Overcoming Nail Biting: Strategies for Anxiety and Self-Image Issues

I want to quit biting my nails (I end up eating them after biting)?

Hello, doctor.
I am currently a freshman in college.
I started to realize that biting my nails was not right when I was in the first year of middle school, but I began biting them in elementary school.
I have tried many methods found online, but none have worked.
I have used breathable tape (which I end up tearing off to continue biting), applied menthol ointment, and used nail polish (even though it has a smell, I still can't stop).
I am from Taipei but currently studying in Tainan.
However, I feel very anxious when I am at home in Taipei.
Whenever I return to my home in Taipei, my nail-biting and nail-eating behavior becomes much worse.
Sometimes I even bite until I bleed.
Additionally, I find it very difficult to fall asleep at my home in Taipei; I often lie down at midnight and only fall asleep around 3 AM.
Sometimes I fear that I will wake up in the middle of the night to help my dad clean up after himself (my dad often got drunk during my high school years and would urinate in the room at night, which would scare my mom and me awake).
The relationship between my parents is not harmonious, but it’s not terrible either.
I witnessed my dad physically harm my mom several times when I was young.
Additionally, when I was a child, I often couldn't eat and was frequently locked in a completely dark room.
Now that I am older, I don't know whether to like or dislike my dad.
On one hand, I feel he is someone who has hurt my mom; on the other hand, I feel he seems to have changed for the better now.
Every time I think about this issue, I feel very anxious and find myself in a contradiction.
Furthermore, sometimes I unconsciously bite my nails and only realize it after I have bitten off the new growth.
However, I almost never bite my nails when I am outside; it only happens in enclosed spaces.
Because of my nail-biting, I always feel that my hands look ugly.
Whenever I need to point something out to others or when everyone is comparing hand sizes, I really don’t want anyone to see my nails.
I also don’t want others to know that I bite my nails.
When someone finds out that I bite my nails, I feel a strong urge to change the subject and feel very embarrassed.
Doctor, what should I do?

Xi, 10~19 year old female. Ask Date: 2017/02/21

Dr. Liu Runqian reply Psychiatry

According to your description, the behavior of nail-biting is highly correlated with emotional anxiety and may require differentiation to rule out obsessive-compulsive disorder or anxiety disorders.
Since your behavior has caused significant distress in your daily life, it is advisable to seek evaluation and treatment from a professional psychiatrist.

Reply Date: 2017/02/21

More Info

Nail biting, or onychophagia, is a common behavior often associated with anxiety and stress. It can be a coping mechanism for dealing with uncomfortable emotions or situations. Your experience, particularly the increase in nail biting when you return to your home environment, suggests that there may be underlying anxiety related to your family dynamics and past experiences.
From what you've described, it seems that your nail biting has been a long-standing issue, beginning in middle school and possibly even earlier. The fact that you have tried various methods to stop, such as using tape, applying unpleasant-tasting nail polish, and other deterrents, indicates that you are motivated to change this behavior. However, the persistence of the habit suggests that it may be more deeply rooted in your emotional state rather than just a physical habit.

Your anxiety appears to be exacerbated by your family situation, particularly your father's past behavior and the tension in your home life. Witnessing domestic conflict and experiencing fear related to your father's drinking can create a significant amount of stress, which may manifest in behaviors like nail biting. Additionally, the feelings of ambivalence towards your father—wanting to reconcile with him while also feeling hurt by his past actions—can contribute to your anxiety and self-image issues.

Here are some strategies that may help you overcome nail biting and address the underlying anxiety:
1. Identify Triggers: Keep a journal to track when you bite your nails. Note the situations, feelings, and thoughts that precede the behavior. Understanding your triggers can help you develop strategies to cope with them.

2. Mindfulness and Relaxation Techniques: Practicing mindfulness can help you become more aware of your thoughts and feelings without judgment. Techniques such as deep breathing, meditation, or progressive muscle relaxation can reduce anxiety and help you manage stress.

3. Cognitive Behavioral Therapy (CBT): Consider seeking professional help from a therapist who specializes in CBT. This type of therapy can help you identify negative thought patterns and develop healthier coping mechanisms. It can also address the anxiety related to your family dynamics and self-image.

4. Substitute the Behavior: Find alternative behaviors to replace nail biting. For example, you could use a stress ball, fidget spinner, or even keep your hands busy with a hobby like drawing or knitting.

5. Positive Reinforcement: Set small, achievable goals for yourself. For instance, aim to go a day or a week without biting your nails. Reward yourself for reaching these goals, which can help reinforce positive behavior.

6. Communicate Your Feelings: If you feel comfortable, talk to someone you trust about your feelings regarding your family situation. Sometimes, sharing your thoughts can alleviate some of the emotional burden.

7. Create a Supportive Environment: Surround yourself with supportive friends or peers who understand your struggles. Engaging in social activities can also distract you from nail biting and improve your self-esteem.

8. Limit Exposure to Stressors: If possible, try to create a more calming environment at home. This might involve setting boundaries with family members or finding ways to manage stress when you are in that environment.

9. Professional Help: If your anxiety and nail biting persist, consider consulting a mental health professional. They can provide tailored strategies and support to help you navigate your feelings and behaviors.

It's important to remember that overcoming nail biting is a process that takes time and patience. By addressing the underlying anxiety and developing healthier coping mechanisms, you can work towards reducing this behavior and improving your self-image.

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