Emma, 34

Sixth form, roughly seventeen. I was applying to university, doing A-levels, running on about five hours of sleep. It started with spots - I'd pick at them and they'd clear, except they didn't clear, they scarred, and then I'd pick at the scars. By the time I got to university it was a fully established pattern. Morning routine, bathroom, inspection, picking. It was just part of how I started the day.

Looking back I can see exactly what it was doing. Everything about that period was about performance, grades, appearances, looking right, presenting the correct version of yourself. The picking was the one space where I wasn't performing. Just me and the mirror, no audience, no judgement. Except obviously there was judgement - mine, which was the worst kind.

At work it usually happens in the afternoons. There's a particular bathroom on my floor that has a specific light and I've become very aware of what that light does. I'll go in to wash my hands or just to have five minutes away from my desk and I'll catch my face in the mirror and start inspecting it. And then I'm picking.

The episode itself has a different quality at work than it does at home. At home I can fall into it for an hour. At work there's a time limit, which should make it easier to stop but actually doesn't always. I know I need to go back to my desk. I'm aware, distantly, that I'm making my face worse. But the part of my brain that controls the picking seems very separate from the part that understands I have a client call in twenty minutes.

Afterwards at work there's this sharp re-entry into who I'm supposed to be. I look at my face, I assess the damage, I fix my foundation as best I can, and I walk back out. I've gotten very good at the repair job. Full-coverage foundation, a particular concealer. The daily maintenance of this is considerable. Nobody seems to notice, or nobody says anything. I honestly don't know which.

The coexistence of competence and this. People who know me professionally would find it genuinely baffling, I think. I manage complex litigation. I have a reputation for being calm and precise under pressure. And then I pick my face until it bleeds in a work bathroom. Those two things feel irreconcilable to me, never mind to anyone else.

I've never told anyone at work. Not because I think they'd be unkind about it necessarily, but because the professional image I've built is very carefully maintained. There's nothing warm and vulnerable about the version of me that exists at work. Bringing this in would change something I'm not ready to change.

The other thing that's hard to explain is the disconnect between intelligence and inability to stop. I understand cognitively exactly what's happening. I've read the research. I know about habit loops and dopamine and automatic behaviour. And that knowledge does essentially nothing in the moment. I stand in the bathroom knowing all of it and I pick anyway. That gap between understanding and doing is genuinely hard to convey to someone who hasn't experienced it.

Dates, mostly. When my face has been bad I've cancelled dates, rescheduled them, or gone but been miserable the whole time in a self-monitoring way that made me very poor company. A few relationships have probably suffered from the general weight of carrying this invisibly. When you're expending a lot of energy managing a secret, you have less energy for other people.

I've rescheduled client-facing meetings. That's something I'm not entirely comfortable admitting. Professional decisions made on the basis of how my face looks. It's happened more than once. And it always feels absurd afterwards - I rescheduled a client meeting because I was embarrassed about my skin, which is an objectively strange professional choice. But it happened.

I wear full-coverage makeup every single day. On a day off, at the weekend, if I'm working from home and seeing no one. It's the first thing I do in the morning and the last thing I remove at night. The removal process is also a trigger. So the day bookends itself with this.

Reading someone else's account. A woman in a profession somewhat like mine - she wrote about managing a demanding career while picking her face and wearing heavy coverage every day and nobody knowing. It was almost forensically familiar. I read it and felt, for the first time, that I wasn't a specifically strange person. I was a person with a condition that happens to a lot of people including people in demanding professional roles.

That sounds like it should have happened years earlier, and maybe it would have if I'd looked. But I hadn't really looked. There was a part of me that didn't want to look, because looking would mean acknowledging it properly, and acknowledging it meant it was real rather than just a thing I did.

I'm not in formal treatment. I haven't taken that step. I'm aware that's something I should probably address. What I'm doing is managing - which is different from recovering, and I know the difference. I've changed the light in my home bathroom, which removed one of the main episode triggers. I set a rule that I don't go into the work bathroom I mentioned after 3pm, which sounds arbitrary but has actually helped because that specific bathroom and that specific time were a consistent pattern.

I pick less than I did two years ago. I'm less self-punishing about it when it happens. The internal critic has gotten slightly quieter. That might just be age. Or it might be the combination of understanding the condition better and investing slightly less identity in the performance of having-it-together.

What I think I actually need is to tell someone who knows me. Not work. But someone. I haven't done that yet and I'm aware that the secrecy itself is a weight that makes everything harder. That's probably the next step, if I'm being honest about it.

You are not uniquely broken, and your professional capability has nothing to do with this. The two things coexist. Plenty of high-functioning, competent people have this condition and manage demanding lives with it. It's not incompatible with intelligence or success or professionalism. It's just a condition, separate from all of that.

Tell someone. I know I'm not there yet myself, which makes this advice easier to give than to take. But the secrecy is expensive. It costs energy and it isolates you inside your own experience in a way that makes everything harder. You don't have to tell a colleague or a manager. You just have to tell one person who matters to you. The relief is, by all accounts, worth it.

And look at the specific triggers rather than the general behaviour. It's easier to change the environment than to change the impulse. Move the magnifying mirror. Change the lighting. Put something in your hands at the times you'd usually pick. Work with the circumstances, not just against the urge. It makes more of a difference than trying to use willpower alone.