HealthYuva - India

BFRBs

Bad habits / Disorders?

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Since I am a person who’s having a BFRB, I find myself apt enough to write something on this topic above to let people know about the basic syndromic behaviors that many among us have.

Talking about BFRB let us first know what it is? BFRB is an umbrella term for a group of disorders or behaviors where a person is used to physically damage one own self in some way or the other just to reduce stress and anxiety.

BFRB stands for Body-Focused Repetitive behaviors like hair pulling, skin picking, nail-biting, lip/cheek biting, rubbing, etc.

These are the disorders that many people among us have but we take it on a lighter note and on not diagnosing it, it becomes insanely huge to control it then.

What causes BFRBs?

This can be even treated as hierarchical as the persons’ parents, grandparents anyone would be doing such repetitive things to themselves (but nobody talks/ talked about it though it’s normal)

Typically, this is been seen between the ages 11 and 15. Even some have BFRBs from a very small age i.e., since they’re infants/babies. They call these ‘baby tricks’ for babies might pull their hair and these habits often are taken for granted.

Some behaviors that take place at an initial stage be our routine or are considered to be our routine, but later on end up becoming a disorder namely BFRB in the human body. Many individuals think that they might be doing this for attention or to relieve some pain in their lives or to harden themselves.

Most of the reasons behind such disorders are to relieve some stress, anxiety, or some discomfort in one’s life.

Further talking about the treatments that serve the disorders like BFRBs, there are two treatments that are mainly talked about, they are

  1. HABIT REVERSAL TRAINING
  2. COMPREHENSIVE BEHAVIORAL TREATMENT MODEL is also known as the COMB model to control BFRBs.

To start with the treatment, awareness of such disorders is supremely important. To be aware and make people aware too, we need to ask some questions on why someone’s doing these odd behaviors? how’re they doing it? When they’re doing it? Since how long they’re doing it? What they think while doing it? What they feel afterwards? Such questions into minds of us will draw our attention to very common behaviors which are abnormally leading us to disorders.

Another way to tackle this is behavioral technique- the most effective one for cognitive behavior, reversal therapy, stimulus control.

Now a different approach to handle such must be taken, to the fact, it’s not going to stop completely, but can be handled by competing self, by distracting oneself, this could make a different choice to that discomfort, anxiety, feeling of distress inside. The BFRBs’ patients should train their brain to do something different or make them aware that they’ll be able to do something different.

Going deep inside there arise some questions which need answers,

Do medications work for BFRBs?

Various medications are suggested to the individuals suffering from BFRBs but most of the time these medications only work on anxiety and depressed feelings of the individuals and there are yet no direct and proper medications specifically made for BFRBs.

The various ailments are as follows:

  1. SSRI (Selective Serotonin Reuptake inhibitors)
  2. Mood stabilizers
  3. Opioid antagonists

Many times, it’s seen that this topic is treated as taboo to talk about.

ARE BFRB SAME AS ‘SELF-INJURY’?

As said earlier, BFRBs are such disorders which leads to extreme level if not paid desired attention up to. Certain disorders lead to some sort of injury to oneself but it isn’t the same as those chronic disorders which lead to chronic injuries on the body. While chronic nail-biting, hair pulling, thumb sucking, etc. can somewhere damage the skin or any other part of the body involved in it.

It can cause injury to self somewhere but can’t be exactly said as ‘self-injurious.

BFRBs are more appropriately categorized as impulse control disorders. These are habitual but are far more complicated than just a bad habit. Anyone can develop BFRB, it is estimated that 1 in 20 people has one.

BFRBs are complicated to treat and complicated to recover from. It takes time, vigilance, creativity, and determination to recover from BFRB.

People with such disorders many times feel shame and embarrassment about the behavior.

these disorders are classified into many but few of them are discussed as below:

  1. DERMATILLOMANIA – a disorder in which a person compulsively picks skin (face/chest/anywhere) to squeeze spots, scratching to the point where it causes bleeding and infections /scars.
  2. DERMATOPHAGIA – where a person bites skin (normally done on lips, cheeks, inside of the mouth, around fingernails).
  3. TRICHOTILLOMANIA – where a person urges to pull out their hair.
  4. TRICHOPHAGIA – where a person pulls the hair and eats it. It does go hand in hand with the above one (Trichotillomania).
  5. TRICHOTEMNOMANIA – where a person has the urge to cut/shave their hair on a repetitive note. (dangerous one).
  6. ONYCHOPHAGIA – when a person bites their nails a lot it falls under this category. A normal behavior when done in extreme amounts, this habit becomes BFRB.
  7. ONYCHOTILLOMANIA – where a person has urges to pull off their nails. This can lead to self-harm to a great extent as a person even tend to pull off their finger or toenails which leads to an extreme bleeding phase.
  8. RHINOTILLOEXOMANIA – this can be identified when there’s compulsive nose-picking. When done on an extreme level it can cause infection and even shares the bloodstream with the brain as it’s nearby.
  9. SCAB EATING DISORDER – where a person has urges to eat scabs or skin of their body.

The above-mentioned disorders are a few common BFRBs seen in the common folks at large. They seem to be misconceived many times as mental disorders but don’t fall under that category and are called BODY FOCUSED REPETITIVE BEHAVIORS. These are often considered as taboos to be discussed nowhere whereas these are certain disorders which need most to beware about as this might be a bad habit today but it won’t take any longer to be a BFRB tomorrow.

Shreya Gohel

Intern, Goa Chronicle
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