'I tore my hair out until I was nearly bald': Woman's 20-year battle with obsessive condition

 

Daria used to make up excuses for the bald spot on the back of her head. Sometimes she said her head rubbed against the headboard of her bed when she was asleep. Other times she said the baseball caps she had to wear at her job were too tight.
She knew people doubted her stories, especially family members. But she couldn't face telling them what was really happening: She'd been pulling her hair out since she was 12.
 


Daria had no idea why she pulled her hair. She just knew that she couldn't stop. Many times, she did it without even thinking. Daria's mom noticed her doing it while watching TV. The two of them did some research and learned about a condition that some people have called trichotillomania.

May these few information can help most of us in this situation, please read on

What Is Trichotillomania?

Trichotillomania (pronounced: trik-oh-till-oh-MAY-nee-uh) is an impulse control disorder (ICD) that involves strong urges to pull out one's own hair. An impulse control disorder is a type of psychological condition.
Doctors used to believe trichotillomania was rare. But that thinking is now changing as experts gain a better understanding of the condition and more people come forward for help. Trichotillomania affects more girls than guys. Most people who have it develop it during adolescence. But trichotillomania can start in kids as young as 1 year old.

 Having trichotillomania can affect how people feel about themselves. Some are self-conscious about how hair pulling affects their appearance. Because of this, they might feel less confident about making friends or dating. Others might feel powerless to control the urge to pull or blame themselves for not being able to stop. Feelings like these can cause a person's self-image to suffer.

Part 1 of 6: Identifying Your Triggers

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   Keep track of when you’re pulling your hair. Consider what kinds of situations cause you to resort to hair-pulling. Do you only do it when you're depressed? Angry? Confused? Frustrated? Understanding what triggers your hair-pulling can help you find other, more positive ways of coping.

   • Over two weeks, jot down every time you catch yourself pulling your hair. Document what happened just prior to the hair-pulling, as well as your feelings.
   
   
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   Make note of how you feel when you pull your hair. When learning the triggers, try to pin down what could be reinforcing the behavior. If you pull hair when you are anxious and this relieves the anxiety, then the hair pulling is positively reinforced by the feelings of relief.^[4] Take stock of how you feel during and immediately after you pull your hair. 
    

   • Knowing this can help you cope because the next time you feel anxious, you can try to find another coping strategy that brings you relief and work to make that your conditioned response to anxiety or your go-to coping strategy rather than hair pulling.
   • There are three distinct phases for sufferers of trichotillomania. Not all sufferers go through each of the three phases. You may experience one or more of these phases:
     • 1.You initially experience tension accompanied by a desire to pull out some hair.
     • 2. You start pulling out hair. It feels really good, like a sense of relief, as well as some excitement.
     • 3. Once the hair is pulled, you might feel guilt, remorse, and shame. You might attempt to cover the bald patches with scarves, hats, wigs, etc. But eventually the bald patches become obvious to everyone and you tend to start hiding at this point. You might start to feel intensely humiliated.
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   Examine the hair that you’re pulling. Do you pull hair because you don’t like certain kinds of hair? For example, one person might pull hair compulsively when they find grey hairs because they don’t like grey hair and “all greys must go.” ^[6]

   • One way to work on this trigger is to re-frame your perceptions of those hairs. No hair is inherently bad--all hair serves a purpose. Attempting to change your thought patterns about these hairs can help reduce the urge to pull.
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   Consider your childhood influences. The initial cause of trichotillomania could be genetic and/or environmental. Researchers see similarities with the triggers for obsessive-compulsive disorder and consider that chaotic, distressing childhood experiences or disturbed early relationships with parents or care-givers might be behind the development of this disorder.

   • One study has shown that over two-thirds of sufferers had experienced at least one traumatic event in their lives, with a fifth of them diagnosed with post-traumatic stress disorder. ^[7] This has led to speculation that it is a form of self-soothing for some sufferers, a way to cope.
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   Look at your family history. When tracing the source of your trichotillomania, look at whether you have a family history of hair pulling, obsessive compulsive disorder, or anxiety disorders. There is a significantly increased risk of developing trichotillomania if there is a family history of this disorder.

Part 2 of 6: Developing Strategies to Stop Pulling Your Hair

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   Develop a plan to stop yourself. The "Notice, Interrupt, and Choose Plan" is one strategy that may help you stop pulling your hair. ^[9] This consists of noticing when you feel like pulling your hair, interrupting the chain of feelings and the urge to pull your hair through listening to positive reminders in your head. Then, you can choose to do something else instead, something that will relax you and calm you.
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   Keep a journal or a chart of your hair-pulling episodes. Through writing you can get a good idea of the times, the triggers, and the impact of your hair-pulling. Record the date, time, location, and number of hairs you pull and what you used to pull them. Write down your thoughts or feelings at the time, as well. This is a good way of getting the shame out, and of expressing how the hair-pulling is impacting your life in general.

   • When you tally up the amount of hair you've pulled out, this can serve as a reality check on how much hair you're removing; is the result surprising to you? What about the amount of time spent on it, was it more than you thought?^[10]
3. 
   
   
   Choose an alternative way to express your emotions. Once you have identified the warning signs and triggers, write a list of alternative behaviors you can do instead of hair pulling. Whatever the alternative behavior is, it should be easy to do and easy to access. Some suggestions for alternative ways of expressing your emotions and feelings include: ^[11]

   • Taking a few minutes to clear your mind.
   • Drawing or scribbling on paper
   • Painting
   • Listening to music that relates to your emotions
   • Calling a friend
   • Volunteering
   • Cleaning
   • Playing video games.
4. 
   4
   Try a physical reminder to make yourself stop. If you’re pulling your hair unintentionally, you may need a physical reminder to make yourself stop the activity. For a physical barrier, consider wearing ankle weights on the arm that pulls, or a rubber glove, to discourage pulling.

   • You might even have Post-It notes placed in areas where you tend to pull your hair a lot. These can act as other physical reminders to stop.
5. 
   
   
   Distance yourself from your triggers. While it’s likely not possible to eliminate all triggers that compel you to pull your hair, you may be able to reduce some of your exposure. Is your girlfriend the cause behind most of your episodes? Perhaps it's time to reconsider your relationship. Is it your boss who's causing you all this stress? Maybe it's time to find a new career opportunity.

   • Of course, for many, the triggers aren't as simple to identify or get away from; for some, change of schools, abuse, newly realized sexuality, family conflict, the death of a parent, or even pubertal hormonal changes are behind compulsive hair-pulling. These triggers are very hard - if not impossible - to get away from. If it is the case that you can’t get away from a trigger for any of the above or other reasons, continue to work on self-acceptance, retraining your habits and enlisting social support to help you cope with your disorder.
6. 
   
   
   Reduce itching or strange feelings on your head. Use an all-natural oil to soothe the follicles and reduce itching, but more importantly to modify behavior from picking and pulling to stroking and rubbing. Make sure to use all natural products such as a mix of essential oils and castor oil. Never use chemical-based products.

   • Also, beware of products that promise quick fixes. Treatments that promise instant results or cures should not be trusted, as trichotillomania has no overnight cure.
   • You can also talk to your doctor about a prescription numbing cream to use on your head. This may be useful if one of your triggers is an “itchy” or strange feeling in your hair. In a case study of a 16-year-old girl, it was found that temporary use of numbing cream in combination with psychotherapy was successful in eliminating hair pulling behaviors.
   
   
   Part 3 of 6: Improving Self-Acceptance and Self-Esteem

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