5 replies to this topic

[Valentin]

Hi ,

 

My girlfriend suffers from severe case of skin picking. After one year on behavioural therapy she sees no improvement. She has a IQ of about 140. We decided to try something, treat it as a heroin addiction. 3 days locked in a room, no mirror, food, (bathroom obviously). She takes huge dose of fish oil and St John wort.

We will do hypnosis, EMDR. I may have heard of low dose LSD but obviously don't possess some . Still if you have any thoughts on that.

I'm interested in any idea you may have.

Edited by Valentin, 17 August 2017 - 08:55 PM.

[Ark]

Sounds like you need to look into OCD and possible treatments like NAC for one.


Good luck and speedy recovery for your girlfriend.

[Dichotohmy]

There is also the possibility that this is caused by something other than an anxiety disorder, such as the hyperactivity side of ADHD. In such a case, its either due to too high of a stimulant dose (IE tweeking), or the boredom and fidgeting of untreated ADHD.

 

For things like trichotillomania, or skin-picking disorder, N-acetyl-cysteine is a safe treatment that actually has demonstrated positive benefits to control or improve the behavior.

[Mind_Paralysis]

Trichotillomania, as it's called, is generally considered to be a form of OCD - Obsessive Compulsive Disorder.

 

Others have mentioned to check for untreated Neuropsychiatric or Neurodevelopmental, in particular, disorders, and I agree - it's very important to figure out if there is more to this than meet the eye. AUTISM is known to cause behaviour similar to OCD - "stimming" or "stereotypical behaviour" as it's called - OCD can also occur as a result of the anxiety caused from miscommunication with neurotypicals as well.

 

I suggest you look into the most recent neuro-imaging and genetic data on OCD - and how NMDA-antagonists and 5ht1d-antagonists have great promise here.

 

SO... Medication-wise, I'd suggest a combo of Vortioxetine (trintellix, brintellix) and Memantine.

 

Low-dose Ziprasidone could also be beneficial, as it is the commercially available compound with the highest affinity for 5ht1d - it's second highest antagonistic action is ALSO beneficial - 5ht2a-downregulation is theorized to be one of the mechanisms which SSRI's treat depression with.

 

 

Good luck, and hope your GF beats this issue.

 

 

PS: I don't suggest the "breaking an addiction" - method... there's no evidence whatsoever, and the effects may not carry over to the real world at all, as some theorize that OCD-behaviour is a coping-mechanism for other issues, possibly caused by the environment, i.e social phobia and stuff like that.

 

Just because she learns to not prick her skin in a locked room, safe and sound, doesn't mean she'll be able to stop it when something unforeseen happens out there in the real world.

[Junipersun]

Severe cases need a combination of medication + therapy. I second the suggestion of Stinkorninjor, the use of Memantine + beign SSRI like Vortioxetine would also be my first line treatment medication wise. CBT alone didn't do shit for my OCD, what has helped me tremendously is a kind of third wave CBT approach like that one which is taught in the book  "brain lock".

Edited by Junipersun, 19 August 2017 - 01:56 PM.

[Mind_Paralysis]

Severe cases need a combination of medication + therapy. I second the suggestion of Stinkorninjor, the use of Memantine + beign SSRI like Vortioxetine would also be my first line treatment medication wise. CBT alone didn't do shit for my OCD, what has helped me tremendously is a kind of third wave CBT approach like that one which is taught in the book  "brain lock".

 

This last part made me rather curious... what sort of stuff is in the Brain Lock book? And what generally sets the third wave of CBT apart from second-wave?

 

Second-wave is stuff like DBT, right? Which is a mixture of CBT with other behaviourally modifying techniques - like mindfulness and such.

 

Is third wave the sort of stuff they're saying they're rolling out to help Autistics with socializing and some of the new stuff they're doing with very specifically "guided" behavioural modification - like some of the stuff that's actually showing ever so slightly some effects on ADHD-symptoms? Not sure what the general idea is, but I'm thinking it's merely more focused and based more on how the morbid brains work, and what the patient can do with what they have?

 

 

I've heard Dr. Kevin T. Blake and Prof. Russell Barkley talk some about this, in passing, if anyone's wondering where I'm getting these ideas from.

 

 

http://drkevintblake.com/

 

Developmentally Disconnected: Evidence-Based Tools for Transforming Social Competence

Traditionally, social deficits that accompany developmental disorders have been attributed to a lack of social skills knowledge. Therapies designed to help have been heavily weighted toward social skills training, often resulting in minimal, plodding progress while clients continue to face verbal and non-verbal communication barriers at home, in the classroom, and beyond. Recent research utilizing advanced brain imaging techniques has identified neurobiological deficits that underlie your clients’ difficulties in social interaction. This one-day seminar will teach you to address these deficits in complement with skills coaching, giving you the tools to guide clients to their full social potential. Review exciting research on the unique neurophysiology associated with neurobiological disorders and its effect on social expression and interaction. Discuss changes to diagnostic criteria in the DSM-5®, and discover effective treatments for a wide variety of the most common neurosocial problems.

 

 

 

https://www.guilford...2509638/reviews

 

Apparently, the leading scientist on the ADHD -part, is Dr. Mary Solanto.