ADHD And Stimming Behaviors: How To Stop Skin-Picking

Medically reviewed by April Justice, LICSW
Updated April 18, 2024by BetterHelp Editorial Team

Attention-deficit/hyperactivity disorder (ADHD) can affect both children and adults. One potential aspect of ADHD that’s often overlooked is the presence of stimming behaviors, which can manifest in various ways—including skin-picking. Here, we’ll delve into what ADHD is, explore stimming behaviors that may be associated with this condition, and provide insights on how to stop skin-picking in the context of ADHD.

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What is ADHD?

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention and/or hyperactivity and impulsivity that can interfere with daily functioning. Individuals with ADHD may face challenges with various aspects of life, such as organization, time management, and impulse control. 

There are three key presentations of ADHD, each of which may manifest as a set of distinct symptoms. Common signs of the primarily hyperactive/impulsive type can include things like restlessness, fidgeting, talking a lot and interrupting others, and making rash decisions without considering the consequences. Common signs of the primarily inattentive type may include things like trouble with focusing, staying organized, and paying attention to details. The combined type may manifest as symptoms from both categories. Although these are some of the most common, there is a wide range of possible symptoms of ADHD, including stimming behaviors like skin-picking.

ADHD symptoms and stimming behaviors

Stimming behavior, short for self-stimulatory behavior, is sometimes present as a symptom in individuals with ADHD. Stimming serves as a coping mechanism for managing sensory input and regulating emotions.

In the context of ADHD, stimming behaviors may take the form of repetitive movements, sounds, or actions that help individuals focus, self-soothe, or release excess energy. Skin-picking is one stimming behavior that individuals with ADHD may engage in to cope with heightened stress, anxiety, or restlessness. Stimming is not inherently harmful, but intervention may be necessary when it escalates to potentially self-injurious behaviors like skin-picking.

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Skin-picking and other body-focused repetitive behaviors

Skin-picking, also known as dermatillomania or excoriation disorder, is classified as a body-focused repetitive behavior (BFRB). BFRBs involve recurrent behaviors that lead to some kind of physical damage to the body. In the case of skin-picking, individuals may repeatedly pick, scratch, or pull at their skin, which may lead to tissue damage, scarring, and/or infections.

Skin-picking behaviors are often driven by a combination of factors, including stress, anxiety, boredom, and/or a need for sensory stimulation. For individuals with ADHD, the impulsive nature of the disorder and the challenges it may present related to regulating emotions could contribute to the development or exacerbation of skin-picking behaviors.

How to stop skin-picking

Addressing skin-picking in the context of ADHD often requires a multifaceted approach that combines behavioral strategies, self-awareness, and, in some cases, professional support. Here are some practical steps that may help an individual stop skin-picking:

  • Recognize what triggers this behavior. First, you might see if you can identify situations, emotions, or environments that trigger the urge to pick—which is often the first step in developing strategies to manage them. Practicing mindfulness may help you become more aware of these, and keeping a journal could make it easier to keep track of them. 
  • Implement habit-reversal training. Habit-reversal training is a behavioral therapy technique designed to replace undesirable behaviors with healthier alternatives. In the context of skin-picking, individuals can use this technique to learn to recognize the urge to pick and replace it with a competing response, such as squeezing a stress ball or engaging in another non-damaging activity.
  • Develop coping mechanisms. Developing alternative coping mechanisms to skin-picking may help an individual with ADHD more healthily manage stress and anxiety. Examples can include deep breathing exercises, grounding techniques, positive affirmations, or forms of sensory stimulation that are not harmful.
  • Establish a routine. Creating a structured daily routine may help decrease stress, which could reduce the impulse to pick at the skin. Consistency in daily activities and healthy habits may also support improved impulse control and emotional regulation.
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Addressing skin-picking in therapy

Seeking the support of a mental health professional can be a beneficial step forward for individuals facing any number of mental or behavioral health challenges—including those with ADHD. If you’re trying to stop skin-picking or learn healthy ways to cope with other symptoms, a trained provider may be able to help. They can support you in uncovering the root causes of various behaviors, trying out different coping mechanisms, and finding healthy, supportive ways to manage symptoms. 

People who are prone to sensory overstimulation due to ADHD or another reason may be hesitant to attend in-person therapy sessions in an unfamiliar environment. In cases like these, online therapy can represent a valuable alternative. With an online therapy platform like BetterHelp, you can get matched with a licensed therapist and then meet with them virtually from the comfort of home. Studies from recent years suggest that online therapy can provide similar outcomes to in-person therapy in many cases.

Takeaway

Many people are familiar with more common ADHD symptoms like impulsive decision-making, trouble focusing, and restlessness, but fewer are aware that stimming behaviors like skin-picking can also manifest as a part of this condition. Addressing skin-picking behaviors in the context of ADHD can involve increasing self-awareness, implementing behavioral strategies, and seeking professional support. 

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