Hair twirling, cuticle picking and nail biting might be annoying habits, but can they sometimes be considered mental disorders?
The psychiatric world is planning to change how it views these behaviours so that it can now identify when these common “bad habits” become outright obsessions.
The American Psychiatric Associated is getting set to issue a revised version next year of the Diagnostic and Statistical Manual of Mental Disorders -- the textbook often called the "psychiatric bible." When it does, hair pulling, skin picking and other forms of "pathological grooming" could be re-classified as forms of obsessive compulsive disorder, or OCD.
Many of us bite our mails or twirl our hair when we’re nervous -- often unconsciously. But some people develop debilitating compulsions with these habits, becoming unable to resist the urge to pull out their own hair, or chew on their nails.
Even when they’ve pulled out so much hair they have bald patches on their heads, or have chewed their fingers until they bleed, they can‘t stop themselves. It’s these people that psychiatrists will now recognize as having distinct mental disorders.
Until now, hair pulling -- officially called trichotillomania -- and skin picking -- called dermatillomania -- were considered "impulse control" disorders. Trichotillomania even had its own category under the current DSM currently, the DSM-IV.
But psychiatrists say both habits are not really forms of "mania," but are much more akin to behaviours seen in OCD. Under the new DSM, they will be recognized as disorders when sufferers say their habits are interfering with their daily lives, causing them stress or leading to visible effects.
Compulsive nail biting hasn’t been recognized as a disorder, but for those who bite their nails so badly it’s causing them mental anguish, they too will be considered to be suffering from an obsessive-compulsive disorder "not elsewhere classified" under the new manual.
Psychiatrists say all of these disorders are similar in many ways.
In all cases, the affected patients have compulsive needs to perform their habits. Even when it causes physical pain or problems for them socially, they can’t stop. And even though they don’t like how they look when they’ve finished their habits, they can’t stop.
Dr. Nilay Shah, a neurologist and medical director of the Integrated Medicine of Mount Kisco, N.Y. tells ABC News including these disorders in the DSM-V is great, because it gives the disorders legitimacy. He adds when there’s a unified definition for a disorder it helps doctors secure funding for further research into the disorders.
But some disagree with the plan to move the disorders under the OCD umbrella. They point out that most OCD sufferers derive no pleasure from their rituals -- such as compulsive hand washing or compulsive organizing. But hair pullers and skin pickers describe feelings of relief and pleasure during their habits.
The good news is that the same therapies that help those with typical OCD can also help those with "pathological grooming" disorders. Treatments include cognitive behavioural therapy as well as medications such as antidepressants.
