So what is it called when you pull out your hair? It’s called Trichotillomania – or trich for short. Trich is an impulse control or obsessive-compulsive disorder where the sufferer has a strong urge to pull out their hair to the point where hair loss is usually noticeable. Most people who have trich find it extremely distressing. They don’t know what it is, why they do it, or if anyone else does it. There has never been a population study, so really we don’t know how many people it effects. The estimated prevalence is about 1-4% of the population, women outnumbering men 3 to 1.
I think it’s easier to tell you about the effects of trich through Judy’s story.
Judy* is 19 years old. Judy has been pulling her hair out from her scalp since she was 13, and has never told anyone, not even her psychologist who she sees for depression and anxiety. Judy pulls her hair out one strand at a time; she searches her hair for the perfect feeling hair (the thick and rough ones). She feels guilty for pulling it out because everyone always tells her what beautiful hair she has. When she was in high school she didn’t pull out that much, just a little bit here or there. Not enough that anyone would notice thinning hair, she didn’t feel the urge that often.
When she got to university and her first exams come up, she started pulling almost anytime she was sitting at her computer, in lectures, watching TV, or lying in bed. It took up all her concentration, so she forgot what the lecturer was saying, or had to re-watch the last 20 minutes of the TV show she was watching because she had no idea what had happened. Sometimes hours would go by but felt they like minutes. She started to notice she had callouses on her fingers, and her hair was thinning. She started wearing her hair up all the time because she didn’t want others to notice. Soon they did, her mum started to ask her, ‘why don’t you wear your hair down anymore? It’s so beautiful. You don’t know how lucky you are that you’ve got such beautiful hair’. This only made Judy feel worse, and more stressed, which made it harder to control her urges. Judy stopped going to see her friends because she didn’t want them to see her hair, and didn’t think she looked nice with her hair up in a bun all the time.
Judy finally googled ‘ what is it called when you pull out your hair’ – she diagnosed herself immediately. But still, didn’t tell anyone, still feeling ashamed. She tried to stop time and time again, even though she knew what it was, she still didn’t know why she did it. She finally did tell her family, but she was met with comments of misunderstanding and judgement.
‘Doesn’t it hurt?’ – ‘Do you want to go bald?’ – ‘Just stop it’ – ‘It’s not normal’
But they didn’t get it, she didn’t really choose to do it, she just couldn’t stop herself.
Judy didn’t know at the time, but her mum had experienced trich when she was in her early 20s, then again in her 30s after she had children. Still though, her mum didn’t tell her because she still felt ashamed even though she hadn’t done it for 15 years.
Judy found a support group on facebook which is private, so no one she knows is on it. As of the end of 2016, there are almost 9000 members. Finally Judy realised that she isn’t alone. And there are people who have it way worse than she does, they pull out their eyebrows, eyelashes, beards, pubic hair, and some of them are almost completely bald and wear wigs. Some of them have been doing it for 30 years, others only 6 months. Some she is amazed, have stopped. Judy decided to really make a go of it this time. Looking at all the tips the support group members had given her, she put physical barriers in between her hands and her hair. Headscarves, band aids on her fingers, whatever she could think of. She tried and failed countless times, but she finally did it. She stopped. But what the people in the group didn’t tell her was that the urge doesn’t go away. She fought everyday to not pull it out. She celebrated each hour, day, week and month that went by. Judy finally told her friends, ‘I used to have this horrible thing, but now I’ve stopped!’ – They didn’t understand, but were proud of her anyway. Her goal was to get to 6 months, which she did. She could see all her new hair growing, she was so proud of herself. But then something happened, it doesn’t matter what happened, because Judy doesn’t exist, she is made up of the average characteristics of trich sufferers. But maybe her dog died, or maybe her boyfriend broke up with her. Whatever it was, it was a stressor. She gave in to one of those urges, because she is human, and sometimes in times of great stress we all waver in our self-control. Pulling out that one hair was like the first falling pebbles of an avalanche.
Two months later and she has pulled out so much hair she feels as if she was back at square one. But she isn’t, because she stopped once, she can stop again. She is determined, so she is going to keep trying. But this time, she’s told her psychologist. They tell her it’s okay! When we are stressed, or sad, or have big emotional changes, our mind finds ways to cope.
There are lots of ways to reduce or cope with the symptoms. Cognitive behavioural therapy (CBT) can help us change habits that distress us by utilising practical strategies. Whether they are thoughts, emotions or behaviours. Habit reversal training has also been found as an effective treatment for trich and other associated disorders.
Judy doesn’t exist, but many people like Judy do. Most people with trich never get diagnosed and never seek treatment.
Dermatillomania is a similar condition that involves compulsive picking of the skin. Find out more here.
If you think you, or someone you know might suffer from trichotillomania or something related, it’s okay! We are here to help, if you would like to book in with one of our Clinical psychologist feel free to give us a call or book through our website here.
Find out more information about trichotillomania here. If you’re not ready to tell anyone, that’s okay too! Here are some support groups.
* Judy is a fictional person developed to assist in explaining the experience of trichotillomania