Trichotillomania

Trichotillomania

Trigger Warning- Some images or descriptions in here may be triggering to trichotillomania sufferers.

Disclaimer- I am not a doctor or medically trained in any way. Everything from this article is based upon my own experience, and the sources linked at the bottom of the piece :)

Every day that goes on, I have further to fall. When the strands hit the floor, I know it will take them about 6 years to grow back fully. If I say ‘oh today I feel like shaving my head, its because if I did that, the growth I would effect would be so little. This is something I will most likely have to deal with for a long time, and I know that. Trichotillomania is not something that can disappear overnight, but I am trying my hardest to not let it control me. Speaking about this is something I just needed to do. Sorry for cluttering your timelines, just I know this week isn't going to be easy.- My facebook status, 31st January 2015

No mental health problems are easy. None are simple, or ignorable. For me, for a long time, trichotillomania ruled my life. But it no longer does.

Trichotillomania (also known as trich or TTM) is defined as a condition where a person feels compelled to pull their hair out. It is a Body-Focused Repetitive Behaviour disorder (BFRB). Other examples of BFRBs are dermatillomania (skin picking), nail biting, and lip biting.

According to the TLC Foundation, approx 2 to 4% of people experience trichotillomania in their lifetimes- it usually begins in the early teen years, and in childhood occurs equally between the genders, but by adulthood, 80-90% of sufferers are female.

People can pull from anywhere- scalp, eyebrows, eyelashes and the pubic region are all common areas, but any hair can be pulled. Some people use tweezers, and others just use their hands. The hair loss is in irregular patches, unlike alopecia (an autoimmune disorder that causes hair loss) in which hair loss is in more regular shapes.

Trichotillomania has a related disorder, trichophagia, which involves eating the pulled hair. This can cause hair balls called trichobezoars, which can be fatal. Along with the trichobezoars, it may additionally cause repetitive stress injuries, and carpal tunnel, simply from the repeated action.

Trichotillomania also has a large crossover with other disorders - in the DSM-V (the American list of all mental illnesses and their diagnostic criteria), it is classed as a subset of OCD, which is itself a subset of anxiety. These disorders often are present alongside trichotillomania and other BFRBs. The physical hair loss can also cause low self esteem and related disorders, such as eating disorders and body dysmorphia.

Triggers for hair pulling can range from stress, to boredom, to nothing - some people even pull in their sleep. Trichotillomania can be described as feeling like youre allergic to your hair - an urge that you cant control without the pull and that pop of pulling it out.

Regrowing the hair can also cause issues - it can be oddly textured or coloured as the pulling can damage (and even kill) hair follicles. Regrowth can also take a very long time; some people with trichotillomania choose to shave their heads or cut their hair short - I myself got a long bob to quicken the time to regrow - growing it out to my waist would have taken years and years. Having shorter hair can also reduce pulling, as the hair is harder to hold on to - head shaving can however become a crutch, and render people unable to grow out their hair at all as they pull it all when it gets long enough to grab.

I myself have suffered from trichotillomania on and off for all of my life. My friend Ella has distinct memories of me pulling my hair out in reception (first year of school, aged 4-5). I lost a lot of my hair in year 4 following some stressful family drama, and lost a lot more following my fathers suicide in February 2014. Since seeing a therapist in March 2016 and being put on medication, my pulling has significantly decreased - I now dont pull from my scalp, and rarely pull other areas. My scalp hair has since grown back, albeit damaged and a completely different hair texture (very curly ringlets versus my lightly waved hair).

This all seems very scary, I understand. But trichotillomania is not some terrifying beast out to get you - it can be tamed.

Currently there are very few treatments that doctors can provide that will assist with trichotillomania. Cognitive Behavioural Therapy (CBT) is currently the foremost recommended treatment for trichotillomania - it allows people to reverse their ‘habits and ways of thinking to stop the pulling. Some may use anti-depressants, while others use an amino acid called N-acetylcysteine, which has not been proven clinically to help, but the benefits of it have been spread via the internet.

If you cant access a doctor, here are some things you can do to help yourself or others suffering from trichotillomania-

One tip for overcoming trichotillomania would be to see how long you can push it before you need to "fix" whatever is out of place or irritating your compulsion. See how long you can last; think of it like a game; see how long you can do it and try to beat your score every time. Train your brain to last longer and longer, and longer, until it's not a problem anymore.

Bear in mind that trichotillomania isnt necessarily a bad thing. Its just a different way of thinking. Dont beat yourself up about it.

Reward yourself. Some people have bracelets which they put beads on for every day pull free, and when I had enough hair, I got a really nice haircut, so I could feel better about my hair!

Finding alternative coping strategies can help. For example, some people twiddle elastic bands, or spinner rings, or special tangles (like the one in the picture on the left).

Using scalp masks or dandruff shampoos - this can prevent the itchiness that can trigger pulling (this REALLY helped me, and I still use it sometimes).

Dont be overly focused on being pull free. Set realistic expectations. These disorders are so so hard to get over! Video related here

Join facebook groups to find like minded people! The main trichotillomania facebook group can be found here

A great video for support can be found here

And a few questions for you all!

What are your experiences with trichotillomania? Share your story!

How have friends and family reacted to your disorder?

Do you chose to hide the bare areas, or rock them? Why?

What coping mechanisms do you use to help control the compulsions?

Sources used-

"What Is Trichotillomania?" The TLC Foundation for BFRBs. N.p., n.d. Web. http://bfrb.org/learn-about-bfrbs/trichotillomania

"Trichotillomania." NHS Choices. NHS, n.d. Web. http://www.nhs.uk/conditions/trichotillomania/pages/introduction.aspx

"Trichotillomania." Wikipedia. Wikimedia Foundation, n.d. Web. https://en.wikipedia.org/wiki/Trichotillomania

A big shoutout to @Hope @NixNixels @WonderfulPumpkin71 @Teagan and everyone else I haven't credited here for the help with my honours project!

Also a shoutout to @Amelia for helping me with juggling the internship with self care and real life :)

And an interesting note- all the images of hair loss used here are actually photos of me in late 2015, when I lost most of my hair :) It has all since grown back, and I have a full head of hair at last :)

Thanks for reading!