Trichotillomania, an anxiety-related mental health disorder, is characterized as an insatiable and persistent compulsion to pull or pick at hair.
The condition, which is much more common among women than men and is frequently diagnosed in adolescent girls and young adult women, can result in baldness or patches of profound hair loss and is often diagnosed alongside other compulsions or mental health issues.
Women, especially young girls, are often stereotyped as hair-twirlers, socially conditioned to play with and touch their hair out of boredom or self-consciousness. This predisposition makes trichotillomania harder to spot.
Of course, frequent hair-pulling and breaking is the most easily diagnosable symptom. Beyond the obvious, though, trichotillomania sufferers often exhibit other compulsions. According to Mayo Clinic, individuals with trichotillomania are likely to pick at or scratch hair follicles on their scalp, pull their eyebrow hair and eyelashes, and obsessively shave or tweeze almost all body hair.
Many people with trichotillomania develop bald spots or patches and suffer from hair loss. Trichotillomaniacs mostly pull hair from its root and, as stated by KidsHealth, usually “feel a sense of relief after pulling,” which decreases an individual’s chances of seeking treatment. As is true of those with many obsessive compulsions, people with trichotillomania frequently feel ashamed or embarrassed of their habits — especially since sufferers of this condition can often go so far as to need wigs or head coverings.
Hair-pulling can be characterized in one of two ways — as automatic (unconscious) or focused (conscious.) Those who pull consciously often develop rituals around the behavior and are aware of what they’re doing. In fact, they might even decide to pull their hair to offset stress or a negative emotion.
Their counterparts who pull unconsciously, however, are likely to pull hair as a sort of fidget — something they do without noticing when they’re sitting idly or feeling apprehensive. It’s generally easier to diagnose and treat focused trichotillomania since individuals who are conscious of their behavior are quicker to accept a diagnosis and can more easily track their own habits.
The impulse-control disorder usually begins to take hold around the onset of puberty and advance as girls get older. Since twirling and playing with hair is considered a feminine habit, many dismiss early warning signs as a bad habit or inability to sit still.
In fact, the disorder creates impulses that are incredibly difficult to resist. Diagnosed individuals in treatment have blogged on community forums about having more difficulty stopping their hair-pulling than they did recovering from eating disorders or quitting smoking.
Though some sufferers find success in creative treatments like scalp sprays and special gloves that help them resist the urge to pick, most find therapy and prescription medication to be the most effective treatment. Therapists often help patients examine why and when they pull their hair, and often help them fight the urge by building a substitute behavior or ritual into their lives. Just as with any compulsion, treatment takes time and effort and requires that the individual in question be ready and willing to get help.
So if you find yourself tugging at your hair the next time you’re catching up on your favorite Netflix series or spot your friend picking at her scalp, consider how common and challenging trichotillomania is. If you or someone you know might be suffering from its symptoms, the sooner you seek help, the sooner you’ll begin to address the compulsion head on.