Compulsive behavior is secret addiction

Dear Annie: I am a female in my mid-20s, a college graduate with a professional job and a terrible problem. When I am not around people, I eat my fingernails, toenails, dead skin, etc. I know this is an unappetizing habit, but I cannot seem to find any information about the condition. I have searched medical libraries and the Internet, and I am not comfortable broaching the subject with a therapist.
This habit doesn't run my life, and I never do these things in front of others. I have read about pica, a condition in which people eat nonfood items such as dirt and hair, but I don't believe I suffer from pica. I don't eat hair, but I have eaten just about everything else I find on my body. Is this a serious medical condition, or just a silly habit? No Name in the Midwest
Dear No Name: We ran your letter by a couple of doctors and a psychiatrist. The doctors do not know why you are doing this, but the psychiatrist thinks you may have Body Dysmorphic Disorder. You are eating your imperfections.
This is not as unusual a problem as you may think. However, you should discuss it with a psychiatrist. Therapy, along with medication, can be extremely effective. Your doctor can refer you to a therapist, and you also can check out the Obsessive-Compulsive Foundation (ocfoundation.org) at 676 State St., New Haven, CT 06511. Good luck.
Dear Annie: My parents and I are having a discussion of whether it is safer to keep your car doors locked while driving (in case of burglary, carjacking, etc.), or better to leave the doors unlocked, for easier escape (in case of illness or accident).
I keep a glass breaker on the side of the door, in case the car goes into a canal or flooded area and I need to smash the window open. Now I'd like to know about the door locks. S.T. in Florida
Dear Florida: Most safety experts say to keep your car doors locked at all times. This prevents someone from entering your car and waiting for you while you are grocery shopping (always check around and inside your car before getting in). It also is a barrier to carjackers.
Many newer cars allow you to open the locked door from the inside without unlocking it first. This way, if there is an emergency, you don't need to fumble with the lock in order to get out of the car. Consider it one more feature to look for when you are shopping for a new vehicle.
Dear Annie: You printed a letter from "Going Bald," whose doctor discounted the possibility of hypothyroidism in spite of a family history. Many women have a form of hypothyroidism called Hashimoto's Syndrome, and this autoimmune disease is hereditary.
Thank you for telling her to ask her doctor to order further blood work. I, too, had hypothyroidism. When my thyroid panel came back normal, my doctor said I was just chunky and lazy. I didn't have the energy to argue with him, but I found another internist who listened. He ordered an antibody test, and sure enough, the results were off the charts.
Unfortunately, because my first doctor didn't take me seriously, there was a lot of damage to my thyroid and I needed to have it removed. However, when my daughter developed the same symptoms, we knew enough to request an antibody level test immediately. She's now on thyroid medication and doing well.
When a woman presents with classic symptoms of hypothyroidism and a family history, it is usually well worth the expense of additional testing. "Going Bald" has to be her own advocate. Please suggest she check out the Web sites thyroid.about.com, or nlm.nih.gov/medlineplus/thyroiddiseases.html (U.S. National Library of Medicine, 8600 Rockville Pike, Bethesda, MD 20894). M.R.
Dear M.R.: Thank you for your invaluable assistance.
Creators Syndicate
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