Behavioral Symptoms
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Anxiety and Compulsive Nail Biting

Henry Vyner, MD, Psychiatrist
Anxiety and Compulsive Nail Biting

A working definition of nail biting is that is a matter of putting one or more fingers in the mouth and biting on nail with your teeth.

Nobody really knows what causes nail biting. Here’s a list of some of the theories that have been advanced for the causation of nail biting:

Given this polyphony of nail biting theories, the prudent conclusion to reach is that we don’t yet understand nail biting.

Types of Nail Biting

One thing that is clear though is that nail biting is not a pathological condition in all times and in all people. However, it is not exactly clear where the border between healthy and unhealthy nail biting lies. 

In keeping with this perspective, many lay and scientific students of nail biting, there aren’t many of them to be honest, have observed that there are two types of nail biting. 

One type of nail biting is a passing phenomenon that occurs in childhood, and that will disappear on its own with time. Sometimes adults will also pass through short periods of nail biting.

The second type of nail biting is nail biting that is thought to be a symptoms of a serious mental disorder. Careful scientific studies have found what are called several comorbidities that coexist with nail biting. All this means is that people who nail bite often have psychiatric problems at the same time. 

Here is a list of the psychiatric disorders that one study found in groups of children who bite their nails along with the percentage of nail biting children who had each disorder:

  1. Attention Deficit Hyperactivity Disorder (74%)     
  2. Oppositional defiant disorder (36%)
  3. Separation anxiety disorder (20.6%)
  4. Obsessive compulsive disorder (11.1%) 
  5. Major depressive disorder (6.7%)
  6. Mental retardation (9.5%)

In addition, it has also been found that 28% of children with Tourette Syndrome — which is an illness in which you have constant tics — were also nail biters.

Of all the children in the above study, all of the boys and 81% of the girls had at least one psychiatric disorder.

The conclusion to reach here is that if you or your child has persistent nail biting that seems or feels compulsive, it is a good idea to go see your doctor to determine if there is an underlying psychiatric disorder that needs treatment. 

On the other hand, if you or your child’s nail biting does not seem compulsive, and if it goes away on its own, then there is no need to see a doctor or worry about the nail biting. However, you might want to try some treatment on your own.

The Treatment of Nail Biting

First let’s consider responses to nail biting that do not work:

Here are some strategies that might help stop nail biting:

Nail Biting and Shame

Finally, lots of people who bite their nails feel ashamed of themselves. It is important to do everything you can to avoid making people who bite their nails feel ashamed. A good way to avoid making a person feel ashamed is to educate everyone involved about nail biting. 

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