Introduction
Nail biting (NB) is more common when individuals feel bored, hungry, or want to keep their hands busy. This habit when repeated by some individuals, helps them cope with challenging emotions. For many people, it happens automatically. It may be associated with underlying psychiatric conditions.
What Is Nail-Biting?
Nail biting is a common habit that is often ignored but this may be serious and misdiagnosed. It may be associated with many mental health conditions. Medically it is also known as onychophagia. It is a destructive habit, especially when repeatedly done in stressful conditions. NB can end up with infections and mental health conditions.
Nb habits can range from benign behavior to deeply ingrained self-mutilative behavior. Generally, nail-biting starts in childhood and increases during adolescence, and slowly the habit may go off or it may remain for life long among some individuals. Studies have found that 20 to 30% of the population bites their nails. NB may affect physical and mental health and may cause damage to nails, bacterial infection, dental problems, psychological problems like depression, low self-esteem, etc.
In some individuals NB is temporary and among a few, it may be repetitive and chronic and called onychophagia. The cause of this is unknown. Some conditions associated with onychophagia are attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder, separation anxiety disorder, Tourette syndrome (TS), and other body-focused repetitive behavior (BFRB) like skin picking, hair pulling, cheek biting and teeth grinding.
Chronic NB is self-soothing in stressful situations and hence it is used as a coping mechanism during stress.
What Are the Causes of Nail-Biting?
There is no clear cause for NB.
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Once the NB becomes a habit, it may occur during frustration, boredom, or when waiting for something.
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It may be an absent-minded act that is done unknowingly without consciousness.
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It can be a nervous habit when an individual feels stressed and anxious.
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It may be related to many mental health conditions like ADHD, TS, etc.
The NB is related to obsessive-compulsive disorder. In the olden days, Greek philosophers considered fingernails are the characterization of people. 2000 years later Freud considered nail-biting as a return to the oral stage of development. In 2006, a study showed that nail biting is a manifestation of anxiety. Among children, anxiety may not be the reason. Recently, nail biting is linked to perfectionism. Studies have demonstrated that these will be showing high standards and unwillingness to relax.
They also show overplanning and get easily frustrated without high levels of activity. Researchers also found nail biting, hair plucking (trichotillomania), and skin picking to self-harm. Recent studies have suggested that NB may give temporary escape, pleasure, distraction, or relaxation to the individual who bites their nails".
What Are the Symptoms of Nail-Biting?
NB has symptoms that are physical and psychological. Damage to fingernails, cuticles, and skin around occurs.
Along with the tendency to NB, individuals affected may feel:
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Tension and uneasiness before biting nails.
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Feelings of relief and pleasure derived after biting the nails.
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These feel ashamed, embarrassed, anxious, and guilty due to the damages that are visible.
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Fear that others can notice and be disgusted with them.
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They may face complicated family and social relationships due to their tendency to withdraw from society.
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Tissue damage of nails, cuticles, and skin.
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Nail biting can cause injury to the mouth, dental problems, and other infections.
Long-term damage is rare but may be possible with the NB habit.
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Infections to the skin, stomach, and intestine may occur and these are treatable.
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Damage to the tooth may occur which needs corrective procedures for care.
NB is a habit that occurs without consciousness or it may be a focused behavior. It is very common and but it is difficult to differentiate between normal and pathological NB.
How to Stop Nail Biting?
Some individuals want to quit the habit and they make attempts to stop habits. Individuals with onychophagia may find it difficult to stop the habit. With repeated effort, one can go near recovery. A combination approach is necessary to overcome the habit.
This includes:
1) Behavioral Therapy: This therapy helps release negative emotions and shame that are present with nail biting. Habit reversal training or hypnotherapy is effective in treating this NB habit.
2) Self-care And Relaxation: Actions like regular meals, movements, and proper sleep help one to achieve calmness and confidence. This can help individuals achieve the strength to recover from the NB habit.
3) Social Support: Talking with a close friend or family member may help individuals avoid the urge to bite their nails.
4) Treating the Psychiatric Condition: Medications and behavioral therapy may be used to treat any underlying psychiatric conditions like ADHD, TS, etc.
Along with an urge to bite nails, other symptoms of NB are,
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Tension and uneasiness before biting nails.
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After biting the nails, individuals experience pleasure or relief.
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Feel embarrassed, anxious, or guilty when there is damage to skin or nails due to biting the nail.
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They fear others who can see and disgust them.
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They generally have strained, complicated family and social relationships, due to social withdrawal or others mocking them.
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Damage to the tissue, nail, and skin.
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Injury to the mouth, problems related to dental, and infections.
What Are the Side Effects of Nail Biting?
Side effects of nail biting include
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Damaged nails and skin.
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Infections of the skin and fungal infections.
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Pain in the mouth and damage to teeth.
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Stomach and intestinal infection occurs when an individual swallows the nail.
Nails contain bacteria and viruses and when these are bitten, bacteria and viruses enter the body causing infections.
Conclusion
Nail biting is a most common habit that comes under body-focused repetitive behavior. This starts in early childhood. It may get resolved on its own or may remain among some for a lifetime. It becomes important to know about the psychology behind NB, its causes, symptoms, and treatment. Knowing helps in seeking advice from a healthcare professional early. Early diagnosis helps achieve effective treatment. This in turn help in achieving good quality of life.
