Good hair gives us a good feeling – everyone knows that. And yet, few people consider the relationship between mental health and hair. Many mental health conditions can cause thinning or unhealthy hair, forming a cycle of damage to self-esteem that may seem difficult to escape. This four-part blog series focuses on four mental health conditions as they impact your hair, and what can be done to help.
Content warning: compulsive hair-plucking, trichotillomania
Trichotillomania, pronounced trick-o-till-o-mania, is a mental health condition which involves compulsively picking at or plucking one’s own hair. It is usually focused on the hair on the head, but in unusual cases can include the eyebrows or eyelashes. Sufferers of “trich” may develop bald patches or patterns of thinner hair, but in spite of the visible damage, often find it difficult to stop plucking.
Amy Jenson* shared her experience of “trich” with The Wimpole Clinic:
“I’m certain that it started with the onset of GCSEs. We all had set tables in the hall, and at the end of all the exams I collected a wad of my hair that I had been pulling out since the first exam. By the time I went to my year 13 prom, I had two big bald patches at the base of my head. My hair had to be arranged around it to hide it. I had consciously switched my picking area from the top of my head where it was really noticeable, to behind my ear and at the base of my hairline.”
If plucking continues for many years, trichotillomania risks permanent damage to the hair follicles, so that bald patches appear and hair may not grow back. Amy recalls the impact, “I honestly thought it was just a strange habit and I didn’t realise how damaging it had been.”
Common triggers are frustration and anxiety, and the compulsion may increase in periods of higher stress. PsychologyToday [https://www.psychologytoday.com/articles/200804/the-tricky-habit-trichotillomania] advises that trichotillomania is probably “an ancient impulse” related to the grooming behaviours of our ape-like ancestors. For some people, increased plucking may even signal stress they were not aware of, as Amy says, “I do question myself if I have a bad day with pulling my hair out, like is there something bad that I’m unconsciously not dealing with.”
Sufferers are advised to try a behavioural therapy such as CBT before medication – and if experiencing bald patches or visible hair loss, visit a specialist hair clinic such as The Wimpole Clinic to confirm trichotillomania and discuss treatment options. Diagnosis includes an analysis of hair loss patterns, and sometimes a scalp biopsy, which can reveal a great deal about the reasons for hair loss.
Recovery is possible
No matter how long you have struggled with trichotillomania, help and support is available. A combination of behavioural therapy and hair restoration treatment can restore confidence in appearance and treat the compulsion. Amy agrees: “When people feel vulnerable and ashamed about a part themselves that they find difficulty in changing, they should always find help. Be it a hair clinic, counsellor, therapist or a doctor for meds.”
Information and support
Next week: we look at clinical stress and hair loss
*names have been changed to protect confidentiality