People with body-focused repetitive behavior disorder may feel tense or anxious just before they engage in nail biting or lip biting, and such behaviors may relieve this feeling.
Doctors diagnose the disorder when people pick at or bite parts of their body enough to cause damage, try to stop their behavior and cannot, and are significantly distressed by their behavior or function less well because of it.
Cognitive-behavioral therapy that specifically focuses on body-focused repetitive behavior disorder and certain antidepressants or N-acetylcysteine may help lessen symptoms.
Body-focused repetitive behavior disorder is classified as an obsessive-compulsive and related disorder. People with body-focused repetitive behavior disorder compulsively pick, pull, or tug at one or more parts of their body. They may bite their nails or lips, chew their cheeks, or pick at their nails.
Hair pulling and skin picking are also body-focused repetitive behaviors. They are classified as separate disorders in DSM-5, but as subheadings of body-focused repetitive behavior disorder in ICD-11.
Some people with body-focused repetitive behavior disorder do these activities somewhat automatically—without thinking about it. Others are more conscious of the activity.
People do not engage in these behaviors because they are obsessed with or concerned about their appearance (as occurs in body dysmorphic disorder). However, they may feel tense or anxious just before they do them, and doing them may relieve that feeling. Afterward, they often have a sense of gratification. People may also be distressed by their loss of control and repeatedly try to stop the activity or do it less often, but they cannot.
If people bite or pick at their nails a lot, the nails may become deformed. Grooves and ridges may develop in the nails, or blood may collect under the nail, producing a purple-black spot.
Doctors diagnose body-focused repetitive behavior disorder based on symptoms:
Treatment of body-focused repetitive behavior disorder may include drugs, such as selective serotonin reuptake inhibitor antidepressants and N-acetylcysteine, and cognitive-behavioral therapy.
Cognitive-behavioral therapy that specifically focuses on this disorder may lessen symptoms. The most highly recommended type of cognitive-behavioral therapy is habit reversal therapy. For this therapy, people are taught to do the following: