Nail Biting As A Psychiatric Disorder?
I am a nail biter. Sometimes I just bite the nails and sometimes it’s the skin around my nails. There, I’ve said it.
I’ve known that for a long time, but only discovered recently that I have a mental health problem.
That’s right. Biting your nails (onychophagia) is not just an ugly habit. Itís being reclassified as a psychiatric disorder.
The American Psychiatric Associationís Diagnostic and Statistical Manual (DSM), the bible for all mental health professionals since it contains a listing of diagnostic criteria for every psychiatric disorder that the U.S. health system recognizes, is expected to include nail-biting as a form of obsessive compulsive disorder (OCD) in its 2013 version.
For me, nail biting is a reaction to stress, and most of the time I don’t even notice that I’m doing it. I’ve even bitten the skin around my nails so fiercely that I draw blood. But does that make me a candidate for mental health treatment?
At the very least, let’s draw a distinction between people who bite their nails casually without paying attention and those who bite them down to the quick until they bleed.
According to NPR, nail biting, along with other nervous tics like picking at your skin and pulling your hair out, is called pathological grooming.
Carol Mathews is a psychiatrist at the University of California, San Francisco, who was interviewed by NPR:
“They are behaviors that stem from normal grooming ó the kind of thing that most animals do and is evolutionarily adaptive, right?” says Mathews.
But in pathological groomers, those behaviors go haywire. Instead of being triggered by, say, a hangnail, the pathological nail biter is triggered by driving, reading or feeling stressed out. “After a while, the behavior becomes untriggered,” says Mathews. “It becomes just an automatic behavior that has no relationship to external stimuli at all.”
Currently, pathological grooming, including nail biting, is labeled “not otherwise classified” by the DSM. Classifying nail biting as an OCD notches my bad habit into a full-blown disorder. According to Helpguide, OCD is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform.
These behaviors have a lot in common. In both cases, it’s taking a behavior that’s normal and healthy and putting it into overdrive, doing it to the point of being excessive. But in at least one way, OCD and pathological grooming are also very different.
“In OCD, the compulsion is really unwanted,” says Mathews. People with OCD don’t want to be washing their hands or checking the stove over and over again. There is no fun in it. There’s fear ó fear that if they don’t do something, something else that’s very bad will happen to them.
But from her pathological grooming patients, Mathews hears a very different story: They enjoy it. “It’s rewarding. It feels good. When you get the right nail, it feels good. It’s kind of a funny sense of reward, but it’s a reward,” she says.
That may be true but we nail biters know that we’re not supposed to bite our nails, so there are all kinds of remedies out there: painting bitter polish on your nails; only allowing yourself to bite your pinkies; wearing gloves; or stopping one finger at a time, maybe starting with your thumb nails.
Nail biting, just like bad habits, isn’t a mental illness until it’s abnormal behavior that interferes with your life. The extreme form of any behavior, when it interferes with normal functioning or becomes disruptive in some way, is a disorder. It can be a hard distinction to identify, but it’s important. So maybe I don’t have to visit a shrink after all.
What do you think? Do you bite your nails? Should nail-biting be classified as an obsessive-compulsive disorder?
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