Trichotillomania and me: How to cope with hair-pulling disorder
My name is Nicola, I’m 45 and I have trichotillomania and I pull out my hair.
What is trichotillomania?
Trichotillomania, also known as trich or TTM, is obsessive hair pulling. This means an uncontrollable urge to pull out hairs, usually from the head or face. I have the urge to pull at my eyelashes and eyebrows however most people with trich pull hairs from their scalp.
TTM is not fully understood and there are many causes of hair-pulling. For some people, it’s a stress response, for others its changes in their hormone levels or an addiction that causes their hair pulling. Trich is an impulse-control disorder and is linked to obsessive-compulsive disorder (OCD) and body dysmorphic disorder (BDD).
What does trich feel like?
When touching eyebrows or eyelashes, my fingers search for a hair that feels longer or thicker than the other hairs. I’m probing for a hair that doesn’t ‘fit in’ and needs to be removed. When I find such a hair (and I will find a hair), I may toy with it before pulling it by stroking it with my fingertips. I enjoy the anticipation of knowing I will pull it out, perhaps now or perhaps later, but it will happen.
When I pull the hair out, there is an immediate sense of satisfaction. I got that pesky hair and I won’t need to pull out another. Sometimes, I test the thickness or strength of the hair by squishing or rolling it between my thumb and forefinger. I’m testing its resistance and justifying why it had to be removed.
Sometimes, I touch the root of the hair to my lips as the root is cooler than the hair itself. Then I discard the hair. I don’t eat mine, but some trich sufferers do.
How do I cope with trichotillomania?
Primarily, it is makeup. I pencil in any gaps in my eyebrows plus I use black eyeliner on my upper eyelids. My makeup has been a mask I find hard to leave the house without. I use makeup to hide my condition so that, hopefully, no one notices.
Besides hiding my hair pulling from others, I avoid my reflection. I will avoid a close-up photo or anything that would risk my make up being removed (such as anyone seeing me first thing in the morning).
How has trichotillomania affected my life?
During my twenties, TTM contributed to low self-esteem and a lack of confidence. I would beat myself up mentally for pulling out my hairs. I look weird and my disfigurement is blatantly obvious to everyone, concluded my brain.
I avoided activities such as swimming as my make up may wash away. Plus I wouldn’t engage in anything where I might get physically close to another person. Yes, trich stopped me dating out of a fear of being thought of as a freak. I was single, lonely and suffered from depression.
This was a low point in my life and trich had the better of me. But I am no longer defined by my hair pulling. The depression was tough but I made it through. My life is so different now that I look back at this period in my life with disbelief that it happened to me.
My husband — whom I had never told about my trich — has never noticed my lack of eyebrows or eyelashes in ten years of marriage. It’s only when he asked what I was writing about did I admit to the condition. His lack of reaction spoke volumes.
So, I could conclude something pithy (but sexist) about men. But instead, I will use this as an example of how, when we internalise something, we can make it feel bigger or worse than it truly is.
What treatments for obsessive hair pulling have I tried?
With varying amounts of commitment and enthusiasm, I’ve tried a few different things to help treat my obsessive hair pulling:
The amount of information during the 1990s on hair-pulling was limited. But I managed to get my hands on a book called “Help for Obsessive Hair Pullers”. Reading it only heightened my awareness of my condition and I would binge-pull my hairs. However, the book did introduce me to Cognitive Behavioural Therapy (CBT).
Asking for help means telling someone about your condition. I was not able to bring myself to admit my problem to another person. Therefore, the idea of accessing CBT from a professional therapist was terrifying. Instead, I took the DIY approach to CBT:
- I tried collecting and counting the pulled hairs to confront the true scale of the condition. But try explaining to a colleague why you have a small pot of eyelashes on your desk. I was not ready to draw any attention to my trich.
- Another idea was an elastic band, worn on the wrist, to ‘snap’ each time I reached for my lashes. This stinging snap creates a negative association with pulling. But to outside eyes, I’m repeatedly inflicting mild pain on myself. Surely, that’s weirder than pulling out your own hairs?
Done properly, Cognitive Behavioural Therapy is the most effective treatment for treating trichotillomania. CBT allows you to address the emotional side of hair pulling and the physical habit of pulling. You will discuss, create a treatment plan and set goals with your therapist. CBT is a more collaborative and ‘hands-on’ approach than hypnotherapy, for example.
My experience: I gave up on CBT because I could not use these therapies and keep my condition secret. Working through a problem with a therapist is central to CBT so I was fooling myself by thinking it was something I could do on my own. To move forward, I had to start talking about my problem.
Hypnotherapy for TTM
In order to admit I had a problem, I tried hypnosis for trichotillomania. My hypnotherapist was very supportive and made me feel safe and accepted even though she had not encountered obsessive hair-pulling before.
Hypnotherapy is an effective form of treatment for TTM. Hypnosis can increase your mindfulness, help identify your triggers and relax you at the same time. It is recommended that hypnotherapy is used in conjunction with other therapies such as CBT, however.
My therapy lasted six weeks and consisted of attempts to ‘hack my brain’ into believing I was a strong person. They were pleasant and relaxing sessions but sadly had no effect on my trich. I don’t consider myself suggestible so this therapy was never going to be the right one for me.
But more than that, the process made me realise my TTM didn’t make me feel weak anymore. Therefore, I didn’t need to be told to “be a strong person” because I already was.
Knowing what I know now, hypnosis in isolation was insufficient to treat trichotillomania. The process of confronting my problem, however, was immensely helpful and I probably wouldn’t be where I am today without it.
Being aware of the nuances in my pulling behaviour, I decided a different approach. Could wearing false eyelashes stop me from trying to pull out my own?
I booked an appointment with a beautician. However, I was unaware that false eyelashes are glued onto your existing lashes (and not your eyelids). The beautician persevered but it was pointless. I could sense her pity. It was utterly humiliating.
My advice: don’t visit a beauty therapist when you really need to visit a healthcare therapist.
Other therapies for treating trichotillomania
Treatment options have improved greatly in the last 20 years and so has the understanding of the condition.
There isn’t yet a single drug that can treat trichotillomania. However, if your hair-pulling is connected to anxiety, you may be able to take medication to help manage the condition. Taking pills won’t cure your trichotillomania, but it may help lower your incidence of pulling by reducing anxiety whilst you seek other treatments.
Scientific studies have suggested a potential connection between diet and trichotillomania.
This list shows foods that help reduce hair pulling plus foods that may increase the urge to pull. The JK Diet has no scientific backing but has anecdotal evidence from hundreds of trich sufferers that this diet helps with their urges. Before making any change to your diet, you should first speak to your doctor.
A study in 2009 showed a common health food supplement may help stop the urges of trichotillomania. Study participants who took an amino acid with antioxidant properties reported a 56% improvement in their hair-pulling urges.
Wearable health tech
There is a new device in development, called the Tingle. This wearable device is worn on the wrist and monitors movement of the hands near the face. It may help diagnose and treat body-focused repetitive behaviours such as TTM.
Trichotillomania and me today
My trich is still a private issue and I have not stopped my hair pulling. But I have stopped worrying about it. I have accepted that trich part of me and that it actually doesn’t matter. I have a wonderful husband and two kids and this life change has redefined how I view my hair pulling.
Society is much more open about mental health conditions. We are less alone and more accepted than we sometimes appreciate.
So, mine is a journey of acceptance and not cure. There are many options out there for someone seeking treatment but you have to want it. You have to be in the right place mentally for treatment have any traction. And part of that means being able to talk openly about your condition without shame or judgement.
Trichotillomania and you
If you are reading this and my story is resonating with you, please do not think you are alone. We hair-pullers are not that uncommon. It’s estimated that around 1 in 30 people will experience trichotillomania during their lives. However, most cases, like mine, go undiagnosed.
Don’t be like me.
If you no longer want to be controlled by obsessive hair pulling, please seek professional help. Your GP is a great starting point for accessing CBT or other treatment options but isn’t your only route. You can also speak to your pharmacist or contact a private CBT practitioner. The charity Trichotillomania Support provides a wealth of information plus has an active forum to help you on your journey towards being pull-free.