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PLEASE HELP ME HELP MY DAUGHTER
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PLEASE HELP ME HELP MY DAUGHTER

I have an extrememly beautiful looking daughter, everyone comments. She is 25 years old and has a history of mental health problems, anxiety, depression and ? bipolar. She is on epilim for the bipolar.  The huge problem she has which to date has had no help for as too ashamed, is picking.  She will spend up to two hours at a time in the bathroom with the door locked. She will make up all the excuses when you keep saying why are you still in there.  putting on a face mask, washing my hair, straightening my hair etc..... but when she comes out she has bleeding gouges all over her face and chest. She will stand in front of the mirror for up to two hours and just pick and pick at nothing. She then comes out in tears and tries to hide her face, its bleeding and she is crying, she has swellings all over her face by the time she is finished.  Today soemone accused her of being on speed or ice - apparently that causes people to do this too.  She only does it during periods of severe stress or anxiety.  Ltely thoght this anxiety and stress has been constant.  She says she sees a tiny blackhead and that sets her off and she just cant stop. She used to do this to the skin around her thumbs till they bled, she still does that too. Her face is getting some very deep scarring and its a tradgedy.  Three years ago she was modelling - aboslutely stunning looks.   Her appearance then causes deeper depression, stress and anxiety about what people are thinking of her face - viscious circle. Please help its breaking my heart
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1699033_tn?1405352675
Who is treating her for the bipolar disorder?  Is it a psychiatrist?  She needs to be in therapy for this.  There are a lot of people who pick due to increased stress levels and it is a tough one to get over therefore I strongly recommend getting professional help for it.  

This is what it says about skin picking in The OCD Workbook:  Your Guide to Breaking Free of OCD

"Closely related to TTM is chronic self-injurious skin-picking, sometimes called neurotic excoriation, dermatillomania, or self-inflicted dermatosis.  It is often found among people with OCD.  Some people pick their skin primarily to sooth an internal feeling of tension and anxiety, while others do so in order to quell feelings of boredom from inactivity, similiar to the urge to pull hair in trichotillomania.  Many pick in both situations.  Sometime an intolerance of imperfection results in attempts to even out blemishes or skin that appears uneven or imperfect.  The preoccupation with imagined skin defects is much like the preoccupations that characterize people with body dysmorphic disorder, and, at times, skin picking can be a part of a broader problem with BDD.  People with skin-picking problems can benefit from approaches simlar to those described for trichotillomania, including habit reversal training (Tend, Woods, and Twohig 2006).  For people who pick their skin as a result of BDD, exposure and response prevention combined with habit reversal yields the best results."  

Hopefully you can get her some professional help.  The sooner the better to prevent further scarring to both her body and her self-esteem.  
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4822967_tn?1367660296
Hi and thanks for the quick reply. she is uner a psychiatrist for the bipolar and also has borderline personality disorder. she has never admitted the picking problem to him and hasnt seen him for months. when she saw him last her skin was okayish.  she has seen her gp a few times and he thought she had a skin infection and prescribed doxycycline, a long term antibiotic - of course it was no help.  Peopel have accused her of taking speed and drugs but she hasnt. I have seen her in action!!! these accusations create greater anxiety and depression and the picking intensifies. she has big lumps some days from squeezing and picking so hard.  at the moment you could count about 25 scabs and lumps on her face.  Friday spent over 2 hours locked in bathroom, it was like a horror stroy when I saw her poor, onnce beautiful face, I wanted to cry - she was crying.  I told her she needs help and she said that child welfare would think she was mad and take her chidlren!!!!!   She said she sees a black head and starts to squeeze, then just cant stop for hours. The damage is unbelievable.  She has good periods where her face is completely unblemished (though sadly has some scars now).  She cakes on makeup like a mask and sometimes I think that makes it even worse because she then scrubs it raw and bleeding to make sure all makeup is off!  
I will try and do a web search for that reference you gave re HRT.  
On the upside, she went to the doctor yesterday and was started on Luvox for depression. When I got home though and looked it up it said that it was most commonly used to treat OCD. Do you think this may also help?? I think its also called fluvoxamine......
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1699033_tn?1405352675
Absolutely....skin picking is an OCD disorder and anti-depressants are used for OCD.  It takes a good 4 to 6 weeks to really see the benefits of the medication since it does have to build up in your system.  OCD is a mental disorder but not one where your kids would be taken away unless she is neglecting them.  But it sounds like she is living with you?  In any case, it is a documented disorder that requires treatment not unlike diabetes.  It all stems from a neutotransmitter imbalance in our brains and the anti-depressants help to correct that imbalance.  Please ask her to talk to her therapist about this.  I'm sure he/she has noticed the difference in her face if he/she has seen her enough times.  They can't help fix something they don't know about.  Also, picking becomes a habit and sometimes people do it without even realizing it.  Your daughter is obviously choosing to continue this habit.  The good news is that habits can be broken with the right help and determination.  I know this sounds stupid but I always advocate for people to wear socks on their hands because in the end, they can't pick if they can't get to it.  Put the socks on in the house and don't take them off.  You can hold a spoon or a fork to eat with a sock on your hand....just something to try.  
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