thank you - and how i'm stopping CSP with inositol

[¤prettyinside¤]

NOTE: I hope you don't mind that I'm posting this on all three sections of the message board. If it's against the rules, feel free to delete it and reprimand me. It's just that I wanted everyone to be able to read this, because I've seen so few success stories on the boards. Here's my story...

I just wanted to log in tonight and post a message here for the first time. I discovered this website about a month ago and was so relieved to know that I'm not alone in this terrible habit. I don't pick my face or arms like the majority of you -- I pick my scalp and (I'm ashamed to admit this) I eat the flakes. It is absolutely compulsive, there is no better word to describe it, and I feel that if I keep picking at it I will be flake-free and have a smooth normal scalp. I don't know why I eat the flakes, I can't possibly explain that in any rational terms. But it seems to soothe my depression and anxiety when I do it. It's only afterward that I realize I'm hurting myself even more by doing it.

Anyhow, I have been virtually pick-free for the last three weeks. I wish I could credit this website exclusively for it, but unfortunately will power alone has never been able to solve this problem for me, and it didn't this time either. But it was on this website and others for compulsive skin picking that I read about taking the vitamin called inositol. I was told that it reduces the urge to pick by regulating the chemicals in your brain.

Well... I certainly had my doubts. Reduce the urge to pick? Yeah right. But I have been taking this for the last three weeks and I can't tell you how much it has helped me. Not just with picking, but with my entire attitude. I feel human again. I feel capable of achieving my dreams. I'm not depressed. Oh sure, I have bad days along with the good. I said I feel *human* -- not perfect. I don't strive for perfect anymore. Just healthy. And I have had days where I pick my scalp for a couple of hours or so and then feel just horrible about it. But I pick myself up, dust myself off, and try again. And every day it gets a little easier.

I've listed a link for all the information on inositol, but here is the way you begin and increase your dosage in case you are impatient like me and don't want to read all the info (I'm on Week 3, by the way):

Week 1 - 1 tsp. 2x per day
Week 2 - 1 tsp. 3x per day
Week 3 - 1.5 tsp. 3x per day
Week 4 - 2 tsp. 3x per day
Week 5 - 2.5 tsp. 3x per day
Week 6 - 3 tsp. 3x per day

You just mix it in water and stir it well (the brand Solaray works the best, others taste funny and don't dissolve well). I let it sit for fifteen minutes so that it dissolves fully, and then I mix it once again and drink it down. It tastes just like sugar.

In addition to taking the inositol, I'm taking a multivitamin every morning. I'm also taking a vitamin called biotin, which promotes healthy skin, nails, hair, and scalp, and grapeseed extract because I figured the antioxidants would help me in more ways than one. I swear to God, if I could just get all of you to take vitamins too, I know that we could get rid of this horrible habit that rules our lives. It's helped me to improve at least 75% so far, and I'm not even taking the full dosage yet. If you haven't tried it yet, please do it. I'm so grateful to all of you for posting your experiences here, good and bad, so in return I wanted to tell you everything about this. I'll be back to update you later as well, after I'm at the full dosage. I know I can do this. We all can.

The information about inositol is at this link:
www.trichotillomania.co.uk/Inositol.htm
www.healthrising.com/stories/trich.htm

The first is a site about trich (hair pulling), but it applies to all of us too. The second speaks directly about compulsive skin picking, but does not give the detailed instructions on taking it. I also suffer from compulsive nail biting, and this has nearly rid me of that habit too. I encourage you to try this, because it's the only thing that has worked for me, and I've been doing this for eight long years. I wish you all lots of luck on your journey, and I have faith that each and every one of us who has the courage to come to this site will recover fully and kick this habit.

Thank you for the support, your words have been my lifeline.

[Karman]

Hi Everyone - I'm really interested in this post, although I'm not sure where to reply, since it looks like she posted it on all 3 boards... I decided to just do it here and follow whatever anyone writes on all 3, too. I have a few questions for you, prettyinside, about the inositol - mainly, what is the cost? I have also found something that has been very effective for me - Haldol (generic name "haloperidol"), but there is a risk of side effects, such as a movement disorder, with it. I take a very low dose, though, only 1 mg per day, so I'm not all THAT worried about it, but I'd be willing to try anything else that has proven effective for anyone else, to see if it works for me, too. The Haldol is relatively inexpensive, which is important to me because I don't have any insurance, so I have to pay cash for prescriptions, which can get really expensive. It costs me approximately $10.00 per month for the generic Haldol.

I'm not due to see my psychiatrist until January for a medication check, but I could experiment with the inositol in the meantime, if the cost is reasonable. If it doesn't work, I could always go back on the Haldol, since I know it works.

I'm REALLY happy for you, prettyinside, to hear that you've found something that works. I've been trying to let people know about the Haldol, in case it's some sort of a breakthrough. I don't know if anyone else has ever used it for skin picking or not, but the effect was really dramatic within a few days, when I began taking the Haldol. By then I had almost given up hope that ANYTHING was going to work!

By the way, where did you get the dosage schedule that you posted? Where did you hear of trying inositol to combat csp? I'm just curious... I'm interested in hearing about anything that has worked for anyone else, in case I ever need an alternative to the Haldol.

Thanks for letting us know about this.

[kara]

I think it's wonderful to post these ideas; I'm doing the inositil (looks like my dosage was too low from this post) so I'll up the dosage and let you guys know in a month. Inositil is cheap, and doesn't require a psychiatrist....just run over to the health food store I think (I have pill form).

[¤prettyinside¤]

Karman, I read all your posts last night about the Haldol, so I'm familiar with your situation. I think it's wonderful that you have such a supportive doctor that was willing to try so many different treatments with you, and most of all who was willing to listen to your own ideas about the causes and take you seriously.

I have not seen a doctor or therapist. The first reason would be that before this past month, I thought I was the only one with this problem. I thought I was damaged. Messed up. That probably should have been reason to see a therapist, but I was scared to death. I wouldn't have known where to begin, explaining this odd habit that I have. Now that I know the truth, I wouldn't feel terribly odd going to a therapist and talking about this.

However, I have this drive to do everything on my own, and accomplish everything solo. I don't know where that comes from, but I suppose it ties in with obsessive-compulsive disorder, which I believe I have. Nearly everything I do is done compulsively. I have learned to deal with it in my own ways, and even use it to my advantage. That may not be the healthiest approach, but I'm too stubborn to go to a doctor if I haven't tried everything else first. It's just a part of my attitude, I guess. But I have felt so balanced for the last few weeks. Not high, not low. Just normal. That is really a breakthrough for me, so I feel that I'm on the right track. If this doesn't work out, I'll definitely seek professional help. But in my heart, this just feels right.

In regard to the cost of inositol, two ounce bottles of the powder cost $12.74, and four ounce bottles cost $19.96. Obviously you save a lot of money by buying the larger containers, but I got a better deal on the small ones this time because they were out of the large ones. I haven't done the math, but it seems that I went through my first four ounce bottle in about two-and-a-half weeks. If you're spending $10 per month on Haldol, that's obviously a better choice financially. But if you have concerns about the side effects, you might want to give inositol a try for a little while. After all, you can always go back to the Haldol. In any case, I'd follow your heart and do what you think is best. All I know is that I'm happy both of us have found something that seems to work. As long as this continues to work for me long-term, the price is definitely worth it.

You asked where I heard about this. I think I first read about it on the guestbook of this site (facepick.tripod.com), and somehow I found this link:

www.trichotillomania.co.uk/Inositol.htm

It's a lot to read but I was impressed enough by their results that I wanted to try it myself. More information can be found at:

www.trichotillomania.co.uk/Inositol.htm

Unless I'm mistaken, the dosage schedule is located at the first link. If you can't find it there, let me know, and I'll try to find the right one for you.

Kara, you said you are taking inositol in pill form? I didn't even realize it was available that way. I think perhaps the reason that powder form is recommended is because you gradually increase to 18 grams per day. I don't know how much is in one pill, but I'll bet it would take an awful lot of pills to add up to 18 grams. Am I right? I'm interested to hear about it. How many milligrams are your pills?

[kara]

Hi they are 500 mgs; that's all I was taking per day; I'm going to try and stick with the pills for awhile but I know if I get to that many I'll have to do powder......

[kara]

Well this is a stupid question but is it 1000 mgs in a gram? Just wondering. Please help, I'm bad at measurements.
I'll probably have to get that powder sooner than I'd like.

[¤prettyinside¤]

You read my mind -- after reading your first post I was thinking to myself, "So if one pill is 500mg, would two pills make 1 gram?" I'm looking it up right now.

OK yes, we were right. 100 milligrams = 1 gram. Now here comes the tricky part... Converting the dosage into milligrams or grams instead of tsp...

¼ of a tsp. = 700mg. You begin with 1 tsp., which is 2800mg or 2.8 grams. So for the beginning dose (first week) you would be taking about six pills, three times per day.

Did I figure that out right? I'm notoriously bad with math... LOL

[kara]

Thanks!

[¤prettyinside¤]

I was thinking about this last night, and I realized I made a mistake. The first dose you're supposed to take is 1 tsp. 2x per day, NOT 3x per day. So to begin, you would take six pills twice per day, not three times. Sorry about that!

[Anna]

Hi, I am new here and find this site very helpful. I think I am a bit compulsive too after realizing I cannot control my destructive habits. Ever since I got off the birth control pill I have had mild acne and seem to be more hormonal. I used to pick more before the pill, but orthotrycyclen seemed to help. Now off and trying to get pregnant my skin is bad again. I noticed that the prenatal pills I just bought have 30mcg of inositol in them. Maybe this will help me. Anyone know how many mcg is in a gram? This dosage is probably too low, but it may not be good to take too much during pregnancy. Any help appreciated, thanks

[¤prettyinside¤]

I think mcg stands for microgram, which is smaller than a milligram. It would take a LOT of those to add up to a gram. I'm sure your doctor would be able to tell you if inositol is safe to take in larger doses while you're pregnant. Are you able to talk to him or her about your compulsive skin picking?

[lauryn]

SKIN PICKING AND NAIL BITING: RELATED HABITS


By Fred Penzel, Ph.D.


Although this newsletter has always been limited to discussing matters related to trichotillomania, I would like to introduce a slightly different but related topic. It may come as no surprise that there are other types of problem behaviors quite similar to trich in a number of ways. I am referring specifically to compulsive skin picking and nail biting (also known as onychophagia). These may not sound serious, but neither does hair pulling to some people. Since I have met quite a number of people who have one of these problems in addition to trich, I now routinely screen for them.


What I am referring to is not the kind of little bits of rough nail or cuticle that everyone picks at or bites from time to time, nor is it the occasional blemish that people might squeeze or pick. These nail-biters continually bite their nails past the nail bed and their cuticles until they bleed and are constantly walking around with red, sore, and sometimes infected fingers. Those who pick their skin compulsively have their faces and bodies covered, at times, with red sores and scabs known as acne excoria, a self-inflicted skin disorder that resembles acne. The smallest pimple or blemish must be opened and picked at or squeezed, either with the fingers or another implement such as tweezers, needles, pins, toothpicks, etc. Numerous scars are often the result.


Just as those with trich wear hats, scarves, wigs and makeup, nail-biters keep their hands behind their backs or in their pockets, and skin pickers wear makeup, put on clothing that covers bad areas, apply Band-Aids or just stay indoors when looking their worst. They feel the same shame and social embarrassment and experience that out-of-control feelings at times. They, too, wonder why they can't stop and they also question whether or not they are crazy.


Another similarity between these problems and trichotillomania is that they seem to happen when people are in one of two modes. Some do it in an automatic way, as if they are in a trance and not really thinking about what they are doing. Usually, they are involved in some other activity at the same time such as reading, talking on the phone, working at the computer, watching TV, etc. For others, the deliberate picking or biting is their main activity at the time, and they will frequently interrupt other activities to engage in it.


There is also a strong commonality seen in the various purposes behind these three problems. At the most basic level, they satisfy an urge. Many report an almost uncontrollable feeling of needing to do them. Pulling, picking or biting also seem to deliver a pleasurable or relaxed sensation. When sufferers feel stressed, doing these things has a kind of soothing effect on their nervous systems, and reduces levels of stimulation. On the other hand, when they are bored or inactive, they seems to provide a needed level of stimulation to the nervous system. This probably accounts for why so many people who dislike doing them find it so hard to stop. It simply "feels good" at the time, no matter what the consequences. These behaviors may really be all about self-regulation in certain individuals whose nervous system may not be doing a very good job of regulating itself (see the article "A Sensory Regulation Theory of Trichotillomania," on this website).


Another factor also seems to be at work for a subgroup of people. This involves a kind of compulsive perfectionism. Some hair-pullers must pull "special" hairs that feel "different" or as if they don't belong due to their look or feel. In the same way, nail-biters will often try to bite off rough-feeling or broken bits of cuticle or nail sticking out in order to make their nails feel smooth and look "perfect" or regular. Skin-pickers will stand for hours in front of mirrors closely examining their faces or other body areas for the tiniest bump, irregularity or enlarged pore and then try to eliminate it, or drain it, in hopes of achieving a 'perfectly' clear complexion. Paradoxically, all of those who pursue such goals always end up looking much worse in spite of their efforts, as a result of the damage that they do to themselves.


What all these similarities seem to point to is that these three behaviors are probably all different aspects of the same problem.Some have theorized that theret may be that the same out-of-control grooming mechanism in the brain underlies them all. My own theory is that there may be some type of dysfunction of a brain mechanism that regulates levels of stimulation within the central nervous system, and that these behaviors represent an attempt to control these internal stimulation levels externally. People seem to pull, pick, or bite when thery are either overstimulated (dus to stress or excitement) or understimulated (due to boredom or inactivity). Many similar behaviors can be observed in animals who are kept in confined or unstimulating environments, or who live in stressful conditions.

There are many that now believe that compulsive hair pulling, skin picking, and nail biting form a subgroup of what is becoming known as the Obsessive- Compulsive Disorder Spectrum. OCD has been previously been regarded as only a single disorder. It may in fact represent a range of related disorders, including classic OCD, Body Dysmorphic Disorder, Anorexia Nervosa, Bulimia, Trichotillomania, Onychophagia, Compulsive Skin Picking, Compulsive Nail Biting, and Tourette's Syndrome. Recently, a new term has been coined for these problems - Body-focused Repetitive Behaviors (BFRBs). As with trichotillomania, skin picking and nail biting are considered to originate within the chemistry of the brain, and may well have an underlying genetic cause.

[lauryn]

In my own practice, I have seen quite a few hair pullers who also bite their nails and/or pick at their skin. While it has never been surveyed systematically, there may be many out there with multiple symptoms. Interestingly, quite a number of people don't realize that their several problems may be connected until it is pointed out.


As with trich, these other two disorders appear to respond best to medication and behavioral therapy. Medication should never be considered an end in itself, but a tool to help you do the therapy. Drugs which remedy these problems do not work instantly- It may take several weeks before you see any results. They also may not work perfectly. Usually, 60-70% improvement from a medication is considered a good result. The medications mainly used to treat picking or biting problems are the same group as those used for Trich and OCD. This group is made up of the latest and most potent antidepressants, and includes Anafranil, Prozac, Zoloft, Paxil, Luvox, Celexa, Lexapro, Serzone and Effexor. Sometimes, these drugs may also be augmented with other medications, most often small amounts of the same medications used to treat schizophrenia. These would include Risperdal, Zyprexa, Seroquel, Geodon, and Abilify. Please note that this does not imply that people with BFRBs are in any way psychotic. Keep in mind that no one drug is best, since there is no drug works for everyone. You have to work your way through them in a trial-and-error way, until you find the one that is most effective for you. One further caution on medications is that they do not necessarily work for everyone.


One other option might be to try the B-vitamin inositol. I have seen this work in a number of cases. It seems to reduce the urge to pull or pick. It is broken down by the body into two secondary neurotransmitter chemicals that enhance the activity of serotonin in the brain. Serotonin, is a brain transmitter that may be implicated in OCD and related disorders. Inositol is usually taken in large quantities, but will not build up to toxic levels in your system, as it is a water soluble vitamin. Side effects can include gas and diarrhea, but usually, they will either quickly pass, or not occur at all. The vitamin is taken in powered form, and is built up to a maximum dosage of 18 grams over a six week period. Some people require the maximum, but some can get by with less. (You can get more detailed information about this in another article listed on this website. The title is "Inositol and Trichotillomania.") Inositol can also be safely used to augment antidepressant medication. The only exception is that it cannot be taken together with Lithium. Children generally take smaller doses than adults.


Therapy for these disorders consists of two parts. The first, is Habit Reversal Training (HRT), a four-step process which teaches you awareness of your habits, how to relax, how to breathe and center yourself, and to perform a competing and opposing muscle response. (I have described this technique in a previous issue of TLC's IN TOUCH, in an article on cognitive/behavioral therapy for trich, which I'm sure you can get copies of.) It can be extremely useful if practiced daily and stubbornly, as it must become as automatic as the habit you are aiming to eliminate. These are stubborn problems for two reasons. First, you have probably rehearsed the unwanted behaviors hundreds or even thousands of times. It is important to accept that they will not simply be overcome in a few days or weeks. Second, you are fighting the fact that they feel good to do, and provide much short range satisfaction and either stimulation or soothing. It takes time and a good deal of effort to master, but I believe it is worth it. Research shows it to be an effective technique.

The second part is known as Stimulus Control (SC). Skin picking and nail biting are a complex behaviors, with many different inputs. SC is a behavioral treatment that seeks to help sufferers first identify, and then eliminate, avoid, or change the particular activities, environmental factors, mood states, or circumstances that have become associated with, and that trigger picking or pulling. The goal here, is to consciously control these triggers that lead to the undesirable behaviors, and to create new learned connections between the urges new non-destructive behaviors. A much more in-depth description of these treatments can be found in my two books - "Obsessive-Compulsive Disorders: A Complete Guide to Getting Well and Staying Well," and "The Hair Pulling Problem: A Complete Guide to Trichotillomania." Both are published by the Oxford University Press, and you can find out more about them at www.ocdbook.com and www.trichbook.com ..


Even if you have more than one of these problems, don't despair. They can be overcome if you have the motivation. More important is learning to "de-stigmatize" yourself. You are not crazy, helpless, morally weak or totally out of control, even though you may feel like some or all of these things at times. Once you get down to realizing that you are just a person who simply happens to have a problem, you can start to make some serious progress. Skin picking and nail biting are chronic problems, so there currently isn't a 'cure', but you can find a recovery if you are willing to work at it.

[Grace]

Can you take initrol with effexor or would there be an interaction to worry about?

[Grace]

oops spelling sucks sorry meant inositol