Trichotillomania (THREE-o-TILL-o-ma-ni-ya) is a disease that causes an irresistible urge to pull hair out of the scalp, eyebrows or other areas of your body. At the site of the pulled out hair, focal bald spots often remain, which people with this disease try to carefully mask. This disease is diagnosed in about one percent of the country's adult population, and most of the patients are women. The compulsion to pluck hair often occurs in early adolescence, although some do it sooner or later. Hair pulling combined with depression can lead to impaired functioning in work and social situations, and you may feel completely helpless if you have already been diagnosed with the condition. But trichotillomania is treatable and, moreover, very successful.
Method 1 of 6: Identifying Your Triggers
Step 1. Trace exactly when you start pulling out your hair
Determine what types of situations encourage you to do this. Do you only do this when you are depressed? Are you angry? Confused? Disappointed? Being aware of the triggers that make you pluck your hair can help you find other, more positive ways to deal with yourself.
For two weeks, write down each time you try to pull your hair out. Also note the events that preceded it and how you felt
Step 2. Write down how you feel when you pluck your hair
As you study triggers, try to pinpoint the exact cause that is contributing to this behavior. If you pluck hairs when you are preoccupied with something, and this relieves the feeling of anxiety, then this procedure is accompanied by a positive feeling of relief. Examine how you feel during and after pulling your hair.
- Having this information will help you deal with yourself next time. When you start to feel anxious again, you can try another coping strategy that really brings relief. You need to work on yourself to develop a certain reflex to anxiety, or to learn how to cope with yourself and apply a special strategy instead of pulling out hair.
Patients with trichotillomania go through three stages. Each of these stages can occur sequentially, one after another, but this does not happen for everyone. You can transfer one stage or more:
- 1. At first, you experience tension, which is accompanied by the desire to pull out a few hairs.
- 2. Then you start pulling out your hair. At the same time, you feel very good, you experience a sense of relief, as well as some excitement.
- 3. After completing the process, you may feel guilty, remorse, or ashamed. You can try to hide the thinning areas with scarves, hats, wigs, and more. But eventually, when patches of baldness become apparent to everyone, you tend to start hiding at this stage. You feel very humiliated.
Step 3. Consider the hairs you are trying to pull out
Are you pulling them out because you don't like a particular color? There are cases when a person constantly pulls out gray hair, because he does not like it and, in his opinion, "all gray hair should be removed."
The way to work on this trigger is to change your perception. This is not to say that you do not need any particular types of hair, because they all fulfill a certain role. By changing your way of thinking, you can lessen your urge to pull out your hair
Step 4. Consider childhood experiences
Trichotillomania can be caused by genetics and / or environmental factors. Researchers find that the symptoms of this disorder are similar to the triggers of obsessive-compulsive syndrome, in their opinion, chaotic, anxious experiences in early childhood or a violation of relationships with parents or caregivers can contribute to the development of the disease.
According to one study, more than two-thirds of patients had at least one traumatic event in their life, and one in five was diagnosed with post-traumatic stress disorder syndrome. Based on these data, it was suggested that trichotillomania is a form of sedation and helps to cope with the problem
Step 5. Pay attention to your family history
When looking for the source of the disease, consider whether your family members have been diagnosed with a condition such as trichotillomania, obsessive-compulsive disorder, or anxiety disorder. If a case of trichotillomania has already been recorded in the family, in the future there is a significant risk of recurrence of this disease in other family members.
Method 2 of 6: Developing Anti-Pulling Strategies
Step 1. Develop for yourself a special plan with which you can tell yourself stop every time
"Preventing, discouraging, and choosing a plan" is one strategy that can help you stop pulling out your hair. You need to notice when you feel the urge to pull out your hair, block the chain of sensations and desires that contribute to this, and awaken positive memories in your thoughts. Then you need to choose and do something that will relax and calm you.
Step 2. Keep a diary or graph in which you record each episode of symptoms
Through these recordings, you will gain a clear understanding of the timing, triggers, and impulses that urge you to pull out your hair. Write down the date, time, location and number of hairs, and the way in which you pulled them out. Also write down your thoughts and feelings at this moment. This is a good way to understand how hair pulling affects your life in general.
Counting the number of hairs pulled out will tell you how much hair you are actually removing: is this an unexpected result for you? Are you spending more time on this than you expected?
Step 3. Choose an alternative way to express your emotions
Once you have identified the prompting signs and triggers, make a list of alternative behaviors that you can use to replace hair pulling. Regardless of the type of such a model, it must be affordable and easy to implement. Some types of alternative behaviors include the following:
- Take a few minutes to clear your mind of unwanted thoughts
- Draw or write something on paper
- Take up painting
- Listen to music that matches your emotions
- Call a friend
- Start cleaning
- Play video games
Step 4. Try to use a physical reminder that can make you stop
If you unconsciously pull out your hair, you may need a physical reminder. For such a barrier, try using a weights that can be worn on your hand or with a rubber glove.
You can even mark the places where you pull your hair most often. They can also act as a physical reminder that can affect you
Step 5. Distance yourself from your triggers
While it may not be possible to eliminate all of them, you can reduce their impact. Perhaps your girlfriend caused these episodes to appear? So it's time to reconsider your relationship. Has your boss caused a stressful strain? It may be time to find a new job.
Of course, many people cannot immediately identify and eliminate their triggers: a change in school, a bad attitude, the first realization of their sexuality, family conflict, the death of a parent, or even adolescent hormonal changes can cause signs of trichotillomania. These triggers are extremely difficult to get rid of. If you are unable to cope with your condition due to one of the above reasons, or any other, continue to work on developing adequate self-esteem yourself or contact social support services where you can get help
Step 6. Eliminate itching and other unpleasant symptoms on the scalp
Use natural oils that soothe hair follicles and reduce irritation. Also, try to change your behavior and related activities: from pulling your hair to stroking and rubbing. Be sure to use all natural products available, such as a mixture of castor and essential oils. Never use chemicals.
- Also beware of remedies that promise quick recovery. Do not trust procedures that guarantee a quick result, since a disease such as trichotillomania requires long-term treatment.
- You can ask your doctor for a prescription for a special pain relieving cream that can be applied to the entire scalp. This remedy can be helpful if one of your triggers is "itching" or a strange sensation in your hair. While studying the medical history of a 16-year-old girl, it was found that the temporary use of anesthetic cream in combination with psychotherapy helped to eliminate manifestations of unwanted behavior.
Method 3 of 6: Increasing Self-Esteem and Building Self-Respect
Step 1. Live in the moment
Hair pulling is often caused by a failure to relive negative feelings and emotions. Use mindfulness techniques to help yourself cope with negative and unpleasant emotions more easily, taking them as a natural part of the human experience. They don't have to be avoided. When the urge to avoid discomfort subsides, the urge to pull out hair diminishes.
For the mindfulness exercise, sit in a quiet, comfortable place. Take a few deep breaths. Inhale for a count of four, hold your breath for four seconds, then exhale for a count of four. During the breathing exercise, you will have different thoughts. Accept these thoughts without judgment and let them go. Concentrate on your breathing again
Step 2. Develop self-esteem and self-esteem
Many people with this disease have low self-esteem and self-doubt. To develop your self-esteem and self-acceptance, use a therapeutic approach called Commitment and Acceptance Therapy (TPO). This approach helps a person to realize the values that are important to him and to focus on his life goals. Boosting self-esteem is an essential part of recovery.
Remember that you are an amazing and unique person. You are loved and your life is priceless. It doesn't matter what you are told, first of all, you must love yourself
Step 3. Replace negative thoughts with positive ones
Negative thoughts lower your self-esteem and make you pull out your hair. Humiliation, fear of failure, and negative thinking will keep you in limbo. Start changing these behaviors, rebuild yourself, and build self-confidence. Here are some examples of how you can change the way you think about yourself:
- Let's say you have these thoughts: "Usually I have nothing to say, and I understand why people think I am pathetic." Track them and make an effort on yourself, changing such thoughts to the opposite. Tell yourself, “Sometimes I have nothing to say, and that's okay. I don’t need to entertain others and take the lead in this conversation.”
- Replace critical thoughts with productive ones. For example, if you think, “There is no point in meeting everyone for dinner. Last time I was so embarrassed when I didn't know what to answer. I felt so stupid. " Think like this: “I was so embarrassed at the last dinner, but I know I make mistakes and that's okay. I'm not stupid, but just honestly admitted my mistake. "
- As you track negative thoughts and replace them with positive ones, you will notice how your self-esteem and self-confidence increase.
Step 4. Write down your achievements and strengths
This is another way to help you learn to accept your emotions and increase your self-esteem. Check this list more often.
If you are having trouble making a list, talk to your friend or family member. You can discuss your personal accomplishments together. Write down any victory, even the smallest one
Step 5. Work together with other people, communicate assertively
Continuing to practice self-affirmation techniques will help you cope with situations that are challenging you. For example:
- Learn to say no. If people ask you to do something that you do not want, defend your own needs and desires, learn to refuse.
- Stop pleasing other people. Don't do work just to win the approval of others. Find out what is important to you. Ask for what you need.
- Declare your own self. These types of statements will help you feel responsible for your own emotions and reactions. For example, instead of saying, "You never listen to me," say, "I feel like I'm being ignored when you look at your phone during our conversation."
Method 4 of 6: Reduce Stress
Step 1. Eliminate the sources of your stress
Many patients note that it is the stressful condition that makes them want to pull out their hair. Do your best to reduce the occurrence of stressful situations in your life and learn to manage yourself using the best coping techniques.
Make a list and list all the things that cause you stress. These can be both major troubles, for example, with money or work, and more minor, for example, queues at the grocery store. While you may not be able to avoid everything that causes you stress, you can change your perception of certain things
Step 2. Relax your muscles using the progressive muscle relaxation technique
With this technique, you can reduce your exposure to stress. This type of relaxation relieves muscle tension and sends a signal to your body, which also needs to go into a relaxed state. By alternately tensing and then relaxing your muscles, you will help your body return to a calm state.
- Tighten the muscles for exactly 6 seconds, and then relax them also for 6 seconds. Watch carefully how each of them relaxes.
- Work your entire body from your head to your toes until you feel completely relaxed.
Step 3. Try to meditate
Meditation can help you reduce your stress levels. Regular meditation exercises, even for 10 minutes a day, help to clear the mind and channel energy in a positive direction.
Find a suitable place for your meditation, sit or lie down. Start breathing deeply, taking slow breaths. You can even try directional visualization by imagining yourself in a quiet place, such as a beach, by a stream, or in a forest clearing
Step 4. Get enough sleep
Make sure you have a specific sleep schedule and get enough hours of sleep. The goal is to get at least seven or eight hours of sleep a night.
If you are having trouble falling asleep, try listening to relaxing music. Do not use electronic gadgets at least 15 minutes before bed
Step 5. Start exercising
Studies have shown that with regular exercise you can significantly reduce your stress levels. Your body will begin to release more endorphins, and you will feel much better.
Don't spend an hour on the treadmill every day. Choose what you like. This can be yoga, martial arts, or other activities. Even gardening can give you a powerful boost of positive energy
Method 5 of 6: Find support
Step 1. Talk to a close friend or family member
Find someone you can trust and talk about your medical condition. If you find it difficult to talk about it out loud, write a letter or send an email. If you are afraid to talk about how you are struggling with the disease, at least tell us about your experiences.
- You can also tell friends or family about your triggers. With this information, they will remind you of them when you are at risk of another attack. They can also help you develop alternative behaviors.
- Ask your friends and family to support you as they see you successfully following the alternative behaviors you have developed.
Step 2. Talk to a mental health professional
A counselor or therapist can help you find ways to cope with your illness. This person can also help you heal depression or other problems that are causing your injury.
- If, after visiting a consultant or therapist, you do not see positive results, contact another specialist in this field. After all, you are not associated with just one doctor or consultant. It is important to find someone with whom you can feel a connection, someone who will provide you with real help.
- Therapies that work for you may include behavioral therapy (especially training aimed at changing habits), psychotherapy, psychodynamic psychotherapy, hypnotherapy, cognitive behavioral psychology, and possibly antidepressant medication.
Step 3. Ask your doctor questions about medication
Several drugs have proven successful in the treatment of trichotillomania, such as Fluoxetine, Aripiprazole, Olanzapine, and Risperidone. They help regulate the levels of chemical compounds in the brain and reduce the symptoms of anxiety, depression, and emotional states that can trigger hair pulling.
Step 4. Contact support online or by phone
If you do not have access to consultant services, you can get them through other sources. Search the Internet for sites and organizations that provide free help for trichotillomania.
Method 6 of 6: Diagnose Condition
Step 1. Watch for specific actions or reactions that may signal the onset of this disease
Trichotillomania is officially classified as an impulse control disorder along with pyromania, gambling addiction, and kleptomania. If you suffer from trichotillomania, your actions or reactions to certain stimuli are accompanied by hair pulling. They can also include:
- Chewing or eating plucked hair.
- Rubbing lips or face with plucked hairs.
- A growing feeling of tension just before pulling out hair or when trying to resist this behavior.
- Pleasure, satisfaction, or relief after pulling out hair.
- You catch yourself pulling out your hair (this is called "automatic" or unintentional behavior).
- You realize that you are pulling out your hair on purpose (this behavior is called "focused").
- You use tweezers or other tools to pull the hair out.
Step 2. Recognize the physical signs of the condition
There are several clear signs of trichotillomania. They include:
- Noticeable hair loss caused by constant pulling.
- Focal bald patches on the scalp or other areas of the body.
- Sparse or missing eyebrows and eyelashes.
- Infected hair follicles.
Step 3. Find out if you have other obsessive habits
Some people may bite their nails, suck on their thumb, shake their head, or constantly scratch or poke at certain areas of their skin.
Track these behaviors over the course of several days to find out which ones are truly compulsive habits. Pay attention to when and how often you do these actions
Step 4. Determine if you have additional violations
Is trichotillomania really your only medical condition? Patients may also suffer from depression, obsessive-compulsive disorder, Tourette's syndrome, bipolar disorder, phobias, personality disorders, and, in some cases, exhibit suicidal tendencies. Seeing a doctor or mental health professional may be helpful if you have a comorbid condition.
- However, it is difficult to tell which disorder is the main cause. Does hair loss cause depression and a desire to isolate oneself from others and avoid having fun out of shame?
- Often, successful recovery from trichotillomania requires treatment for other comorbid conditions.
Step 5. Talk to your healthcare provider about hair loss disorders
If a person believes that he is sick with trichotillomania, he needs to be examined by a qualified specialist in order to exclude other disorders of the hair follicle. Certain medical conditions can also cause hair loss, such as alopecia and ringworm. During the examination, the doctor will look for evidence supporting trichotillomania: unevenly pulled hairs, broken hairs, and other abnormalities.
Step 6. Recognize that trichotillomania is a disease
First of all, you need to understand that this disorder needs to be treated without attributing everything to a lack of willpower. This disorder is caused by genetic causes, mood swings, and your personal causes.
Brain scans have shown that people with trichotillomania have distinctive features in the brain that are absent in those who have not been diagnosed with the disease
Step 7. It is necessary to understand that this disorder is a special form of self-harm
Don't tell yourself that pulling out your hair is “okay”. Like all forms of these disorders, trichotillomania can manifest itself over time with signs of additive behavior. Over time, its treatment becomes more and more difficult, so it is necessary to bring the disease under control as soon as possible.