When Mental Health Becomes Visible

By: Ashlyn Barnes-Stewart

Mental health is something that we have become accustomed to silencing. We are told, “Speak up, end the stigma,” but do you really feel empowered to speak out about your own struggles and hardships? Now what if your mental health was a hot topic? What difference does it make if you have physical symptoms from a mental illness and it isn’t always something that you can hide?

Dermatillomania, also known as excoriation, is a skin picking disorder that is categorized in the DSM5 as an obsessive-compulsive disorder. Dermatillomania is recognized as the constant urge to pick at one’s skin, usually in the same part of the body. The constant picking ultimately results in tissue damage, frustration, and low self-esteem. Not only is it difficult to live with dermatillomania and be asked questions like, “What happened to your hand?”, it is also quite painful when you are a university student who is expected to write an exam by hand for 2 hours when your hand is raw and bleeding.

Although psychiatrists often overlook dermatillomania, it is actually quite common in the general public, especially for people who live with mental illnesses such as OCD or anxiety disorders. Because it is not a well-known disorder, it is not only hard to find a psychiatrist who is knowledgeable on the topic but it is also difficult to find help that isn’t discriminatory against the disorder. One of the biggest issues reported by people living with dermatillomania is that people (more specifically, doctors) say, “Just stop picking”. This approach is undoubtedly frustrating for those who wish it was as simple as not picking, because in order to be diagnosed with dermatillomania, it is likely that you’ve tried and struggled with quitting multiple times.

Dermatillomania doesn’t only affect people in terms of physical pain and struggles with self-esteem; it is also a difficult disorder to cope with when you are in certain lines of work. For example, as a social work student I will be expected to do clinical counseling, which requires me to have an open body posture to ensure that clients feel as if I am comfortable. This becomes particularly difficult when you pick at your hands very frequently without even noticing that you are doing so. Going into these types of classes, I have had to prepare myself for the possibility that my disorder may cause me to lose marks, or give me no choice but to disclose myself to my professors and possibly classmates when the time comes.

As for treatment options, dermatillomania is difficult. One of the most successful and well known treatments is cognitive behavioral therapy. Unfortunately, many people living with dermatillomania do not even realize that they fit into a mental illness category. Most people just think that they have developed a habit that they are just trying to curb, but hopefully, with time and effort, we can make people more aware of dermatillomania so that those living with the disorder feel comfortable to seek help and those in helping positions can become more understanding.

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