Trichotillomania and Me

I recognise that although I have a lot of experience of mental health problems, I know that I have have not experienced everything and I never will. However, I want to provide a resource here on my blog that will help as many people as possible and that means letting other people share their stories on mental health. Today I am delighted to introduce Lucy, a talented, brave and amazing young lady sharing her experience of Trichotillomania. I hope you enjoy and maybe learn something you didn't know about Trichotillomania.

My hair has always been my token feature. Until I turned fifteen, it was long enough for me to sit on, and even now, at almost twenty-one, it’s the thing people most remember and recognise about my appearance. I’ve always been oddly proud of it, and am loathe to dye it or cut it too drastically.  So perhaps you can imagine my shock when, in Year 11, I found myself uncontrollably taking out my stress on the thing I most loved about my looks.

Like many young people, I was overwhelmed with the impossibility of balancing schoolwork, relationships and a half-decent sleep pattern, and after a particularly stressful day at school I staggered up to my room to escape from it all. But rather than feeling any relief upon dumping my bag on the floor, instead, I felt a burning sensation in my toes.

 It tingled its way through the veins, up my legs, red-hot, coursing its way up my body, causing my heart to race and searing my airways tight. My hands flew, entirely of their own accord, to my scalp. It was over in a split second, and I collapsed onto my bed, shaking, and utterly baffled. I opened my damp fist, clenched so tight my nails were threatening to pierce the skin of my palm. In my hand was a small, tangled clump of my own hair. 

Close friends of mine had battled with the demon of self-harm for years, and I’d acted as a support system when they had nobody else to turn to, but it wasn’t something I’d struggled with myself. And this was different. There was no moment of choice; no feeling of wanting or needing to cause myself pain. In fact, it wasn’t about pain at all: ripping out a fistful of hair was seemingly the only way that I could be released from the awful build-up of blistering pressure that forced its way around my bloodstream. More than anything, it was entirely involuntary. My body had acted before my mind had a chance to prevent it – and that was truly frightening.

So much so, in fact, that I managed to suppress it entirely for almost a year after that first incident. I pushed it to the back of my mind as a moment of complete loss of control, and focused on my exams and enjoying my last few weeks of secondary school. But halfway through Year 12, having been thrown in at the deep end in a brand-new school three times the size of my previous one, I found myself overworked, stressed out, and quite socially isolated. One night it all got too much, and I felt an eerily familiar burning sensation in my toes, followed by a sharp sting on the top of my head. It had happened again – and this time, it was here to stay.

For the sake of transparency, I want to stress that I was never formally diagnosed because I never spoke to a doctor about what was happening. However, these actions are entirely consistent with a disorder known as Trichotillomania (trick-oh-till-oh-mania; TTM or ‘trich’ for short). At its crux, TTM is the compulsive urge to pull out one’s own hair. ‘Compulsive’ is an important word here: the disorder has been linked to Obsessive Compulsive Disorder (OCD). It can have a devastating impact on a sufferer’s mental health; many struggle with feelings of guilt or shame, which often lead to further social withdrawal, thus further ingraining the problem.

The NHS describes TTM as ‘an impulse-control disorder, a psychological condition where the person is unable to stop themselves carrying out a particular action’. It also notes that the cause of the disorder is unknown, but there are ‘several theories’: that it functions like an addiction; that it reflects a mental health problem and is used as a method of relieving stress or anxiety; or that it is a form of self-harm. In my experience, it’s most likely to be a combination of these, depending on the individual. TTM often affects young people during the hormonal changes brought on by puberty, or young children. It can be difficult to spot as sufferers work to cover up the visible signs with makeup or headwear, and is even harder to talk about given its lack of public attention.

TTM isn’t confined to the pulling of hair from one’s head; some sufferers compulsively pluck out their eyelashes or eyebrows or even, in rarer cases, pull from other parts of the body, such as facial or pubic hair. Though it sounds dramatic, my case was fairly mild: hair-pulling episodes took place maybe two or three times a week at their most intense, and that period lasted a very short time. Others suffer much more severely, pulling multiple times a day and facing the struggle of covering up significant bald patches for fear of others’ judgement. In some cases, sufferers don’t only pull the hair out, but eat it, too; this can lead to hairballs, known as trichobezoars, which can have very serious consequences.

In amongst all of this, however, there is – as always, if you look hard enough – a glimmer of hope. There are many treatment options for TTM. This might be professional help such as counselling, psychotherapy, or Cognitive Behavioural Therapy (CBT) which aims to teach participants how to reconstruct behavioural patterns. Anti-depressant medication has also proved to have a positive impact on some sufferers of TTM, leading to the theory that it could be caused by an endorphin deficiency in the brain. TTM may also be a symptom of another underlying mental condition, and these forms of medication and/or talking therapy can also support the healing of these illnesses.

Alternatively, there are self-help options which can be equally successful, though this naturally depends on the severity of the individual case. Some people use distraction techniques; my boyfriend at the time picked up a Stop Smoking pack from the NHS with a ‘tangle’, a so-called ‘fiddle toy’ made of plastic which I kept handy at all times. Anytime I began to feel that tingling, I’d grab the toy instead and keep my hands busy with it and focus on breathing until the urge eventually left me. As time went on, I got better at recognising the beginnings of an episode, and better able to control it. Eventually, I was able to leave the ‘tangle’ behind entirely; occasionally I would slip up, but after a while, I was able to hold my hand to my head until I stopped feeling the need to pull.

And then, one day, I pulled for the very last time. I don’t remember exactly when it was; it was no momentous occasion. But after that day I never did it again, not even when I was suffering from debilitating depression and anxiety during my first year at university. I don’t know whether I gained complete control over it, or if I just grew out of it, but today I am probably over two and a half years pull-free. Perhaps my pride in my hair isn’t quite so ‘odd’ after all: it’s an emblem of a victory over TTM that I celebrate each and every day.

Lucy Furneaux is a student journalist in her second year studying English and Related Literature at the University of York. Normally found with a notebook in her bag and a camera around her neck, she blogs advice and insight for students, with a bit of creative writing thrown in for good measure, at Lightly We Go (www.lucyeyf.co.uk).

Check out my advertisers for April here: Vicky Meg  Amani Beth and Holly