When I was 13, I was completely dedicated to a few hobbies outside of school.

For a large part of my life, I felt compelled to pick at myzits.

It seemed all-encompassing, as if I was dying from acne.

illustration of circling heads from anxiety and polka dots

Getty / LuckyTD

Most people struggle with acne during their teen years, but mine was on another level.

For years, my face produced thesedeep, painful, pus-filled cystswhich I can still only describe as hateful.

I had crayon sticks in two colors: green to counteract redness, and pale to mimic my skin.

I went to see a dermatologist too, but I was frightened by the drugs many listed side effects.

I remember the pamphlet they gave me was bright yellow and red like a toxic waste warning.

No way, I thought.Im supposed to have acne because something is wrong with me.

She told me I hadgeneralized anxiety.

And I realized it was fueled by my acne.

I dont think its a coincidence that my skin cleared up as I worked through my anxiety disorder.

As it turns out, its not unusual for cystic acne and anxiety to occur together.

But managing them requires complementary strategies.

Our skin and mental health are connected in ways were only beginning to understand.

Barr says it has roots in old psychological concepts.

She pointed me to aclassic review articlepublished inMedical Clinics of North Americaback in 1948.

What happens, then, when people blame themselves for their skin conditions?

And sometimes, it gets worse.

People who fear negative appearance-related judgments may choose to cope through isolation, she explains.

Thats why they recommend treating acne and mental illness simultaneously, keeping the symptoms in conversation with each other.

Treating one while ignoring how the other is connected is to ignore half the roadmap to recovery.

I wish I could travel back in time to my bathroom in seventh grade and talk it through.

(Id also throw my Good Charlotte CD out the window and replace it with Sleater-Kinney.)

I think that emotional knot may have been contributing to my acne.

And slowly I stopped relying on my old ritual at the mirror.

But neither of those facts feel like a defining part of who I am.

And a zit is a zitit sucks, but like a negative emotion, its always temporary.

Wallowing, blaming yourself, and prodding at a problem only exacerbates it.

The key is to learn to let go and keep living.