Breaking the Pull: A Journey with Trichotillomania

Breaking the Pull: A Journey with Trichotillomania

My Story

Hi, my name is Paulette, Im 42 years old and I've been recently diagnosed with Tricotillomania.  I've had lots of up and downs over my life time. I've struggled in the past with anxiety, depression, eating disorder, PTSD, alcoholism, intravenous opioid drug addiction.   After I got sober I was working in a nursing home as an RN RCC and had the job of a lifetime, husband, and my life was great.  My Husband is a retired doctor and we weren't rich but we had enough. In March 2025 I got a scalp biopsy for a rash that wouldn't clear up.  I have extremely thick hair to begin with and I developed a foreign body reaction from the dissolvable sutures.  As the biopsy site tried to heal, I kept feeling like there was "something stuck" in my hair.  That was the start of my hair pulling journey that was filled with all kinds of emotions: shock/disbelief, denial, anger, bargaining, guilt, depression and acceptance - exactly like the stages of grief.


What Is Trichotillomania?

Trichotillomania (trik-o-til-o-MAY-nee-uh), also known as hair-pulling disorder, is a mental health condition characterized by recurrent, compulsive urges to pull out hair from the scalp, eyebrows, eyelashes, or other areas of the body. Despite wanting to stop, people with trichotillomania find it extremely difficult to resist these urges.

Trichotillomania is classified as an obsessive-compulsive related disorder (OCRD) by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). It affects an estimated 1–2% of the population, with onset most commonly occurring during childhood or adolescence.

 

Common Signs & Symptoms

  • Repeatedly pulling hair from the scalp, eyebrows, eyelashes, or body
  • A sense of tension or anxiety before pulling, followed by relief or pleasure
  • Noticeable hair loss or bald patches
  • Attempts to stop or reduce pulling without success
  • Feelings of shame, embarrassment, or distress about the behaviour
  • Avoiding social situations due to hair loss

 

What Causes Trichotillomania?

The exact cause isn't fully understood, but research suggests a combination of factors may contribute, including genetics, brain chemistry, emotional regulation difficulties, and stress or trauma. It is not a character flaw or a choice — it is a recognized medical condition that deserves compassion and proper care.

Solutions & Support

The good news is that trichotillomania is treatable, and many people find significant relief with the right support. Here are some of the most effective approaches:

1. Therapy

Habit Reversal Training (HRT) is considered the gold-standard psychological treatment. It involves becoming more aware of pulling triggers and replacing the behaviour with a competing response. Cognitive Behavioural Therapy (CBT) and Acceptance and Commitment Therapy (ACT) are also widely used and effective.

 


 

2. Medication

While no medication is specifically approved for trichotillomania, some antidepressants and supplements (such as N-acetylcysteine) have shown promise in clinical studies. Always consult a healthcare professional before starting any medication.


 

3. Support Groups & Community

Connecting with others who understand what you're going through can be incredibly healing. Organizations like the TLC Foundation for Body-Focused Repetitive Behaviors (bfrb.org) offer resources, support groups, and a directory of trained therapists.

 

 

4. Self-Care Strategies

  • Identify your triggers (stress, boredom, certain environments)
  • Keep hands busy with fidget tools, textured rings, or crafts
  • Practice mindfulness and stress-reduction techniques
  • Wear barrier items like hats, gloves, or bandanas to reduce access
  • Track pulling patterns in a journal to build awareness

 

 

5. Hair & Scalp Care

Caring for your scalp and any areas affected by hair loss is an important part of recovery. Gentle scalp treatments, nourishing hair products, and protective styles can support regrowth and boost confidence during the healing process.

You Are Not Alone

Living with trichotillomania can feel isolating, but millions of people around the world share this experience. Recovery is possible — and it often starts with simply talking about it. Whether you're just beginning to understand your condition or you've been on this journey for years, know that there is hope, help, and a community ready to support you.

If you'd like to share your own story or connect with others, feel free to reach out or leave a comment below.

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