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Nail Biting As A Psychiatric Disorder?

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.

From NPR:

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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122 comments

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3:17PM PST on Dec 12, 2012

Pshrinks want to classify EVERYTHING as a mental disorder!

10:57AM PST on Nov 28, 2012

My husband unconsciously bites his cuticles and nails until they bleed, but it makes him furious if I remind him that he's doing it. He has other odd OCD-type behavioral tics that he's also completely unaware of doing, but at least they don't leave him with what looks like a really gross skin condition on his hands. So I've decided to try to just make him aware of it--gently--when he's doing it, in hope that he'll be motivated to change the behavior. His hands look really terrible right now, to the point that he's put bandaids over the worst gnawed spots. I wish there was a treatment for this that would really work, since the condition of his fingertips is really awful to look at :(

3:23PM PST on Nov 27, 2012

"(the DSM, the book of all psychiatric mental disorders)...is a social/economic/political manifesto...the DSM determines medical insurance reimbursement and educational services. We operate within a diagnosis/disability culture, which is an insidious incentive for people to want to be determined as sicker. Doctors recognize this and regularly upgrade an illness to a slightly more serious condition. This is harder to do with a broken bone, but relatively easy to do with psychiatric diagnoses's vague and broad criteria (and in the absence of any biological markers)" Dr. Lawrence Diller, M.D

"The history of Psychiatry is filled with fad diagnoses that far overshoot their target, get wildly misapplied, and spawn new "treatments" that are often no more than expensive quackery" Dr. Allen Frances, Professor Emeritus of Psychiatry

"(regarding Psychiatry)...This is not science. This is incredibly effective marketing. It has nothing to do with science". Kathleen Slattery-Moschkau, former pharmaceutical sales rep.

"We're up against an enormously powerful alliance---pharmaceutical companies that are making billions, and a profession (Psychiatry) that is self-interested" Dr. Jerome Kagan, Psychologist.

8:55AM PDT on Oct 26, 2012

my messages are not posting!!!!!

8:50AM PDT on Oct 26, 2012

I don't really know. I am a nail biter. I used to be a lot worse. Now I mostly only bite the skin around my nails. or nails that snag my yarn when I crochet.

1:35PM PDT on Oct 23, 2012

Bonjour,

This is really not by putting of "psychiatric" label of mental disorder that this will solve anything.

Psychiatrists would like to put "mental disorder" labels everywhere to have more patients in their office. They will give you some "medical drugs" and let you go...

Psychiatrists are just looking at the symptoms, not the real cause of the problems. And the medical drugs they used have a more destrutive effects on you theu somehting positive.

If you are seeing "mental illnesses" everywhere in any human behaviour, you begin by seeing the others like "mad" persons... Then, this will not help to create a better world.

"Mental illnesses is everywhere"... this is to say "Everybody is mad"... Everybody needs a treatment... Rationality and analytic thinking are not possible for human beings...

Let's concentrate on human skills ! Let's develop them !

7:07PM PDT on Oct 21, 2012

If you rationalize it, want to quit, but at the same time insist you can't you need help.

11:05AM PDT on Oct 19, 2012

ridiculous

12:08PM PDT on Oct 17, 2012

Obgryzanie paznokci niekoniecznie musi oznaczać zaburzenia zdrowia psychicznego, często jest problemem u dzieci. Moim zdaniem wynika raczej z nieumiejętności dostosowania się do wymagań, czasem zbyt dużych, którym dziecko nie potrafi sprostać. Często jest to związane z niedojrzałością układu nerwowego i często szybko przechodzi. Zdarza się, że powraca w sytuacjach silnego stresu.

11:05AM PDT on Oct 17, 2012

Wacko talk

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