The Unusual Overlap of ADHD, Pores and skin Choosing & Auto-cannibalism

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The Unusual Overlap of ADHD, Pores and skin Choosing & Auto-cannibalism

The Strange Overlap of ADHD, Skin Picking & Auto-cannibalism

Do you battle with ADHD Pores and skin choosing or biting like me? Do you, too, sport embarrassing uncooked or bloody spots someplace in your pores and skin as a result of you may’t appear to cease doing it? If that’s the case, you aren’t alone.

ADHD overlaps with lots of issues: anxiousness, melancholy, OCD, Autism… However perhaps the strangest of all is the hyperlink between ADHD, pores and skin choosing, and auto-cannibalism AKA pores and skin biting. (Let’s be trustworthy, auto-cannibalism is much more enjoyable to say, in a twisted type of approach.)

We’re infamous for this mixture, scuffling with it at a a lot increased fee than the overall inhabitants for causes we’ll get into all through this text. The overlap and connections between these three points are surprisingly robust. Whereas researchers have some theories as to why, analysis continues to be too restricted to reply definitively why ADHD, pores and skin choosing, and biting correlate. Right this moment we’ll discover what we all know to this point. Buckle up, any article with ‘cannibalism’ in it’s positive to be a wild trip.

Frequent pores and skin choosing and auto-cannibalism fall right into a class generally known as Physique Targeted Repetitive Behaviors. BFRBs are any repetitive and persistent conduct you inflict upon your physique. Everybody picks at a bump each from time to time, however when it turns into compulsive, extreme, and persistent, it’s a BFRB.

Past pores and skin choosing and biting, BFRBs can even embrace nail biting, knuckle cracking, lip/cheek chewing, hair pulling, extreme nostril choosing, thumb sucking, hair pulling, and different comparable repetitive, physique primarily based behaviors. Whereas they undoubtedly trigger hurt, it’s vital to know that self hurt shouldn’t be the motivation behind the conduct. However we’ll discuss extra about that later within the article.

Pores and skin choosing and biting are among the many commonest BFRBs in ADHD. Among the many normal inhabitants, researchers aren’t truly optimistic how prevalent physique targeted repetitive behaviors are. Conservative research present one thing like 3%, however others present upwards of 15%. In ADHD although? It’s considered a lot increased. Probably as much as 38%.

When a physique targeted repetitive conduct is extreme sufficient to trigger harm, particularly of a long-lasting selection, it’s sometimes called a Physique Targeted Repetitive Dysfunction (BFRD). Within the DSM 5, the one particularly diagnosable BFRD’s are Pores and skin Choosing, generally known as Excoriation, and Hair Pulling, AKA Trichotillomania. They’re listed underneath the OCD umbrella, however they aren’t OCD.

ADHD, Pores and skin Choosing, and…Wolf Biting?

I’m undecided why every conduct wants 50 thousand completely different names, however somebody determined they did and now there are a number of related labels to pay attention to. At the very least a few of them are fascinating. The signs, nonetheless, suck it doesn’t matter what you name them.

Pores and skin Choosing

Pores and skin choosing can be identified and Dermatillomania, and in additional excessive (learn diagnosable) types, Excoriation. These are essentially the most generally used phrases. However, much less generally, it’s additionally referred to as Pathological Pores and skin Choosing, Neurotic Excoriation, and Psychogenic Excoriation. All these names jogs my memory of these mother and father everyone knows who present 6 completely different names to their new child as a result of they love all of them and might’t resolve between them.

Pores and skin choosing can come in numerous types, similar to choosing, squeezing, rubbing, scratching, or digging at your individual pores and skin. That may embrace issues like:

Scratching off scabs till they scar
Extreme pimple popping
Ripping off hangnails
Tearing your cuticles
Choosing at uneven, tough, useless, or dry pores and skin

That’s only a pattern, however the potentialities are countless. Most individuals decide at their face, however the scalp, neck, fingers, palms, arms, legs, toes, and toes are additionally frequent targets. Keep in mind, in these instances, we aren’t speaking about often popping a pimple or scratching at a scab. These are repetitive and persistent behaviors.

Pores and skin choosing can occur in each automated and targeted methods. Automated choosing occurs on autopilot, like whenever you’re watching tv and all of a sudden notice your face is bleeding. You weren’t taking note of what you have been doing, it simply occurred.

Targeted choosing is the other. It’s the extra obsessive model; there’s a powerful urge to choose at some perceived imperfection or sensation on the pores and skin and also you do it virtually compulsively. You’ll be able to’t appear to assist your self.

Pores and skin Biting

Pores and skin biting will get all of the fascinating names, beginning with the one beforehand talked about: auto-cannibalism. I’ve a morbid enjoyment of the time period, however it’s a little bit of a misnomer. Pores and skin biters don’t essentially eat their pores and skin, they as an alternative use their tooth of forcibly take away components of it.

Along with auto-cannibalism, pores and skin biting can be referred to as wolf-biting which may be simply as fantastical a reputation. It was used after folks noticed the same tendency for pores and skin biting in trapped wolves.

After all, it has extra ‘official’ names, too. Dermatophagia is mostly used; ‘Derma’ is Greek for ‘pores and skin’ and ‘phagia’ that means ‘to eat’. Auto-cannibalism makes further sense in gentle of that, proper? Much less generally, it’s additionally referred to as Dermatodaxia.

Whereas pores and skin biting shouldn’t be explicitly said within the DSM standards for Excoriation, it’s typically lumped inside that umbrella if the signs are persistent and extreme sufficient. Which additionally means ‘Dermatillomania’ is one more attainable identify for this ferocious conduct. (Ferocious seems like a optimistic reframe that I feel I’ll preserve).

Pores and skin biting can occur wherever you have got pores and skin however fingers and lips are commonest. I personally battle with this one and my fingers practically at all times have uncooked sores or scabs across the nail beds. Like with pores and skin choosing, this may occur in each automated and targeted methods. For me, it’s undoubtedly, 100% each.

The ADHD Overlap

Regardless of the necessity for much extra analysis into ADHD, pores and skin choosing, and pores and skin biting and the hyperlinks between them, what info we do have factors to a powerful correlation. As an illustration, analysis signifies {that a} quarter of individuals with Excoriation even have ADHD. Practically 30% of all folks with Trichotillomania have ADHD. Whereas this text isn’t about trichotillomania (clinically diagnosable hair pulling), the BFRB nature of the battle nonetheless makes it a related statistic.

Past the extra excessive types, we don’t have sufficient analysis to say with certainty how rather more frequent the sub-clinical variations of those challenges is inside ADHD, however it’s considered simply as vital. Some theories for this overlap hyperlink comparable natures of the 2 circumstances collectively. Others are extra ADHD particular. We’ll delve into either side.

Whereas Excoriation and different BFRBs are sometimes related on the anxiousness finish of the psych spectrum and ADHD on the developmental finish, one principle as to why they co-occur so continuously is this concept of frequent underpinnings. It additionally helps that over 50% of grownup ADHDers meet the factors for an extra anxiousness dysfunction, that means the 2 are already extra more likely to discover one another.

So what are these frequent overlaps of their nature? We’ll begin with the neurotransmitters.

Associated: Do I Have ADHD or Anxiousness? Right here’s Learn how to Inform

ADHD, Pores and skin Choosing, and the Position of Dopamine

Each ADHD and Pores and skin choosing (all BFRBs, actually) have ties to neurological and genetic circumstances as their most important trigger. In case you’ve been across the block with ADHD, it’s possible you’ll already realize it’s connection to Dopamine, the ‘wellness’ neurotransmitter. Mainly, that we lack an satisfactory provide. That immediately pertains to our core ADHD signs as Dopamine is answerable for our potential to really feel effectively, discover motivation, domesticate a productive quantity of psychological alertness we are able to use to push ourselves to do issues, get organized, and cease procrastinating. It’s answerable for the sense of reward that comes with a job effectively executed, how effectively our reminiscence works, our potential to manage emotion or consideration, and so forth…

Dopamine helps us regulate our impulsivity and compulsivity, too. Having a lower than satisfactory provide of this neurotransmitter is an enormous reason behind why folks with ADHD battle with the actual govt functioning challenges we have now.

Like with ADHD, Pores and skin choosing and different BFRBs are additionally believed to revolve round a Dopamine deficiency. On this case, that deficiency results in the compulsive nature of BRBFs. Impulsivity and compulsivity aren’t all that completely different; whereas compulsions aren’t a typical function of ADHD, our struggles with regulation and impulsivity create the same impact. Each circumstances embrace challenges with mindlessly partaking in behaviors (these autopilot responses, like choosing at your pores and skin with out realizing) and hyper-fixating on sure behaviors or results (like obsessing over a raised cuticle and tearing it off whatever the harm you’re inflicting).

ADHD, Pores and skin Choosing and the Position of Serotonin

Within the ADHD realm, we don’t discuss sufficient about Serotonin, so some could not notice this neurotransmitter can be concerned in our struggles. Serotonin performs an enormous position in temper and emotion regulation. In each ADHD and pores and skin choosing / BRBFs typically, the genes that regulate our serotonin aren’t doing their job as successfully as we’d like them to.

Challenges with emotion regulation are a well-researched and confirmed actuality for folks with ADHD. The identical a part of the mind that regulates consideration, regulates emotion as effectively, which is why we battle with it. That dysregulated battle can be why we’re so more likely to develop further anxiousness problems, like Excoriation.

Pores and skin choosing and different BFRBs are sometimes coping mechanisms folks use in an try soothe dysregulated anxiousness. That creates the targeted, compulsive urge to choose at your pores and skin that feels virtually unattainable to disregard. As soon as we efficiently scratch off our scab or chew off the hangnail, we really feel reduction and pleasure, till the urge begins anew.

Associated: ADHD and Feelings: The Hidden Hyperlinks You Must Know NOW

ADHD, Pores and skin Choosing, and Sensory Processing Points

Each ADHD and pores and skin choosing typically contain variations in sensory processing. The repetitive side of pores and skin choosing and different BRFBs offers sensory enter to the mind that’s sometimes skilled as soothing and pleasurable. That helps calm anxiousness, restlessness, and regulate consideration. Sensory processing variations could contribute to a heightened consciousness of pores and skin imperfections or sensations that enhance the urge to choose, chew, or in any other case resolve the difficulty.

ADHD Pores and skin choosing: the Particular Methods ADHD Results in BFRBs

Past the commonalities between them, there are additionally inherent ways in which ADHD particularly encourages (and exacerbates) these repetitive behaviors like pores and skin choosing and biting.

Stimming

Stimming is when an individual repeatedly engages in the identical behaviors or sounds. That may appear to be enjoying the identical tune 50 occasions in a row, repeating phrases in your head since you like how they sound, fiddling with issues, bouncing your leg, or, extra related to this text, choosing or biting at your pores and skin.

ADHDers use stimming as a method to higher regulate ourselves. It’s thought to assist us enhance focus, consideration, and temper, whereas reducing stress, boredom, anxiousness, and sensory overload. Particularly for girls with ADHD, pores and skin choosing is a quite common approach that typically stim.

Govt Functioning Challenges

The manager operate challenges inherent to ADHD could contribute to our growth of physique targeted repetitive behaviors and undoubtedly exacerbates them. Impulse management, consideration regulation, and temper regulation are all govt capabilities that folks with ADHD are inclined to battle with. Low impulse management coupled with an anxious temper or boredom and poor consideration naturally lead us to interact in automated repetitive behaviors with out realizing it. Low impulse management coupled with sensory challenges and a hyper-focused state, typically result in targeted or compulsive repetitive behaviors which can be very arduous to disregard.

After I’m in a distracted place, I can tear the pores and skin round my fingers to shreds with out realizing it. After I’m in an obsessive place, I swear I can really feel a distinction in sensation of the pores and skin I wish to ‘repair’, which is normally round my fingernail. That sensation will drive me to madness if I can’t chew on the offending space. Whereas sensory processing isn’t essentially an govt operate, the shortcoming to manage our ideas round sensations to the purpose of hyper-fixating on that, definitely entails govt operate.

In these moments of sensation hyper-focus, it’s arduous to consider anything however the way in which that finger feels. I’ve tried carrying gloves and different methods to cover the pores and skin from view however the sensation continues to harass me. The one approach I’ve efficiently been in a position to transfer previous that feeling with out destroying my pores and skin is to use compression in a approach that disrupts the sensations. A good Band-Help, ideally.

I mentioned it earlier than, I’ll say it once more. This hyper-focused place we are able to get into round pores and skin choosing, biting, and so forth… seems to be virtually equivalent to the compulsivity inherent to BFRBs.

Sensory In search of and Cognitive Fatigue

Whereas pores and skin choosing is usually related to the necessity to self sooth throughout occasions of tension, stress, overwhelm, or overstimulation, for folks with ADHD, it may also be the other. I’ve typically mentioned that ADHD is like residing on the sting of a tightrope between being overstimulated and being under-stimulated, overwhelmed or to this point past bored we wish to cry. That under-stimulated, existentially bored place typically contains cognitive fatigue that complicates the the entire expertise. It leaves us feeling unfocused, hazy, and exhausted.

Pores and skin choosing and biting are ways in which ADHDers search sensory enter to alleviate the discomfort of stimulation deprivation. It helps us really feel extra alert, distracts from the psychological fatigue, and stimulates our drained, bored, overloaded mind.

Associated: ADHD and Overwhelmed: Learn how to Cease it In it’s Tracks

Relying on the particular methods your ADHD Pores and skin choosing or different BFRB overlap, getting handled for ADHD might also enhance your repetitive conduct. ADHD meds assist us regulate every little thing higher, which implies much less of a necessity to choose or chew at our pores and skin. That’s not at all times the case, nonetheless. In case you’ve developed a full blown, main Excoriation dysfunction, as an illustration, your ADHD meds may assist however they’re unlikely to cease the conduct. Listed below are the remedies most advisable for treating pores and skin choosing and different physique targeted repetitive behaviors.

Really useful Therapies

A number of remedy fashions are useful in treating physique targeted repetitive behaviors. Particularly:

Cognitive Behavioral Remedy: a kind of remedy that depends on altering dysfunctional underlying beliefs as a method to impact optimistic adjustments in conduct.
Behavior Reversal Coaching: a kind of behavioral remedy that helps elimminate undesirable behaviors by changing them with different actions.
Complete Behavioral Therapy: an proof primarily based remedy for BFRBs that makes use of self monitoring and sensible methods to interrupt undesirable behaviors and substitute them with more healthy options.
Acceptance and Dedication Remedy: a kind of mindfulness primarily based behavioral remedy that emphasizes acceptance of adverse ideas, emotions, signs, or circumstances. It encourages elevated dedication to wholesome, constructive actions that uphold your values or objectives.

Really useful Medicines

There presently aren’t any medicines which can be particularly cleared to deal with physique targeted repetitive behaviors. At present, medicines are used ‘off-label’ for treating them. Up to now remedy has been more practical, however some folks require medical intervention earlier than therapeutic work can get very far. In these instances, these medicines are essentially the most generally used:

Anafranil
SSRIs similar to Zoloft, Lexapro, or Prozac
Different antidepressant medicines together with sure Tricyclic Antidepressants and SNRIs
Naltrexone
Neuroleptics like Zyprexa and Abilify
Lithium
N-acetyl cysteine (NAC)

Self Care Therapies

There are additionally some methods you should use by yourself to deal with pores and skin choosing, biting, and different BFRBs. They primarily revolve round 1. growing consciousness 2. Figuring out and monitoring triggers and contributing components 3. Create want particular methods to experiment with

Rising Consciousness

The profitable remedy of something begins with growing your consciousness of it. On this case, that’s gathering perception into your commonest triggers for pores and skin choosing, the operate it serves for you, components that enhance your want to interact or complicate your potential to shift away from the conduct, ect…

After all, taking note of oneself when you have got ADHD will be…tough. To say the least. Usually, our consciousness is available in retrospect, when our zoned out mind lastly clues into the present second. If you lastly catch your self choosing at your pores and skin, be aware of the way you’re feeling, what’s taking place in your surroundings, and what it seems like you might be getting out of the conduct.

In case you are conscious of the conduct, struggling in a hyper-fixated, obsessive urge to choose or chew, concentrate to what’s drawing you. Is it the necessity to really feel a selected sensation? The necessity to do away with one? Is your thoughts latched on to the way it feels, or is your physique a life wire needing one thing to calm it down? Does it really feel such as you may cry for those who cease?

Figuring out and Monitoring

As you begin taking note of what drives your conduct, write down your observations. I can’t stress that sufficient. You will neglect for those who don’t. That’s simply ADHD for you. Don’t fall for the ADHD lie ‘it’s wonderful, I’ll keep in mind.’ You received’t. Your mind is mendacity to you. Do what I do and create your self a google doc (or a selected file in your cellphone, no matter works) the place you may put all of your observations.

Take note of patterns and themes. Does boredom present up lots in your notes? Does it worsen whenever you’re sitting nonetheless? What actions, environments, or moods are least more likely to set off your pores and skin choosing? These sorts of patterns will let you know a lot and assist you determine methods which can be extra possible to assist.

In noticing and monitoring my very own particular experiences with biting at my fingernails, beds, and cuticles I’ve been capable of finding just a few methods that do assist. (FYI: They haven’t mounted it, I’m nonetheless engaged on that however they’ve helped). By targeted statement, I’ve found that my largest triggers are boredom, cognitive fatigue, excessive stress, and sensory points.

Create Wants Particular Methods

By way of experimentation with this info, I’ve realized that when biting my pores and skin is said to boredom or fatigue it actually helps to have chewing gum, arduous sweet or one thing else I can mindlessly fidget with. I’m almost definitely to interact in bored/drained primarily based pores and skin biting whereas sitting nonetheless: watching television, listening to an extended speech, or typically whereas focusing.

Pores and skin biting associated to excessive stress sometimes wants a extra bodily method to set free further power and extra self soothing coping methods to assist me keep away from biting. If I’m harassed and sitting nonetheless, I’m virtually assured to destroy my fingers except I’ve one thing very soothing and distracting. Coloring has helped a bit. So has journaling and getting train.

In relation to the sensory points issue, wrapping the offending space in a Band-Help is the one factor I’ve discovered to quell the obsessive urge to chew at my pores and skin. I wrap a cloth Band-Help across the tip of the finger I’m hyper-fixated on, tight sufficient that even strain of it disrupts the sensations I really feel lingering on my pores and skin.

Your personal experiences could result in completely different triggers, components, and due to this fact which methods you’ll find best. Take a while to work on actually taking note of why you decide your pores and skin, what’s taking place whenever you do it, and what it does for you. Then, experiment with completely different methods from there.

ADHD Skin Picking and Skin Biting: Strangely Curious Overlaps pin

That’s a Wrap

That’s the connection to ADHD, pores and skin choosing and biting, as promised. In case you’re tearing at your pores and skin whereas studying this text, don’t neglect to take a minute and take note of what you’re feeling and what it’s doing for you. It’s sophisticated battle and one I haven’t fully received but, however with the knowledge and methods listed above, I’m making progress towards stopping and you may too.

In your individual battle with ADHD and pores and skin choosing, what have you ever discovered that has helped? Drop a remark under; you by no means know who it would assist.

Tia CantrellMedical Psychological Well being Therapist

Tia is a Licensed Skilled Counselor, ADHD Girl, and the Mind behind the Little Miss Lionheart Weblog. She’s a Harry Potter Nerd, Canine Mother, and Espresso Connoisseur with a ardour for serving to. She lives in Charlotte, NC along with her husband and a pair of loopy canine.

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The Unusual Overlap of ADHD, Pores and skin Choosing & Auto-cannibalism