https://womensnetwork.blog.essex.gov.uk/2021/05/13/mental-health-awareness-week-trichotillomania/

Mental Health Awareness Week: When things get Trichy

photo of Willow Stratton

Contributed by Willow Stratton

You know when someone says a situation makes them so stressed that they tear their hair out? 🙋🏽 That's what I actually do. My name is Willow and I have trichotillomania.

So, what is it? Throughout this blog I'll mostly call it Trich as that allows me to make it sound fun and I can say things like 'I was feeling a bit trichy' etc.

I didn't know that what I did was a condition until I happened to watch one of those horrible programmes (with a title that if you saw it on the internet it would be clickbait) that capitalises on people's suffering, I'm thinking around the late noughties. It did raise awareness – certainly for me to recognise that what I did was a thing – but the main purpose was to shock people with this almost bald woman who only had a halo of hair left along her hairline which she would scrape back into a pony tail.

 

The NHS describe Trichotillomania as “when someone can't resist the urge to pull out their hair” It’s not exclusive to the hair on your head. Here’s the NHS list of who might be affected:

“Trich is more common in teenagers and young adults, Check! I developed Trich when I was 11 years old.
and tends to affect girls more often than boys. Yup, I’m a woman.
A person may sometimes pull their hair out in response to a stressful situation, Parents divorcing the summer before I started high school – check!
or it may be done without really thinking about it.” Also me!

I was a prime candidate for it. The NHS website goes on to say: “It's not entirely clear what causes trich. It could be:

  • your way of dealing with stress or anxiety
  • a chemical imbalance in the brain, similar to obsessive compulsive disorder (OCD)
  • changes in hormone levels during puberty
  • a type of self-harm to seek relief from emotional distress

For some people, hair pulling can be a type of addiction. The more they pull their hair out, the more they want to keep doing it”

My parents divorced in the summer before I started high school, and I developed trich following these two big life changes. I think I started just with pulling my hair on my head out, and then at some point I moved onto my eyelashes. By the Spring term of my first year of high school I had a bald patch about the size of a £2 coin on the crown of my head.

People started to notice so I tried to be more covert with the hair pulling; spreading it out across my head instead of focussing in one place and I developed a nervous habit of pushing my hair back from my forehead to cover my bald patch. My other habit was turning red whenever anyone spoke to me. I still remember my English teacher shouting at me in front of our whole class because I kept touching my hair. She was scary initially but actually ended up being one of my favourite teachers.

Even as recently as this year, the crown of my head was still my go to place on my head for hair pulling. It doesn’t hurt as much, you’re more likely to get a nice bulb out, and a weird added bonus for me was if it was wet (probably from the sebaceous gland near the hair follicle). The worst place for my hair pulling was if I was stuck in traffic. I would just prop my elbow up against the window and start pulling my hair out. This would happen unconsciously. The other time was watching television. At least with the recent lockdowns I’ve not been making long car journeys. I’m not going to comment on how much television I watched in the last year.

I think my mum had started to notice in that first year but she had just gone through a divorce and had three other children to think about, my brother at the time had just turned one so I can’t blame her for not picking up on it. If she came across a pile of hair in my room I’d tell her that it got knotted on my hairbrush and I’d accidentally pulled it out. This seemed to satisfy her. I was only when I started to pull all my eyelashes out that it was quite obviously not accidental.

Despite my mum not really noticing that I probably needed some help, she did do something that was probably my saving grace during my high school years. She let me cut my hair really short. It was past my shoulders when I had started school and I had it cut into a pixie crop I guess. Hair that’s only a few inches short is a lot harder to pull out than mid length hair. I asked her recently if this was a deliberate move and she said it wasn’t. Inadvertently she had stopped my problem from getting worse.

I’d had trich for at least three years before I caught the TV show which meant I had a name for it, but this was pre social media so my only chance to research it would have been during an ICT lesson at school. My hair had grown back into a bob and then when I was 16 I had it shaved to a grade 2 at a party so once again, I’d managed to cut the trich out.

I’ve been fortunate that my hair has always grown back and I’ve not damaged it enough that I’ve developed alopecia. I can remember a hairdresser in my twenties commenting that the hair at the crown on my head was a different texture, as though I’d straightened it repeatedly and I couldn’t bring myself to tell him the real reason.  My eyelashes are stubby and I always wonder if they would be this way if I had never started pulling them out. I’ve also never progressed to digesting my hair after pulling it out, which is the element of trichotillomania which can lead to fatalities.

The thing that surprises people about my trichotillomania is not the severity of it but the longevity. I started pulling my hair out when I was 11 and I ‘stopped’ when I was 34. It wasn’t consistent during those 23 years; it would come in cycles depending on what was happening in my life at the time. It started as a way of managing stress but eventually it was such an ingrained habit that I would do it without thinking.

Periods of hairpulling flared up again over the years. I had hypnotherapy for it in my twenties which worked briefly. I also tried telling my close family and friends to look out for it and to tell me to stop. It was when my first daughter was born in 2016 that I decided that I really needed to nail this on the head. She was a hair twiddler when tired and I didn’t want her to copy what I did with my hair or think that it was normal.

Christmas 2017 was particularly stressful. I’d been back at work for a few months when we were told there would be an organisational redesign and we would lose 30% or our team. We went into consultation just before Christmas and had to be interviewed for our jobs. I was convinced that as the last person in (following my maternity leave) I would be the first person out and between that and the usual stress of Christmas (social commitments, juggling seeing each of my parents and my husband’s family, financial concerns etc) my trich returned.

photo of Willow Stratton
Me and my spriggy regrowth at the crown of my head in 2018

I made an appointment with my GP in the spring of 2018. I was incredibly fortunate that my appointment was with a Doctor who knew a specialist in trichotillomania and I was referred for an out of county treatment at the Royal Free Hospital in London. A few months later a cancellation came up and I was able to speak to a consultant. He then referred me to a four week habit reversal clinic which I started in September. I was discharged after three weeks.

The key things I learnt were;

  • That you have to want to stop. I’d made a conscious decision that I couldn’t carry on pulling my hair out and even before I started the clinic I’d massively reduced my hair pulling on my own.
  • Keeping a diary helps you recognise your triggers.
  • When you do feel an urge coming on, distract yourself. Now when I am in the car in traffic I have to sit on my right hand. One of the things suggested was knitting, which I really want to start.

More than anything though my advice is, if you notice your child or someone close to you pulling their hair out or if you are doing it yourself, is to seek professional help. It’s the best thing I did and I just wish I’d done it years earlier.

Earlier in the year when we were eagerly awaiting the reopening of hair salons I was talking to a colleague about beauty maintenance and she said something about pulling her hair out. It turns out she routinely pulls her hair out and so does her mum. I’ve got a second daughter now and she is a hair twiddler, just like her sister, but more aggressive in that she did pull out a significant amount of her hair on the right side of her head which means she sported a toddler combover for quite some time. I can’t help but question whether I’m responsible in some way for that, if she’s seen me do it, or if it is something hereditary. It’s a relatively under researched area still.

I think I’ll always have trichotillomania, it doesn’t have a “cure” but it is something that I have the strategies to control. Because it’s not a well known disorder, medical professionals suspect it is more common that the number of sufferers suggest. Hair pulling might be something you do, you just didn’t have a name for it. Mental Health Awareness Week has been a great opportunity to hone in on lesser known conditions.

If you want to know more about Trich I’d suggest the following sites/reads:

https://www.nhs.uk/mental-health/conditions/trichotillomania/

https://www.theguardian.com/news/2018/aug/23/tearing-our-hair-out-learning-to-treat-compulsive-hair-pulling

https://metro.co.uk/2020/11/23/trichotillomania-sufferers-have-been-struggling-in-lockdown-13640002/

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2 comments

  1. Comment by Neera posted on

    This is a fascinating read, thank you for sharing your story and I'm glad you were able to get help. I've read a little about trichotillomania and dermatillomania (skin picking) too but it's intriguing to see it from the perspective of somebody who has it. I'm sure your post will help others identify it.

    Reply
  2. Comment by gemma posted on

    It's so good to read this I wish it was talked about more. I have suffered with this for 27 years now and at times I get so depressed and feel like a freak. I've currently just cut all my hair really short to help I'm too embarrassed at this point to go to the hairdressers and ill just have to keep trying . I have never found my gp helpful they just look at me a bit blank so I don't really ask for help anymore .

    Reply

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