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26 year old male here. I have had acne for a good 14 years now and was one of the lucky few guys to not have it go away. I have done it all. Creams, diets, antibiotics. Each of them gave me results but never the long term results that I wanted. 1 factor that I have never addressed (and has been worsening every single year) is stress. I have always been a very anxious, high energy person whose mind never shuts off. When I turned 23, I lost my long term girlfriend at the same time I got my first "real career job". The combination of both kicked my baseline stress levels up even more. Ever since that time, my acne turned cystic, and another "childhood to puberty" disorder (minor motor tics; not the yelling and cursing that you see on tv and movies =p ) that I have had all of life went from manageable to not very manageable. Both of these disorders go into remission for the majority of people at the end of puberty but both of them for me are getting worse. My stress is literally chronic and 24/7 where I very rarely relax. If I am not thinking about my bad skin, I am obsessing over something else.
One obvious physical symptom of stress that I have is bruxism. Before I got a mouth guard, I grinded down my teeth considerably and needed extensive dental work to correct. I still grind my teeth every single night when sleeping as well and my dentist tells me that I do this to release all of that energy that I build up during the day. I know that my body is under an extreme amount of stress at all times but I am really wondering how much that could be keeping my acne alive? Is this something that I should really focus a lot of my efforts on correcting as I have always neglected it.
yes, yes, yes. stress definitely plays a role in how your skin appears.
please find a way to discharge that energy that you're building up throughout the day. not sure what you do to relax, but find a way to do so - take deep, cleansing breaths, listen to music that soothes you, move your body so that you can get out of your head, etc.
do whatever you can to alleviate the effects that stress has on you physically.
Stress can be very destructive, not just for your skin but your overall health, esp. chronic stress. Is there anything you like doing that would help you relax?
Btw, is your mouthguard made of metal? If so, you may want to look into metal toxicity, or if it's plastic make sure it doesn't have bisphenol because that can cause some potential issues.
yes, yes, yes. stress definitely plays a role in how your skin appears.
please find a way to discharge that energy that you're building up throughout the day. not sure what you do to relax, but find a way to do so - take deep, cleansing breaths, listen to music that soothes you, move your body so that you can get out of your head, etc.
do whatever you can to alleviate the effects that stress has on you physically.
I honestly don't remember what it is like to feel relaxed. It has been that long but great suggestions 
Stress can be very destructive, not just for your skin but your overall health, esp. chronic stress. Is there anything you like doing that would help you relax?
Btw, is your mouthguard made of metal? If so, you may want to look into metal toxicity, or if it's plastic make sure it doesn't have bisphenol because that can cause some potential issues.
The mouthguard is made of plastic and I get it from the dentist. My grinding is so bad that I have to get a new one every 4 months and they are expensive. I actually had heavy metal testing a few years back and my results were negative. Every single time I try and sit down to relax, I get distracted immediately and reach for my computer to do work (I have my own business) or reach for my cell phone. Literally from the time I wake up, I am either on the computer working, on my cell phone working or handling a stressful phone call, or laying in bed worrying about the next day. I go to the gym a few days a week which is great while I am there, but it comes right back when I am done 
Stress usually doesn't cause acne, but it most certainly makes existing acne worse. It seems like you're really really stressed. All you can do is try to reduce that. I don't really have any tips for you other than meditating in the morning before you do anything else or finding another job.
