Scratching the Surface

A couple of weeks ago, I shared about my “itchies,” which have followed me over the years. In that post, and in a couple of other posts I’ve written in the past, I’ve also made reference to my history with picking (for example, in my first post and my first “Victories” post). Picking has often been a source of shame for me, from trying to hide the bloodstains on my socks and blouses in grade school and high school, to trying to hide scabs with makeup on the rare occasion that I have one on my chin or cheek. I’ve been ashamed that I pick, and that, for all appearances, I haven’t had the willpower to just not pick.

When I was first coming up with ideas for posts for my blog, back before I posted even my first post, writing about my picking was on the list. I’ve been wanting to write about it, but unsure where to start, or even if I was brave enough to admit that I pick and I struggle to not pick if I ever have a scab or other non-smooth area on my skin. I have a lot of conflicting thoughts and feelings about it. Cognitively, I know that it is an unhealthy thing to do. I know that, each time I pick a scab, it increases the risk of infection. Not only that, I also know that picking prevents quick healing, and increases the chance of scarring. That said, knowing things cognitively and registering them emotionally or behaviorally are different things entirely.

In practice, in the moment, there’s a strange satisfaction to the act of picking, to the illusion of a smooth surface after a scab has been removed. There’s some satisfaction, and even some small, almost grounding effect from the twinge of pain as the scab comes off, which satisfies and supersedes the itch of healing skin that may have helped instigate the picking in the first place. When I’m in the depths of depression, or my mind is running through thoughts faster than I can register, when I’m overwhelmed, stressed, anxious or emotionally numb, that same twinge of pain can feel like a reminder that I am able to feel something, anything. Aside from times of overwhelm, I also find myself subconsciously drawn to picking when I’m lost in thought.

So, putting it very mildly and simplistically, if it wasn’t already clear, I have a lot of conflicting thoughts when it comes to my picking, but, mostly, I feel ashamed. I know it’s something I shouldn’t do, and, with my desire to not appear weak, I only feel more ashamed and frustrated with myself that, over the years, the decades, of picking and feeling ashamed and hearing how bad it is for me, that I haven’t found a way to stop and not re-start. The picking increases as my depression worsens, and the shame of picking is also amplified. Not only do I dislike that I pick in the first place, but, when my depression is bad, it echoes back and amplifies every reprimand, every chastisement, every disappointed observation of my scars or scabs, calling them failures and tying them to other apparent failures in my past, claiming I’ll never get the upper hand, so to speak, claiming that others will someday see me as the failure that it knows me to be. Such are the lies of depression, the lies that echo in my ears when depression takes hold.

The past couple of weeks, I’ve been trying to catch up on reading the blogs I follow, as well as the mental health community on Twitter. Since I just wrote the post on itching, my picking has been on my mind again, especially since I again have a few scabs I’m trying to let heal. Imagine my surprise when I stumble across a post by My Loud Bipolar Whispers. It’s about an addition to the latest DSM (DSM V), which includes a separate entry for a condition called dermatillomania, which is also known as Skin Picking Disorder (SPD). Now, I am not so forward or presumptive to assume or presume that my own issues are definitely this, and I am not trying to minimize my responsibility for my own behaviors, but the information she shared in her post, as well as the points made in an article she quoted really rang true, and, even though I’m not presuming that this is directly applicable to me, seeing that others share a similar struggle is somehow a bit comforting.

I mentioned this to my therapist last week, and we spent some time talking about it. She mentioned that certain diagnoses tend to have a fair amount of overlap, and that depression frequently pairs with other issues, like anxiety, OCD tendencies, and things like skin picking or hair plucking, which was also good to hear. It helps me understand why I had someone want to increase my meds because I was still picking, and helps me understand why the tendency to pick seemed to ebb and flow with my bouts with depression.

Understanding a little more doesn’t automatically change anything, though, but it does help me build my tool kit some more. Knowing that others struggle with picking in similar ways as I do, while comforting, doesn’t give me a perfect outline on how to stop picking overnight, and it doesn’t immediately erase my tendencies towards picking. It does, however, help me fight my self-inflicted shame, which helps me reframe when I notice that I’m picking. Combine this with the tools I’m learning and practicing, as well as the work we’re doing to reprocess some of my emotional scar tissue, not to mention the meds helping moderate the physical causes and symptoms of my depression, and, well, from where I’m standing (or, to be more accurate, sitting), I think I’m in a pretty good place to work on building some new habits that will help minimize my picking moving forward.

Is there something you’ve struggled with for a long time that you’ve learned more about recently? What do you do to find more tools when you need them?