The reality of Trichotillomania

Trichotillomania, also known as hair pulling disorder, is a mental disorder that is part of the obsessive compulsive disorder classification. Trichotillomania involves the overwhelming compulsion to repeatedly pull out their own hair, which can be from the head, eyebrows, lashes, pubic hair, or any hair on the person's body.

Trichotillomania is often reported alongside other mental health conditions, commonly anxiety based issues, and could also be thought of as a form of self harm. Self harming can be any activity that inflicts pain, injury or damage to the person's own body this can include anything from smoking to picking scabs to the more commonly known about; cutting. Trichotillomania could be thought of as a less damaging type of self harming but try yanking out a nostril hair before saying that. Or you could just read my story to see the emotional damage instead; rather than the easier to examine physical damage.

Where it began

I remember distinctly the period during which I started pulling my head hair out by the root but not the actual day or time I thought "Oh yeah, to help distract me from my worry and anxiety I think I'll cause myself pain by yanking my individual hairs out. Perfect!" I was eleven years old, life had been pretty idyllic up to this point except for my parents splitting up when I was four. I was gifted at my school work, I was getting taller and started to think a little bit more than just "boys are disgusting". I was on the run up to my SATs (Standard Assessment Tests) which are done at the end of primary school in the UK. I was also going to be sitting an extra exam in the three subjects (Maths, English and, Science) in order to try and score an even higher grade in my SATs. At this time I really wanted to do well, please my mother and my teachers plus there was an emphasis that it would set me up well in my secondary school career. How little I knew! At this point in school being smart was considered great, desirable even amongst my peers at the time therefore I was highly thought of amongst adults and children around me. I felt a lot of overwhelming pressures to do well, most of which came from my own mind - exam pressure wasn't something I had ever come across before, it was something seemingly invented for me as my year was the first year SATs had been introduced.

I remember my mum coming into the school to speak to my teacher due to the amount of homework pressure I was being put under. As it turns out I was overachieving and taking home any work that I just wanted to finish. This was either to please my teacher, from a misunderstanding between myself and the teacher, me taking the teacher far too literally, or because it felt more "right" not leaving the piece unfinished. Writing this sentence I realise this probably should have been a massive red flag (probably with OCD Obsessive Compulsive Disorder printed on it) but I don't ever recall mental health disorders being widely discussed back in the mid 90s. This is in spite of several mental health markers being present in my lineage:

• My dad trying to commit suicide
• My dad's family containing a few alcoholics as well as him
• My mum's need to clean everything
• Mum's mother's (my grandmother's) utter abuse and rejection of my mum

But anyway I digress. I was doing all my work, my homework and extra things I didn't quite get done at school. Plus extra classes to give me an edge at the higher SATs, on top of being a kid and noticing boys occasionally.

The first memory I have of what started as trichophagia (eating of the pulled out hair) was twirling my hair around my finger and loads of strands of hair being on the floor next to my desk in class. I just stared down at the long brown strands and just wondered to myself "did I do that?". It must have continued on from there as a few weeks later a girl from my class stopped me in the corridor and asked me if I had Leukemia, presumably she wondered if I was having chemotherapy treatment and was losing my hair as a result. This moment is still burnt onto my brain, I was confused about why I was doing this to myself, why this girl felt the need to point out my bald patch, whether she was actually being truthful or just exaggerating. I wondered whether there was a way I could brush or part my hair to hide the part of my head because up until this point it was just the back top right of my scalp I was plundering. In an effort to avoid these sorts of comments in the future I let my hand wander to other corners of my head to find my victims. With the hair loss being more dispursed I hoped I wouldn't get one small focussed bald spot. Also, this moment also made me obsessively touch my head even more as I wondered if my developing bald patch was that obvious.

Trichophagia

The eating of the strands (trichophagia) came shortly after, maybe to hide the piles of hair next to my desk every lesson. At that time I would pull an individual strand out, bite it into small pieces, and swallow them. This led to me having an intervention style chat with my mum and GP talking about the growing hairball sitting in my stomach. I tried to explain that often I wasn't aware of my activities but it fell on deaf ears, I said it's not something I wanted to do and they really couldn't understand that. I felt like the whole thing was my own fault, I mean it was my hand doing the pulling and my head so on some deep level, I must want to pull my hair out right... I suppose OCDs weren't really well known back then, it was a small town in Wales in the 90s.

Once again I modified my behaviours in order to fulfill some external emotional trigger. Now I pulled out the hair bit it into small lengths and blew them away, this I "enjoyed" even more than swallowing them plus I could make each hair last longer because there was a nack to blowing the hair away in just the right way. So technically it was trichotillomania as I no longer swallowed the hairs. I would often stick them to walls for some reason that I don't even really understand to this day. I can only really compare the feeling of blowing my hairs away to the act of smoking that I found out about many years later.

College

During college I had a weird moment with one of my best friends, I was doing Psychology A level - why this is important will become apparent later. One day we were sitting together in the canteen when I noticed her hand moving near her hair roots, the way I knew my hands did. I asked her about it and she said for some reason she liked to pull the thicker hairs out of her head. My first thought was "Oh My God I'm not the only one" and "I'm not alone" which is often a comfort to those with a mental health condition. Then I thought "Oh no, what if I taught her this!" My psychology training led me to believe she had done this by learnt behaviour, watching me fiddle with my hairs for years and eventually picking up the habit herself. When we spoke further it turned out she just didn't like these hairs, they felt like pubes apparently. My friend didn't put the hairs in her mouth, didn't play with them or bite them she just threw them away.

Today

Slowly this changed again to me only picking out the thickest roughest hairs and eventually perfecting pulling out the hair follicle with the hair and eating the follicle. So back full circle to trichophagia again although now I was hunting the follicles rather than the hairs themselves. This is what I do now at the age of 35, ironically those thick hairs tend to be the white ones, my stress and old age hairs. I have been pulling my hairs out for over two decades and I don't see it stopping any time soon. There have been periods where it has stopped but it always comes back. If you feel my scalp, despite it not being visible by just looking you can feel the stubbly texture of broken pulled hairs right next to the skin.

Now I seem to do a lot of my hair pulling in my car, mostly because one hand is free a lot of the time and I am usually concentrating really hard. I am only aware of the extent of my hair pulling by the increasing number of tiny white hairs coating my dashboard after every journey. I also do it in bed as this is when the tasks of daily life stop and I have the time and the headspace to spiral into all my worries and anxiety in peace and quiet.