Onychophagia is commonly referred to as excessive and persistent nail biting. Onychophagia is an obsessive-compulsive behavior that can cause serious repercussions to both an individual’s physical health and social well-being.
Social and Physical Effects
Although many of us at some point engage in biting our fingernails, especially in stressful situations, the real symptoms of onychophagia are much more severe than what is commonly observed in general populations. The behavior can result in bleeding of the affected fingers, which may lead to an infection when left untreated. The physical aesthetics of the hands of an individual with onychophagia also deteriorates as the disorder progresses.
Excessive nail biting, as well as other forms of compulsive behaviors, is just one of the many forms of obsessive-compulsive disorder and body dysmorphic disorder. Often, individuals with the disorder perform such a behavior without any awareness of the actions until the behavior stops. When such persistent behavior of nail biting is left unchecked, minor to major physical injuries may occur that could also lead to serious complications.
Emotional states, such as heightened anxiety or stress can trigger the onset of the compulsive behavior. Some speculations focus on neurotransmitter imbalances in the brain; however, such claims have yet to be proven by further research.
The wounds and infections caused by excessive nail biting may eventually make the patient realize the extent of the physical damage their behavior has caused, and they will tend to hide their hands and fingers away from sight, especially in public places.
Medication and Psychotherapy
Medication, antidepressants and SSRIs in particular, have been known to treat a wide spectrum of obsessive-compulsive disorders, including such disorders as nail biting. Often, medications are administered in conjunction with the duration of the psychotherapy to ensure reversal of the onychophagia.
Treatment of obsessive-compulsive disorders may also include cognitive behavior therapy to reverse the unwanted behavior. In the case of excessive nail biting, habit reversal training (HRT) may be the best approach in the treatment of the disorder.
The first stage of the therapy involves self-monitoring activities such as recording the occurrence and the length of each episode, as well as indicating the intensity of the obsessive urge to perform the behaviors.
In the second stage, the individual’s levels of anxiety are targeted, in which he or she is subjected to instructions to relax and regain focus, after which breathing and other relaxation techniques are mastered to be in total control of the compulsive behavior.
Not only do individuals with onychophagia benefit from these techniques, but the therapy would also benefit many of us who wish to control our anxiety levels, thus keeping us from performing unwanted stress-induced habits.