I started picking at my skin when my anxiety got bad and work became a struggle. Here's how I dealt with it.

• Lauren Brown suffered from anxiety so severe she would obsessively pick at her skin.
• Even turning up to work became a struggle.

Over the years, my anxiety has taken many, often strange, forms.

When I was little, that mischievous, hounding internal voice would pressure me into biting down really hard on my two front teeth or to go and make sure, for the umpteenth time, that cutlery on the kitchen table was perfectly straight.

I worried nonstop that if I didn't, something terrible might happen.

As I grew older, my anxieties grew from a handful of young saplings into a knotty forest of sprawling twigs and branches. The shadowy gaps between them became darker, scarier.

If someone didn't text me back, it made complete sense to me that they were, obviously, dead. In the middle of the night, I'd be gripped by the sudden and painful recollection of something I'd said to someone years prior, ruminating over actions I'd taken, about the future and whether I was properly blending in as a "normal person," whatever that meant.

In my early 20s, my anxiety began manifesting itself as the ravenous picking of my skin: something I would later find out had a name: dermatillomania, or excoriation disorder, which is related to obsessive-compulsive disorder. With it, body-focused behaviors most of us do — plucking hairs or popping pimples — spiral out of control, become repetitive. and go beyond the realm of habit.

Turning up to work as a journalist became a daily battle, and I spent more and more of my pay on expensive serums and makeup. I was quieter in meetings where I'd usually have been buzzing with ideas and contributions and struggled to concentrate for anything more than short bursts of time.

Thankfully, through professional help, support from people I connected with online, and books — this one in particular — I've forged a path through the dense forest. I even wrote a book about it.

I feel professionally capable and comfortable communicating what I need, and as a result, I'm getting more of a handle on my anxiety every day.

Here are some of the things that I've found helpful.

Writing in a journal

Negative thoughts, I've found, have a way of digging deeper and deeper the longer you let them stay in your head.

Things can seem much worse than they are, or than they'd seem if you just exposed them to the light. Opening up can be scary, especially if you're scared of peoples' reactions, but you don't have to start with other people right away.

Just articulating your thoughts to yourself in a journal can be immensely freeing.

At least then those thoughts don't exist only in your head. I started journaling at the start of the pandemic, when I first started cognitive behavioral therapy for my skin-picking disorder, and have found it really helps.

It helped me identify the thought pattern that I hadn't realized was why I was picking my skin: I felt like I had to "correct" my skin. I hadn't properly articulated that to myself before writing it down.

Opening up to people, including managers

After writing in a journal at first, I found it easier to be clear with managers and others what I needed from them.

I'm not saying you have to spill out your life story to every person you meet.

But even just emailing a manager at the start of a working relationship, explaining what you need, can relieve some of the pressure to be "perfect" all the time.

Every professional relationship is different, so I'd recommend tailoring the below to your own style of speaking with them. But I generally use the same vague template for communicating my needs to new managers:

"Hi there, I hope you're well. I wanted to email to let you know that I suffer from anxiety, as I feel that you knowing will help me feel and get on with things better. For example, if I seem a bit off or need more reassurance about something, I'd really appreciate being able to talk to you."

I've found that most people are kind and basically never react in the negative way you're imagining. If anything, they're flattered that you feel able to trust them in this way.

Simply saying what you're going through can feel freeing.

Identifying your triggers and finding ways to handle them

Even though it may just feel like you're anxious all the time, and therefore don't know the cause, it's supremely beneficial to be really honest with yourself day to day about whatever little things may be irking or setting you off.

This may be particular locations or situations, but once you've identified more keenly not necessarily the cause of your anxiety but at least what makes it worse, you can start to make little changes that will add up.

Taking mental-health days off work, having morning check-ins with your manager during particularly hard times, talking about missing meetings you don't need to be at: Have a think about what would really make a difference to your day, and talk to a trusted manager about which changes may be possible.

It's not easy, and some things will work sometimes, while other things won't, but having a tool kit of things that make you feel better is a great first step.

I still pick my skin, but these tactics have meant that I do it far less than I used to, as I'm able to often catch it in time and recognize what I'm doing — and reflect on why I don't want to do it.