Uprooting the Problem: My Struggle with Trichotillomania

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The average woman loses between 50 and 100 strands of hair per day. For me, on a bad day, this number can climb up to 200 individual hairs. No, I do not have alopecia, Lupus, or cancer. I do this to myself.

Three years ago I was professionally diagnosed with Trichotillomania, an impulse control disorder that lies on the obsessive-compulsive spectrum in the Diagnostic and Statistical Manual of Mental Disorders (DSM for short). For as long as I can remember at times of stress and anxiety I would enter trances in which I would pull out hair from my scalp, eyebrows, and private regions one at a time. Sometimes these trances last for hours; I will pull out hairs one at a time, placing each one on my arm to the point where my limb will be shrouded with black strands, with no flesh peeking through. In fact, I am playing with my hair as I am writing this.

So why would anyone in their right mind pull out their own hair by their own volition? Well, it not entirely voluntary. When these trances start, it is almost as if my brain shuts off: I can do nothing else besides pull and it is as if the entire world stops while I am going on a plucking spree. In fact most times during these trances I have moments of intellectual clarity: I briefly perceive what I am doing and tell myself to stop but it is no use. It is not until I pause to see how much hair has collected on my arm that I am able to distinguish just how long the pulling episode has lasted. How much hair have I ruined? I ask myself. Do I have any hair left?

 

 

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A permanent scar on my finger from pulling too often.

Often times no, I do not have any hair left. Luckily, my pulling is targeting at my eyebrows so holes in hair coverage are easy to conceal with makeup. I grow out my existing hairs to cover the holes, so thank God that Cara Delevingne has cultivated the on vogue bushy eyebrow trend.

Obscuring holes with makeup however is sometimes not enough to keep my disorder hidden. Often times the compulsion to pull penetrates my daily activities in public, the worst of these while being enrolled in University. The constant stress of exams, papers, and figuring out my future (which I have yet to do to this day) was more than enough for me to pull at the library, during class, and in my co-ed dorm. One of my friends would constantly yell at me to “leave your eyebrows alone!” when we studied together, prompting me to consult with the on campus psychiatrist.

During my first appointment was when I heard the magical word “trichotillomania” for the first time. Everything became crystal clear in that moment and I reveled at the fact that my affliction is something that is an ailment to others as well. She immediately prescribed an antidepressant (the other magical word: Prozac) as I had described that pulling episodes commenced during times of peak restlessness and worry. She also imparted one other morsel of wisdom in combating compulsions and errant behavior. She had explained that it may be beneficial to wear a rubber band around my wrist.

Of course being an athlete and millennial female I never leave the house without a hair tie around my wrist, whether intentional or not. Finally, a cure that was feasible! All I had to do, she said, was snap the hair tie whenever I am feeling the urge to pull, similar to classical conditioning experiments. I would soon learn to associate pulling hair with a painful snap of the band, thereby reducing these urges, she explained.

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To this day I still never leave the house without a tie around my wrist. While the compulsion to pull is still ever present, my pulling episodes have decreased and are seldom ever public. Of course, being on antidepressants and eliminating feelings of anxiety have worked in conjunction with the band, as many of my pulling trances were precipitated by thoughts of apprehension and panic.

Trichotillomania is often chronic and difficult to treat. Similar to OCD and addictions, it is not enough to tell yourself, or for others to tell you, to stop. It requires a conscious effort and continuous devotion to treatment, not only in combating the frequency of episodes in which you pull, but also in uncovering why you pull in the first place.  Like most other mental disorders, the fight is life long, with roller coaster ups and downs, but is manageable with trial and error. So maybe next time you see someone pull out their eyebrow hairs, or tug at their eyelashes instead of yelling at them to stop, maybe you can offer them a smile instead. Trust me, it can make a world of difference.

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