Under my Skin: Hidden Anxiety

I’d had it in mind to write a post about this at some point, and as I was browsing Pinterest this morning an article came up from Buzzfeed, sharing tips from a variety of people on how they deal with skin picking. This brought it to the front of my mind, so here we are.

If you’re not familiar, skin picking is a habit related to stress and anxiety, and in some cases OCD. It’s also known as dermatillomania or excoriation. NHS defines it as below:

Most people pick at their skin from time to time, but you may have skin picking disorder if you:

• can’t stop picking your skin

• cause cuts, bleeding or bruising by picking your skin

• pick moles, freckles, spots or scars to try to “smooth” or “perfect” them

• don’t always realise you are picking your skin or do it when you are asleep

• pick your skin when you feel anxious or stressed

Looking at the definition makes me doubt whether I actually experience this as a disorder or just a bad habit. It’s true that it’s somewhat compulsive with me, I know I shouldn’t be doing it, but I can’t help it. There’s also a sense of picking things to smooth them over or get rid of them, and often these are things that others can’t see. As far as I know I haven’t done it when I’m asleep, other than picking scabs off – I reckon this can be excused if they’re itchy when you’re asleep and it’s a subconscious reaction, though. Don’t ever tell me I’m not an apologist for my own bad habits!

I’ve caused bruising, but my excuse is that the skin on some parts of my arms is very thin, and I do bruise like a peach and scar easily, so even a tiny little squeeze might cause a bruise. I’m casually ignoring the omnipresent mild scarring on the tops of my arms caused by picking.

I definitely do it when I’m anxious or stressed (so all the time, then). This is why I assume it’s a bad habit rather than a disorder. I’m not sure, and to me it’s just another ‘anxiety quirk’. As I’m sitting here, incredibly self-aware, I’m not sure if I really do mess with my hands, arms, and face as much as I’m noticing or if it’s because I’m writing about it.

So far I’ve: inspected my arms for any pickable bumps; noticed I’ve had my finger in my mouth chewing on the skin around my nails; caught myself rubbing the skin around my nails to try to find some rough bits to pick off; been chewing the inside of my mouth; chewed some dry skin off my lip (could all my suitors PLEASE form an orderly queue); found my hand wandering over my face, focusing on any bumps, bits of dry skin, or  other areas that might be ripe picking material later. I’ve only been sitting here for about ten minutes.

I’m slowly starting to realise that yes actually, I really do fidget, bite, pick, and otherwise manhandle myself a lot. The most common action seems to be rubbing the skin around my nails; it’s such a subtle action, nobody would notice what I was doing, it’s not weird. I can put hand cream on and make it look as though I’m rubbing it in more. Honestly, now I’ve stopped to notice my actions, the frequency of them is starting to stress me out. That’s even though Warren G and Nate Dogg has just popped up on Spotify.

So, how did I start skin picking? I’m really not sure (wow, way to ask yourself a question and not answer it, mate). I do remember having bad skin in my early teens and I would always pick my spots (again, please take a numbered ticket and form a queue). I knew it wouldn’t help, but I also desperately wanted them to go away. I don’t know if it started there or it if was already a habit I had and this just gave me rife opportunity to run away with it. I’m pretty sure I’ve always been a scab-picker, but really, who hasn’t? Everyone does it, especially kids. It’s just something I started doing, and I never even realised it was anything of note until my boyfriend kept pointing out my red arms, or that I’d been sitting there picking at something without realising.

I’m not always aware of it, but sometimes I know exactly what I’m doing. It’s hard to keep track of fidgeting and picking at my fingers or hands. Having a nosy around my arms to find little bumps to pick is second nature. If I pluck my eyebrows (which has do be done with alarming frequency), the tweezers naturally just wander over the rest of my face. I use the magnifying side of the mirror to make sure, of course, that I don’t miss anything. Anything that would be barely visible to the naked eye, but in my head still needs to be rectified. I’ve used tweezers and even pins or needles in the past to try to ‘open up’ blemishes.

Again, I know that this is something other people do – lots of people, in fact. I don’t know if you’ve seen Dr. Pimple Popper on YouTube or Instagram (if you are squeamish, DO NOT look at this), but it’s ridiculously popular. Essentially you’re just watching a dermatologist squeeze various pimples, boils, cysts, etc. People find it grossly fascinating. It’s a very common thing, we know we shouldn’t, but we are a weak species and these things are so tempting. When I sit calmly in front of the mirror squeezing non-existent blemishes, faded scars, or tiny bumps in my skin, I use this as my reasoning. It’s fine, everyone does it. I know people who ask to pick their partner or friend’s spots.

I’m starting to find myself quite funny now, not in a #banter way, but in the way I’m clearly normalising some of my problematic behaviour by claiming that everyone does it, and making excuses for causing myself minor injury. Still, I would be hesitant to step into the dermatillomania/excoriation camp. Is this because I’m aware I just have a lot of anxious fidgety habits, nothing more, or because my behaviour is so normal to me that I don’t realise it’s, well, not normal? Where is the line with this sort of thing? When does it stop being a mildly improper habit and descend into a full blown obsession? Anything that I’ve briefly read on the subject speaks of it in terms of relation to anxiety disorders without acknowledging that actually, skin picking is incredibly common outside of these disorders, as well.

We all know someone who bites their nails, a habit which many people struggle to break and that undoubtedly becomes more prevalent in times of stress. It’s a way to expend nervous energy. This can be damaging, too – it’s painful, your fingers can become sore or even infected. It must be the same with skin picking, and I’m wondering why nail biting isn’t noted as something that can also surely descend into obsessive, unhealthy depths?

Perhaps my overall point is, how on earth is one meant to tell when this sort of thing becomes a problem? What’s the threshold? I can look at that NHS description and think, ‘Yep, that’s me’, but I honestly don’t think it’s a disorder as such. At worst, it’s repetitive and unhealthy, something I should avoid. I don’t want to appear as though I’m in denial, but I just don’t think it’s that big of a deal.

So, why write a post about it, then?

Great question, and I’m starting to wonder that myself. I can completely understand how it would become a real concern for people, and I’ve seen some pretty sad pictures of people who have really caused themselves some problems with picking their arms or face. I suppose what I’m wondering is – given that although I am a frequent picker, I’d say it’s definitely on the mild end of the spectrum – what exactly are my fidgety, picky, habits covering up?

I can sit and fidget, pulling at the skin on my fingers, chewing my lips, whatever, when I’m in a stressful situation. I wring my hands, I jitter, you know the type. Physical manifestations of anxiety. A lot of the time, though, when I am at home, I don’t feel anything. I’m not anxious or nervous, I’m just doing it. It’s just habit, but it’s an exceptionally hard habit to break.

Is it just a habit, though? I wonder if it relates to something deeper. I’m going off a bit here, working with assumptions, but when I last spoke with my therapist we discussed how difficult I find it to tap in to my anxiety. There’s clearly all kinds whirring around in my brain, causing me physical symptoms, and presumably, linking in to my constant faffing with my skin. I don’t know what’s behind this wall – it’s as though I’ve built it to protect myself, which seems like a pretty reasonable idea apart from the fact that it isn’t really working. I may be able to cover my eyes and ears to ignore the thoughts, but the fact is, I’m still suffering with anxiety. I just don’t know why.

I know that there doesn’t have to be a reason, per se. I also know that there are almost certainly plenty of ‘reasons’ for me to be anxious – I just can’t feel them. Am I anxious about not having a real job? Probably, but I don’t really think about it. It just happens. Do I get anxious about social situations? Of course, but I couldn’t tell you precisely what it was I would be worrying about. Do I get racing thoughts? Yes – but they’re either completely mundane, or it’s just a sort of blur in my brain, wordless, a sensation more than anything.

I used to be able to hear these things – this situation will be awful because such-and-such will happen, or so-and-so will think this, what about that, what about this, what about the other? I’ve become sort of numb to it, but somewhere my body and brain are still connected, and I get the feelings all the same. This must be where the skin picking comes in; deep down, I know there’s something wrong, so if I just expend this energy by fidgeting or just try to make my skin look better like this (spoiler: it never does) then maybe it will be okay.

Physical anxiety is so interesting to me. Although it’s horribly unpleasant, it interests me simply because I am so used to being in tune with my own thoughts, with knowing myself so well, even though everything I knew was in no way healthy or helpful. The skin picking I know as part of me – but I’m coming to realise, that whatever’s deep down in there, literally under my skin, I have no control over. It’s a complete stranger, hiding in the shadows whenever I bother to go looking.

There’s a mine of untapped fear and discomfort down there, somewhere. It pops up in my habits, my mood, my body – but I have no idea what it is, or what it means. It’s as though I am trying to get to it through my own skin.