you must:¹

1. Have reoccurring bouts of rage that have resulted in a loss of control and to violent behavior or the destruction of property

2. Experience bouts of rage, aggression and violence or destruction that are clearly out of proportion as a response to a given situation

3. Not have another mental health disorder that better explains the rage behaviors, such as anti social personality disorder, psychosis, a manic disorder etc.

4. Not be using substances, such as illicit drugs or medications or have hallucinations that would better account for the rage behaviors. Not have experienced a medical condition, like  ahead trauma or a disease, like Alzheimer’s that  would better explain the violent outburst

People with this disorder generally feel tension preceding an attack and feel relief afterward. Feelings of relief often transform to feelings of remorse after the fact.

Still not sure? Ask yourself a few questions.

According to Daniel Ploskin MD, if you answer yes to 2 of the first 4 questions or to 5 questions in total, you may have a problem and should strongly consider getting an evaluation by a trained mental health professional²

1. Do you find it hard to control your temper?
2. Do you sometimes have rage attacks?
3. Do you ever find yourself overreacting to a situation or a provocation?
4. During a rage episode, have you ever physically assaulted another person or destroyed property?
5. Do you have a drug or alcohol problem?
6. Do rage problems run in your family?
7. Have you ever had a head trauma or brain injury?
8. Do you have epilepsy of a history of epilepsy?
9. Do you or does someone in your family have a mood or anxiety disorder?

In the DSM-IVr, Intermittent explosive disorder is currently considered an impulse control disorder not otherwise specified.

What Does an Intermittent Explosive Disorder Episode Look/Feel Like?

Episodes generally last for 10 or 20 minutes in duration and the rage exhibited during an episode often results in violent actions, injury to self or to others and/or to the destruction of properties. Symptoms, such as headache or feelings of irritability and tightness can emerge minutes or even hours before an outburst of rage.

Symptoms that may accompany or precede a violent outburst include:³

• Feelings of tension
• Headache
• Tightness in the chest
• Chest palpitations
• A surge in energy
• Irritability and rage
• Tingling sensations

Who Gets Intermittent Explosive Disorder?

The disorder affects men more than women and the typical age of onset ranges form childhood to a person’s early twenties - onset is typically quite sudden. People with intermittent explosive disorder frequently suffer from a co-occurring condition, like alcohol addiction, personality disorders or other brain disorders. They are also more likely to have a family history of addiction and/or mood disorders.

People with the disorder usually get better as they age, but factors like extreme stress, alcohol abuse or drug abuse, brain injury or head trauma can cause a sudden worsening in symptoms.⁴

What Causes Intermittent Explosive Disorder

Scientists aren’t yet sure exactly what causes the disorder, but strongly suspect that a combination of biological and environmental factors play a role.

Some factors thought to increase the risks of the disorder include:⁵

1. Growing up in a household where physical, emotional or verbal violence or assault are commonplace
2. Growing up in a very unstable household, or one lacking an appropriate role model to teach impulse control for aggressive behaviors
3. Having very low self esteem
4. Learned negativity – assuming the worst in those around you
5. Abnormalities in the brain’s serotonin system
6. Abnormal levels of testosterone
7. Dysfunction in areas of the brain related to planning or memory

Intermittent Explosive Disorder Treatments

Treatments for the disorder most typically combine one or more medications with psychotherapies, like cognitive behavioral therapy.

Medications sometimes used include:⁶

• Anti anxiety drugs, like valium or other benzodiazepines (although in some cases, some minor tranquilizers have been shown to exacerbate the severity of symptoms by lowering inhibition, similarly to alcohol)
• Anti depressant medications, such as the SSRI Prozac
• Anti convulsant medications
• Mood stabilizers, like lithium

Psychotherapy, such as psychodynamic therapy or cognitive behavioral therapy can help a person with the disorder learn better control over their actions, such as by learning to avoid situations that can prompt aggressive impulses and by learning to recognize early symptoms of an outburst and by countering these feelings with relaxation exercises.

Image Copyright: Darwin Bell

Most arsonists aren’t pyromaniacs as most can control their actions. A true pyromaniac suffers from an impulse control disorder and a deep fascination with fire and sets fires only to feel pleasure or relief and not for any financial or other gains.

Pyromaniacs love fire and they have trouble controlling their impulses to light them. They set fires to feel pleasure or relief and they’re generally fascinated with fire and the consequences of fires. According to the APA’s manual of mental health disorders, the DSMV-IV, pyromania is a manifestation of an impulse control disorder.

To be diagnosed as a pyromaniac you must:

• Have intentionally set fires on more than one occasion
• Experience emotional arousal and or tension before lighting a fire
• Experience relief gratification or pleasure from setting or watching fires
• Feel drawn and fascinated by fire the consequences of fire and things related to fire (paraphernalia)
• Not set fires for financial or ideological reasons, out of criminal motive or out of anger or out of impaired or altered judgment (intoxication, hallucination, dementia, developmental delay etc.)
• Not have another mental disorder which better explains the fire setting, such as antisocial conduct disorder, a personality disorder or a manic disorder¹

Pyromania Treatment

Pyromania is a relatively rare disorder in adults and most pyromaniacs suffer also from other co-occurring disorders, like substance abuse, obsessive compulsive disorder, anxiety disorder and mood disorders.²

Behavior modification psychotherapy is the most common treatment for pyromania. In some cases, medications like SSRIs may also be warranted.³

Image Copyright: Kevindooley

Strong urges to pull hair from your scalp and from other parts of your body results in bald patches and emotional stress. Trichotillomania is an incompletely understood condition that may affect as many as 9 million Americans. Read on to understand this disorder and what treatments are used to manage it. Learn also about self-help techniques that you can use today to start controlling your hair pulling at home.

You suffer from very strong urges to pull out your hair, urges too strong and persistent to be resisted; and since you pull the hairs of your scalp, eyebrows and other parts of your body so often, you have noticeable bald patches or hairless areas on your body.

You feel a great tension before pulling or as you try to resist these urges and when you succumb to your urges your tension turns into pleasure, relief or gratification; and if you’re like many with this disorder, you go to great lengths to conceal your hair loss and so many of the people in your life have no idea of your debilitating condition.

If you suffer from mild trichotillomania, you probably feel frustrated by your disorder, but you can likely control your urges through awareness and concentration. In more serious cases, the urges felt are overpowering and can result in deep feelings of shame and even a curtailment of normal daily activities. People with noticeable hair loss may go to great effort and expense to hide their hairless areas and may avoid also social contact to minimize feelings of embarrassment and shame – in some cases these feelings make it difficult to work or socialize outside of the home, or get needed medical or dental care.¹

Do You Have Trichotillomania?

According to the APA’s manual of mental health disorders trichotillomania is a form of impulse control disorder, to meet a diagnosis of Trichotillomania, you must:

1. Recurrently pull your hair out and this hair pulling must result in noticeable areas of hair loss

2. Feel amplifying tensions just before the hair pulling or as you try to resist the impulse to pull your hair.

3. As you pull your hair out, you must experience pleasure or relief

4. Not have a dermatological or medical condition which explains your need to pull your hair out

5. Not have another mental health disorder which better explains your hair pulling

6. Feel significant distress due to the condition or the disorder must limit your performance at work, in relationships or in other important areas of your life*²

Who Gets Trichotillomania?

In children, trichotillomania occurs equally in both boys and girls, but by adulthood, women are more likely to experience the disorder.

No one knows the exact occurrence rate, though in one study of college students, the disorder was found to occur in 0.6% of students. The Trichotillomania Learning Center puts the incidence rate at a slightly higher 1% to 3% of the general population, or 3 to 9 million Americans. ³

Adults with the disorder often report first onset in adolescence. Some people experience symptoms chronically and continuously, while others experience active periods followed by periods of remission. The site of hair pulling on the body will often change over time. Without treatment, the disorder generally persists chronically, for a lifetime (the exception being small children, who sometimes experience a period of hair pulling that later goes away).

People with a close relative with the disorder are at greater risk themselves to also experience it. ⁴

Swallowing Hair

Some people with Trichotillomania will eat the hairs that are pulled from the body. This can result in hairballs (trichobezoars) which can in turn result in intestinal blockages requiring surgery to remove, and which can be fatal.

Trichotillomania Treatments

Because people with this condition frequently experience other co-occurring mental health disorders, like depression or anxiety, it is useful to receive a complete psychiatric screening to ensure comprehensive treatment.

The two most common treatments offered for trichotillomania are:

1. Cognitive behavioral therapy (CBT)
2. Medication

Cognitive Behavioral Therapy for Trichotillomania

With CBT, you are taught ways to control the way you think to control your behaviors (hair pulling). You might be taught, for example, to become more aware of what types of emotions or behaviors trigger your urges to pull hair, and once you can recognize these triggers, you can take conscious steps to minimize them in your life (for example, if you pull hair unconsciously as you watch TV, you may need to substitute more active recreational pastimes for that high-risk activity).

You may also be taught stimulus control procedures that make hair pulling difficult, such as learning to clench your hands into fists as you experience urges, or be encouraged to wear clothing or devices that make hair pulling difficult, such as hats, or certain kinds of gloves.⁵

As stress can sometimes trigger hair pulling, therapists may also teach and encourage stress management techniques.

Medication

Anti depressant medications, such as the SRRIs and other types of medications are sometimes prescribed to assist in symptoms control. These medications seem to be most effective when used as an adjunct therapy to cognitive behavioral therapies.⁶(Because many people with this disorder suffer from co-occurring mental health problems, treatment with anti-depressants sometimes results in increased mood or reduce anxiety, as a beneficial side effect).

Helping Yourself - Self Help for Trichotillomania!

You can take action to reduce the severity of your condition on your own.  According to Ruth Golomb LCPC of the Behavior Therapy Center of Greater Washington, steps you can take to control your hair pulling include:⁷

• Figure out your hair pulling profile – try to understand (and record) what makes you pull, where you typically pull, why you feel urges to pull and at what times of day you feel these urges. Also try to understand if your urges are caused primarily by a need to feel tactile sensations, by environmental, cognitive or emotional cues or by the feeling that your hands have a mind of their own.

• Give yourself something to ‘fiddle’ with instead of pulling, such as a string of beads, silly putty, a bristly brush, some string, etc.

• Give yourself a sensory overload without needing to pull hair – try a cold cloth on the face, strong mints, eating seeds, menthol scents, a firm brush, etc.

• Wear gloves on your hands or band aids on your fingers, use a tight tension bandage on your elbow that makes bending uncomfortable, wear a hat, a scarf or put your hair in a towel, etc.

• Change your environmental routine – use a different bathroom, sit in a different chair, change the lighting etc.

• Change your emotional states – practice relaxation techniques, meditate, do yoga, write a journal, etc.

Image Copyright: ashley.adcox

Do you feel overwhelming urges to steal things that you don’t need, that have little value and which you could easily afford if you wanted to pay? Do find that stealing gives you a momentary sense of pleasure or relief from the tension that builds up prior to stealing? If so, you could be one of the less than 1% of people who experience kleptomania disorder – an impulse control disorder that’s very tough to manage without treatment.

People with kleptomania steal things they don’t need and could afford to pay for if they so choose – for a kleptomaniac, stealing isn’t so much about getting something for free as it is about relieving the tension of an overpowering urge.

Kleptomania is a form of impulse control disorder, and since it leads to illegal acts, people with the disorder are often reluctant to admit to their problem and seek help, and are also at great risk of getting caught and facing criminal prosecution.

Although there is no real ‘cure’ for kleptomania, there are treatments that can help minimize the severity of the symptoms and which can help you gain better control over your impulses to steal.

What Is Kleptomania?

According to the APA’s manual of mental health disorders, the DSM- IVr, to meet the diagnostic criteria for kleptomania you must:

• Repeatedly steal things that you don’t need, or which have very little personal or monetary value
• Feel tension before stealing and experience a sense of relief or gratification after the fact
• Not steal as a way to exact revenge or out of intoxication or hallucination
• Not steal because of another mental health disorder, such as mania, a conduct disorder or an antisocial personality disorder¹

People with kleptomania feel tension and irresistible urges to steal what are often small items with little personal value. The act of stealing relieves the tension that builds up preceding the act, but feelings of relief and gratification are quickly replaced by feelings of guilt, fear of getting caught and even self revulsion.

People with kleptomania will typically try to control their urges to steal, but be unable to do so.

Who Gets Kleptomania?

It’s not yet understood what causes kleptomania. Hypothesized causes include serotonin abnormalities in the brain and a link to obsessive compulsive type disorders.

Risk factors thought to increase the odds of Kleptomania include

• A history of traumatic brain injury
• Being a woman
• Having a close genetic relative with an obsessive compulsive disorder or kleptomania
• Experiencing a great life stressor²

The age of onset is most commonly the late teen years and the average course of the disease is about 20 years.

How Common Is Kleptomania?

Since people with this disorder rarely seek treatment and are often quite secretive about their actions, the prevalence rate remains unknown. In one recent study, the condition was found to occur in 0.6% of the population.³

Research shows that people with mood disorders, anxiety disorders, eating disorders, substance abuse disorders and other impulse control disorders are at greater risk to also experience kleptomania.

The vast majority of convicted shoplifters (more than 95%) do not meet the criteria for kleptomania.⁴

Kleptomania Treatments

Doctors and scientists are still very much exploring what medications and psychotherapies work best in the treatment of kleptomania, and much remains unknown. What is known, however, is that it is very difficult to overcome kleptomania without treatment and that too many kleptomaniacs avoid getting help out of feelings of shame or out of a fear of prosecution.

Some of the treatments that doctors now sometimes use include:

• Medications, like SSRI anti depressants, mood stabilizers, anti anxiety medications, anti seizure medications, naltrexone and others.

• Psychotherapies, like cognitive behavioral therapy (CBT). Using CBT, you can relearn healthier ways to think and feel and this in turn can help you to change the way you think about yourself and by extension change your everyday behaviors.⁵

In addition to medical based treatment, some people with kleptomania will also find worthwhile support from self help and support groups like shoplifters anonymous and others.

Since doctors are still learning about the disorder and about what works best to treat it, you may have to experiment with different types of treatments to find one that helps you to manage your urges to steal. Treatment can be slow going and relapse is not uncommon. This doesn’t mean that treatment isn’t working or that progress is unlikely, just that treatment takes time and that patience and commitment is required!

Image Copyright: Rebecca:)

Could an inexpensive over-the-counter amino acid supplement really help you best your hair-pulling, skin picking, nail biting or other form of impulse control disorder? Initial research suggests that it just might.

Struggling with trichotillomania, nail biting, skin picking or another form of impulse control disorder?

If so, have you heard of an over the counter supplement called N-acetylcysteine (NAC)?

It’s a natural amino acid that’s also used to treat a number of medical conditions – and just recently, researchers are finding that people with impulse control disorders who use this very affordable (cheap, actually) supplement get significant symptoms relief in a relatively short period of time.

So is NAC right for you?

Read on to learn a bit more about what it is, how it works and about some of the research that demonstrates its effectiveness, and see whether you might want to talk to your doctor about adding a new supplement to your treatment regimen.

What Is NAC?

N-acetylcysteine is a supplement that delivers the amino acid L-cysteine to the body. You also get L-cysteine in your diet naturally, from protein, but taking the supplement greatly increases the amount that gets to your brain.

NAC has long been used as a medication to treat conditions as varied as ALS, acetaminophen overdose, kidney and liver diseases and others.

Within the last 5 years or so, researchers have started to find that NAC also works quite well as medication for certain psychiatric conditions, such as bipolar depression, OCD, addictions and notably – for impulse control disorders.

How Does It Work?

Researchers aren’t totally sure how NAC helps people overcome impulse control problems. They suspect that NAC might help by moderating the over-action of the neurotransmitter glutamate.

How Well Does It Work to Reduce Impulse Control Disorders

Researchers are just starting to investigate NAC for impulse control disorders – but early results are very positive.

Anecdotal reports indicate that it works and the one major clinical trial that investigated its efficacy against trichotillomania found that it worked very well.

The Major Study

Researchers at the University of Minnesota enlisted 50 trichotillomania patients and gave half of these patients a daily dose of NAC and the other half a daily dose of a placebo (none of the patients knew which medicine they were receiving).

After 12 weeks, 56% of the patient taking NAC had significantly reduced their hair pulling, compared to just 16% of patients on the placebo who had achieved the same success.¹

Another Study: NAC and Pathological Gambling

27 pathological gamblers were assigned to receive either NAC or a placebo. After 8 weeks, more than 80% of the subjects receiving the NAC has reduced their gambling behaviors by 30% or more, while only 28% of the subjects on the placebo had achieved the same reduction.²

Other Case Studies

Although not as convincing as double-blind clinical studies, doctors have also published case reports on patients having success with NAC for nail biting and skin picking.³

Are There Any Safety Concerns?

Most people tolerate NAC very well.

• Side effects sometimes observed include nausea, vomiting, diarrhea and constipation, as well as some other side effects that occur quite rarely.⁴
• You should not take NAC if pregnant or asthmatic. Some drugs may interact badly with NAC, so, as always, you should talk to your doctor before trying this, or any, new supplementary medication.

Where Can You Get It?

You can buy NAC legally over the counter at well stocked pharmacies or supplement retailers. At the date of writing, you could buy 100, 600mg tablets on Amazon for between 6$ and 12$.

Does It Help in the Treatment of Any Other Psychiatric Conditions?

Initial research studies suggest that NAC may have a role to play in the treatment of several psychiatric disorders, such as:

• Reducing depressive symptoms for people with bipolar disorder⁵
• Reducing irritability among autistic children⁶
• Marijuana addiction – in one study, teens receiving NAC and therapy were twice as likely to stay abstinent as teens getting therapy only⁷
• As an augment therapy for chronic schizophrenia⁸
• As an augment therapy for OCD⁹

Image Copyright: DiegoDiazPhotography

People with compulsive buying disorder buy when they feel down and they buy to good – unfortunately, those good feelings are quickly replaced by guilt, remorse and by ever more financial problems and credit card debt. If you think you’re a ‘shopaholic’ you may well have a mental health disorder that’s not going away on its own.

Do you feel an irresistible pull to the mall and own far more shoes than you reasonably need? Do you spend a lot of your time thinking about money and shopping and juggling the books to continue your spending ways? Does your buying habit cause you problems, either financial or with those you love? Do you think you might have a serious problem with shopping…?

Although we may consider ourselves a nation of shoppers, for about 1 in 20 of us, the way we shop and buy has gone beyond the range of normal and results in significant consequences to wellbeing and financial solvency. For about 5% of us, our shopping behaviors are actually a mental illness that requires treatment.

Compulsive buying is also known as compulsive shopping, shopping addiction, shopoholism and oniomania. Most experts consider compulsive shopping to be a form of impulse control disorder (not otherwise specified).

If you have a compulsive buying disorder you experience regular powerful urges to shop or buy that are very difficult to resist, and because of the time and money you spend on buying, you very likely experience financial or relationship problems. Although you likely shop as a way to deal with negative emotions, and although buying can make you feel very good temporarily, buying usually results in feelings of guilt and remorse, which can in turn restart the compulsive cycle.¹

Prevalence – How Big Is the Problem and Who’s at Risk?

The prevalence of compulsive buying in the general population ranges from 1% to 6% in research studies. Women are far more likely to have this type of impulse control disorder (90%).²

Compulsive buying typically emerges in a person’s late teens or early twenties and is generally a chronic or lifelong problem. People with a compulsive buying disorder are also likely to experience another co-occurring psychiatric issue, such as substance abuse, another impulse control disorder, depression, anxiety, eating disorders and obsessive compulsive disorders.

Warning Signs, Treatment and Self Help

According to the Illinois Institute for Addiction Recovery, some warning signs that may indicate a compulsive buying disorder include:

• Using buying or shopping as a way to relieve negative emotions
• Your buying is causing you some serious problems in your life
• Experiencing negative emotions after buying (remorse, guilt, shame, confusion etc.)
• Needing to have your credit cards on you at all times
• Buying on credit things you wouldn’t likely buy with cash
• Experiencing relationship conflicts over your spending habits
• Feeling preoccupied with money
• Hiding or lying about what you buy or how much you spend
• Feeling a high (euphoria) when buying
• Juggling your finances to accommodate your spending habits³

Recognizing 4 or more of these behaviors in yourself may indicate a problem.

Compulsive Shopping Disorder Treatment

Because research into the disorder has only really begun to accelerate within the last decade or so, there have been few rigorous studies done on the efficacy of differing treatment methods for compulsive buyers.

The two most commonly used treatment methods are:

• Psychotherapy using cognitive behavioral therapy (CBT)
• Medication using anti depressants ⁴

Because compulsive buying can so often result in financial and relationship problems, other types of interventions that can be beneficial include:

• Credit or financial counseling
• Relationship therapy

Because compulsive buying disorder often co-occurs with other psychiatric disorders, it’s also important to receive a full psychiatric assessment and screening to identify, and if necessary treat, any undiagnosed disorders.

Self Help

According to April Lane Benson, Ph.D., an expert on the treatment of compulsive buying disorder, one thing that you can do on your own to take control of your buying behaviors is to be conscious about your shopping. She recommends writing down 6 questions on a card and then before buying something asking yourself:

• Do I need this?
• Why am I here?
• How do I feel?
• How will I pay for this?
• What if I wait?
• Where will I put this? ⁵

She also recommends that you take note of what emotions trigger your urges to buy and to then think of solutions that will truly meet your needs. For example, if your shopping urges are triggered by feelings of loneliness, rather than buying as a quick way to feel good, you could instead take steps to increase the relationships in your life by joining a club or by volunteering, for example.

Parkinson’s Medications

People taking dopamine-agonists medications for the treatment of Parkinson’s are between 2 and 3.3 times more likely to experience an impulse control disorder than the general population – and the most likely impulse control disorder experienced by Parkinson’s medication patients is compulsive buying disorder. ⁶

Image Copyright: Orin Zebest

Are you one of millions that continue to bite your nails into adulthood? Find out more about nail biting and learn what you can do on your own to overcome you ‘habit’. Find out also about medications and psychotherapies that are also available for those that can’t break free on their own.

While many children and teens develop fingernail biting habits, it’s something that most people outgrow.

But for between 10% and 20% of adults, nail biting is a tough habit to shake, and it’s one that can cause embarrassment, physical pain and an increased risk of infections. Fortunately, if you’re determined to break free from a nasty habit, there are some easy self-help steps you can take that and that really work, and if you find that doing it on your own isn’t working and/or if you’ve got a very severe case, there are also psychotherapies and even medications that can make it easier.

In more rare severe cases, compulsive nail biting may become a mental health disorder, with similarities to trichotillomania (hair pulling) or skin picking disorder. Although at this time compulsive nail biting is not yet recognized as a specific disorder in the DSM-IVr, those that treat people with severe compulsive nail biting problems suggest that the condition likely falls somewhere in the obsessive compulsive disorders category umbrella.¹

Why Make Such a Big Deal? – The Consequences of Nail Biting!

Nail biting does not result in any serious medical complications, on its own, though it is unsanitary and frequent hand to mouth contact does increase the risk of infections. Other consequences of nail biting can include

• Red, raw and painful fingertips
• Skin infections on the fingers
• Embarrassment
• Feelings of shame at being unable to control a habit
• Gum infections and other dental problems

How Many People Bite Their Nails, and Why Do They Do It?

Nail biting is a very common phenomenon.

• 28% to 33% of children aged 7 to 10 bite their nails
• 44% of teens do it
• 19% to 29% of young adults bite their fingernails
• Between 10% and 20% of fully grown men and women continue to bite their fingernails²

People bite their nails both consciously and unconsciously. Nail biting often occurs when you are:

• Stressed
• Anxious
• Bored
• Excited

Nail biting can be soothing in times of stress or anxiety and can offer some degree of stimulation when bored or tired. People with nail biting habits often report feeling a sense of needing to bite their nails and a sense of gratification during and immediately after the act.

Image Copyright: Brenderous

If you pick at your skin long and hard enough to cause sores or lesions on a re-occurring basis and you feel distressed about your habit and/or your inability to control your picking habit, then you may have skin picking disorder (dermatillomania) a treatable type of impulse control disorder. Learn more about getting diagnosed, the causes and consequences and the treatments that are used to reduce the severity of symptoms.

If you have skin picking disorder you can’t resist your impulses to pick at your skin. You probably spend a great deal of time each day either picking or hiding the effects of your actions and your skin definitely suffers lesions or tissue damage as a result. Your disorder causes you to feel embarrassed or ashamed and it interferes with your ability to lead a normal and happy life.

You may well feel tension before you pick and a sense of relief afterward and if you’re like most skin pickers you pick at your face using your fingers or tweezers – picking at real and imagined blemishes – often until you end up bleeding.

You almost certainly try to hide your disorder and its effects on your skin and if you’re like many with this condition you’ll avoid certain types of social situations to keep your affliction a secret.

Although doctors aren’t yet sure how to classify skin picking disorder (probably a subtype of impulse control disorder or obsessive compulsive disorder) no one denies the seriousness of the condition, the difficulty people with the disorder have in controlling their impulses and the need for treatments that can help.

Skin picking disorder is also sometimes called dermatillomania or copmpulsive skin picking.

Diagnosis – Do You Have Skin Picking Disorder?

Although not currently in the American Psychiatric Association's Manual of Mental Health Disorders, the DMV-IVr, it is under consideration for addition to the upcoming DSM-V edition.

Based on the criteria under consideration for inclusion into the upcoming manual, to meet a diagnosis of skin picking disorder you must:

1. Engage in re-occurring bouts of skin picking and this picking must result in tissue damage or lesions

2. Feel or experience significant distress or impairment in social, occupational or other important life-area functioning as a result of your skin picking disorder

3. Not pick as a result of substance use or abuse (cocaine or methamphetamine use, for example) nor pick as a result of a medical condition, like scabies

4. Not have another mental health disorder which better explains the skin picking, such as body dysmorphic disorder or delusional disorder
   

Basically, if you find that you chronically skin pick, your skin picking results in noticeable cuts or lesions, your skin picking is interfering with your quality of life and no other medical or psychiatric condition better explains your actions – then you have skin picking disorder.

Image Copyright: Me and the Sysop