When confronted with periods of extreme stress, anxiety, boredom, or tension, our bodies can respond in many ways. Hair pulling, also known as trichotillomania, is a disorder that can be triggered these periods, though it’s rarely talked about.
When Jessica* was in her final year of school, she desperately wanted to be like the cool girls. Straight, sleek, perfect hair. Jessica’s hair, however, was thick and wavy, and so any hair that possessed even the slightest kink, she pulled from her scalp.
As a naturally anxious teenager, Jessica found both satisfaction and release from hair pulling. It became an addiction; a way of coping in particularly stressful situations, like getting through the exam period and, later, when her mother was diagnosed with breast cancer.
We don’t talk about trichotillomania much—an obsessive-compulsive related disorder that causes a person to have an overwhelming need to pull out their own hair from the scalp, eyebrows, or other parts of their body. You may not have even realised there was a name for it, but ‘trich’, as it’s often referred to by sufferers, affects around one in 20 individuals.
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“It typically starts in early adolescence as a way of dealing with tension, stress or anxiety, whereby someone’s psychological concerns manifest into a physiological habit,” explains psychologist Rucha Lele.
“It can also start as a result of a chemical imbalance in the brain, similar to obsessive-compulsive disorder.”
Trichotillomania—derived from the Greek ‘trich-’ (‘hair’), ‘tillein (‘to pull or pluck’) and ‘-mania’ (from ‘mainesthai,’ meaning ‘to be mad’)—is within a group of behaviours known as body-focused repetitive behaviours (BFRBs).
Others who possess the same compulsion have plucked all their eyelashes out, some hide bald spots on their head with wigs and have gotten so well at hiding it, even their partner doesn’t know.
In the /trichotillomania subreddit, more than 17,000 sufferers or loved ones of sufferers share advice, achievements, and their experiences with the disorder, though for obvious reasons no videos of pulling are permitted. The group has become noticeably more active since the beginning of the pandemic.
“A person’s emotional state is the main trigger for trichotillomania and feelings of worry, stress, anxiety, tension or even boredom can be a trigger,” explains Lele.
“Unfortunately, right now with everything that is going on in the world can be a trigger for someone, especially those that might be in lockdown.”
There are several treatments available to someone who suffers trich, including self-management or with the assistance of a professional. Habit Reversal Training (HRT) teaches individuals to recognise triggers and symptoms and substitute it with other behaviours.
“A great example of this is when a sufferer might wear an elastic band around their wrist and snap that whenever they feel the compulsive urge to pull their hair,” says Lele.
Embarrassment or shame is something frequently experienced by those with trich and many conversations on the subreddit are dedicated to sharing tips on how to disguise bald patches.
“A blunt, layered, or textured haircut is a great way to make the hair appear fuller and more voluminous,” says Belinda Keeley, expert hairstylist at Grow, a range of hair care and styling treatments designed to promote longer, stronger strands.
“Depending on where the hair pulling is happening, you can also work with different hairstyles to cover up areas, such as sweeping fringes or a messy up-do.”
She adds: “Many people mistakenly think that a longer style is better for covering up hair loss or hair thinning, however, what it usually does instead is makes the disparity more apparent. In all instances, you’ll want to avoid any styles that make you look like you have a combover such as really long hair that is brushed over the head.”
The most important thing for those suffering trichotillomania is to remember you’re not alone. A professional therapist or psychologist can help you identify your triggers and work on strategies to manage the impulse. Support groups like the subreddit, which can help you understand the condition and talk to others who are suffering as well.
“With conditions like trichotillomania, there is a mind-body connection and when we are physically healthy, we are better equipped to handle anxiety and stress – particularly during times of immense stress,” says Lele.
“Ensure that you are getting enough sleep, eating healthy meals and exercising which are all things that can enhance our overall cognitive functioning. If we are physically feeling good, it can make it easier to ward off our worries and helps us burn off the extra adrenaline our bodies are producing when we experience bouts of nervous energy.”
*name has been changed at the source’s request.
Rucha Lele is a psychologist at Lysn. Lysn is a digital mental health company with world-class wellbeing technology that helps people find their best-fit professional psychologist while being able to access online tools to improve their mental health.