Recovering from BFRBs can be a challenging process, and it becomes more complex if one has to deal with co-occurring disorders. Managing dual diagnosis often requires one to keep up with integrated treatments to avoid relapse. Treating BFRB symptoms alone may not address the underlying issues. Conversely, therapy for mental health conditions such as depression and ADHD may not address compulsive habits. Therefore, you need to use treatment methods that address the BFRBs and co-occurring disorders simultaneously. This write-up explores the various co-occurring disorders individuals dealing with BFRBs experience and how they can navigate dual diagnosis.
Common Disorders that Co-Occur with BFRBs
It is common for body-focused repetitive behaviors such as tongue biting and hair pulling to co-occur with other mental health disorders. These mental health conditions are often the underlying cause of the BFRBs since they trigger a response as a way of seeking relief or coping with restlessness. The co-occurring disorders also complicate the treatment process since they need to be addressed first for the treatment plan to be effective. Some common co-occurring disorders associated with BFRBs include.
- Anxiety disorders: Most individuals dealing with BFRBs experience heightened anxiety and may adopt compulsive behaviors such as hair pulling as a way of managing the anxiety.
- Obsessive-Compulsive Disorder: BFRBs and OCD are pretty similar, especially in terms of compulsive habits that one adopts as a response to intrusive thoughts.
- Depression: BFRBs can lead to depression and vice versa. One may be ashamed of their appearance or the helplessness that comes with BFRBs, resulting in depression. Depression can also be a trigger for the adoption of BFRBs as a coping mechanism.
- Attention Deficit and Hyperactivity Disorder (ADHD): ADHD is characterized by a lack of emotional regulation and impulsivity, which can result in one adopting BFRBs as a way to manage restlessness or anxiety.
- Autism Spectrum Disorder (ASD): Individuals with ASD may engage in BFRBs as a way of self-stimulation (stimming) or as a coping mechanism for emotional distress.
- Body Dysmorphic Disorder: Some BFRBs, such as hair pulling, nail-biting, or skin picking, may be related to BDD, in which one focuses on the perceived flaws in one's body.
Navigating Dual Diagnosis
One of the best ways to navigate these conditions is by first getting a comprehensive assessment, which involves a holistic examination by a mental health professional to determine the correlation between BFRBs and the specific mental health condition one might be going through.
You will also need to educate yourself on the co-occurrence of these disorders to understand how they work and equip yourself with information that can help you understand the integrated treatment process and your recovery journey. Psychoeducation also keeps you in the loop about your triggers and how to manage them.
Most importantly, you will have to prepare yourself for multidisciplinary care. The dual diagnosis requires integrated treatment, which calls for collaboration between psychiatrists, psychologists, therapists, dermatologists, and other cadres.
Integrated Treatment Approaches
Several integrated treatment approaches are used to manage BFRBs and co-occurring disorders simultaneously. Holistic treatment plans play a vital role in the long-term management of these conditions. Some of the integrated treatment approaches you will likely go through in managing BFRBs and accompanying disorders include:
Cognitive Behavioral Therapy
The most common approach to BFRB and co-occurring disorder management is usually cognitive behavioral therapy. Techniques such as Habit Reversal Therapy and Acceptance and Commitment Therapy play a crucial role in managing these conditions. These behavioral therapies help one engage in more positive habits in response to their triggers. Most individuals engage in BFRBs as a coping mechanism to stress, depression, intrusive thoughts from OCD, and more. CBT, therefore, helps one identify and challenge the distorted thoughts that result in adopting BFRBs.
For co-occurring disorders such as depression and anxiety, CBT can help one recognize and shift negative thoughts. Habit Reversal Training is a component of CBT that mostly promotes awareness training, competitive response, and relaxation techniques. Through awareness training, one becomes more attuned to their triggers and environment, while competitive response helps in the replacement of BFRBs with other healthier habits. Relaxation techniques are particularly essential in handling co-occurring disorders such as depression, ADHD, and OCD since one learns how to manage the intrusive thoughts that may result in one engaging in BFRBs.
In cases where BFRBs co-occur with OCD, a branch of CBT known as Exposure and Response Prevention (ERP) is used. It primarily involves exposing individuals to situations that trigger their behavior while preventing impulsive habits. ERP helps you handle your triggers without engaging in BFRBs. Moreover, for anxiety disorders, ERP helps individuals face their behaviors without resulting in compulsive behaviors.
Support Groups
Joining support groups plays a crucial role in managing BFRBs and co-occurring conditions since they provide a platform for social interactions and sharing experiences. Understanding the aspects of these disorders from different people dealing with them gives a fresh perspective on the management and effects of these conditions. Also, knowing that you are not the only one dealing with such conditions enhances positivity, which is essential in the healing process. These support groups also have professional therapists to help you navigate the dual diagnosis. Learning from the experience of others also gives you first-hand information on how to manage BFRBs and co-occurring disorders.
Self-Care and Coping Strategies
Identifying triggers and practicing stress management techniques can reduce urges for BFRBs and help manage symptoms of co-occurring conditions. Self-care and healthy coping mechanisms help one manage negative emotions, reducing the likelihood of engaging in BFRBs. Depression, anxiety, and other mental conditions often exacerbate emotional stress. Hence, self-care activities such as working out and mindfulness can help with stress management, thus lowering BFRB symptoms and co-occurring disorders.
Mindfulness
Most individuals often engage in compulsive habits subconsciously, hence the need to find ways to increase awareness. Being more aware will help you identify your triggers when you are engaging in these compulsive habits, and you can instead shift to a healthier coping mechanism. Mindfulness is an excellent way to manage stress; undoubtedly, it’s a healthy recommendation for managing co-occurring disorders such as anxiety and stress. Being aware is usually the first step towards navigating these conditions since one can create a space between their emotions and response, making it possible to avoid impulsive actions. Co-occurring disorders such as OCD or anxiety usually create a strong urge to develop impulsive habits. However, mindfulness makes you more aware of these urges as mental events, not commands, allowing you to adopt a separate response.
Summing Up
While BFRBs exist independently, they can co-occur with other conditions, often mental health-related. The co-occurring disorders can complicate the treatment process since they need to be addressed to guarantee a better recovery process. A holistic treatment plan provides the best management for dual diagnosis since these conditions are highly interconnected. This is why an integrated treatment plan should address the condition's behavioral, emotional, and cognitive elements. Some integrated treatment strategies to adopt include mindfulness, behavioral therapy, self-care, and joining support groups.
