Picking, Cracking, Scratching: How ADHD Leads to Impulsive Body Behaviors

Sam Spadafore | September 18, 2021

"How could I waste so much time doing something so harmful to myself?"

I have a confession to make: I pop my pimples.

Actually, it’s not really a huge confession. I do it all the time: in public, in private, when I’m nervous, when I’m bored, when I see my reflection and notice a blemish.

I used to have a lot more shame around this habit because I had been told by many family members over the years that I was going to end up with terrible scarring and only make things “look worse.” I didn’t know how to tell them that I felt like I needed to pop my pimples.

Even writing this article, I notice my skin tingling and my hand wanting to touch my face, shoulders, or back to scratch at some dry skin, or feel that painful bump that’s forming on my forehead.

I learned about this insistent picking from a TikTok by Dani Donovan, who explained what Body Focused Repetitive Behaviors actually are: impulsive behaviors that often hurt the body in some way.

Donovan said, “Plenty of people want to pop a white head when they see it but they don’t because their brain knows, ‘Don’t do that, you’re going to scar your face.’”

But, Donovan notes, people with ADHD have a hard time with impulse control. If we do act on impulse, we feel guilty for engaging in that behavior because if we don’t it can be incredibly painful to resist.

These repetitive behaviors are usually grooming behaviors that can actually do more harm than good.

Some of them include pulling out the hair on your body, eyebrows, or scalp (Trichotillomania), ripping off nails, compulsive nail biting (onychophagia), picking your skin (dermatillomania), compulsively popping pimples, repeated popping joints or cracking knuckles, biting the inside of your cheek, and scratching or picking at the scalp.

These behaviors are not only just related to ADHD, but people who have ADHD can suffer from these behaviors. I personally pop pimples and can get lost in doing so for long periods of time. I used to believe that I was dissociating because so much time would pass without me realizing.

I was getting lost in time because that sensation or pain from the picking and popping was giving me a moment of relief. My mind is usually racing around all day with other thoughts of what I have to do next, where I need to be later, what I did in the past, and what I would have said differently.

Picking stopped that, if only for a short time. It became a source of comfort and even a relief from my anxiety.

But when I finally came to, and I realized how much time had passed, it was like an avalanche of guilt and shame. How could I waste so much time doing something so harmful to myself?

Not only was it an escape, but it also was stimulating.

ADHDers are often looking for that boost of dopamine because their dopamine receptors aren’t picking up those signals. Some research says that it could be correlated to lower concentrations of proteins called dopamine transporters.

Essentially, ADHDers are looking for things that cause pleasure or instant gratification because their brains aren’t picking up that dopamine on their own.

People who are neurodiverse sometimes need to stim. Stimming for people with ADHD can be triggered by sensory overload or when trying to concentrate.

Looking back, I’ve been stimming from sensory overload my entire life. Scratching, popping, or picking throughout school because I was overwhelmed with certain irritating noises. Popping pimples when I’m with my family because of emotional triggers causing emotional overload. Sometimes I needed to stim because the room was actually too quiet.

I never knew why I couldn’t stop doing it, but now that I know it has to do with my lack of impulse control I know how to avoid doing it.

I stopped putting mirrors in my bedroom or around the house. I put a limit on my time in the bathroom (yes, I even set an alarm). My executive functioning has me struggling to get to a dermatologist, but the next step is getting rid of the acne in the first place.

I’ve also found that the old saying about ‘idle hands’ is pretty true for me. I wear rings a lot now so I can keep my fingers busy. You can also purchase stim toys that cover a wide range of sensations. Or you can try making your own with things like pipe cleaners, beads, and other fairly cheap and common household items.

It’s always good to talk to a doctor about any body focused repetitive behaviors. So far, my ADHD medication has helped me a lot. I don’t find the need to stim or to soothe myself in that way to be necessary as much anymore. I do notice at the end of the day when my medication wears off I have a desire to pick again. It’s definitely not a cure all, but it has made a noticeable difference.

Something that has been inconsistent (because ADHD of course) but overall helpful was tracking when I felt the impulses to do the harmful behaviors.

Triggers sometimes can be difficult to figure out, especially because our minds travel a mile a minute. Keeping a small journal near me while I’m walking about the day, or using my phone to jot things down quickly, has made it easier to see the patterns.

One last thing that is really important is community. Reach out to people who have ADHD, see how they deal with their need to stim or soothe. Join an online forum for people to talk about ADHD and share experiences. Of course, keep reading about people’s experiences in blogs like this one. Or share your story on TikTok!

You might come to realize you are not as alone in this as you think.

Looking for support? Inflow, an ADHD management app, is here to help. Learn more about how Inflow can help you thrive with ADHD by downloading our app on the App Store or on Google Play!

Sam Spadafore (He/Him They/Them) is a white, queer, nonbinary trans man currently living on settled Wabanaki tribal land known as Portland, Maine. Sam writes poetry and articles focusing on mental health, Queer and Trans issues, sex and sexuality. They are also a consent educator, actor, activist, and steering committee member at MaineTransNet. Check out what Sam’s been up to at samspadaforeofficial.com.