How many times have you heard someone say, “that makes me want to pull my hair out,” when they were annoyed or stressed about something?
Well, for me, sports actually did make me pull my hair out. What I didn’t realize at the time was that this common expression describes a real mental health disorder—one that affects an estimated 5 to 10 million Americans.
The disorder is called Trichotillomania (TTM), or hair-pulling disorder. TTM is a mental health condition characterized by frequent, repeated and irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body. Many people with TTM feel an itch, tingling, or an overwhelming urge to pull. When they do, they feel a brief sense of relief, and to the brain, this relief is a reward. The brain releases reward hormones, like dopamine, which reinforce this behavior.
While the causes of TTM are unclear, and vary from person to person, for me, pulling out my hair became a way to cope with the stress and anxiety I faced in sports. As an athlete, I loved sports, but they also brought me intense anxiety. Performance anxiety haunted me during every practice and game; it followed me to school and back home. It was everywhere, and TTM became the only temporary relief from my constant spiraling thoughts.
What started as an innocent habit to momentarily distract me and relieve my anxiety turned into something far more serious—11 years of hair-pulling.
And it wasn't until year 9 that I built up the courage to seek help from a doctor. While it’s estimated that 5 to 10 million Americans are affected by TTM, that number is likely much higher, as there is an intense shame, embarrassment, and stigma that comes along with the disorder. TTM appears as common as other serious psychiatric disorders but is often underestimated because many people conceal it from those around them.
I was so nervous to go to my doctor and explain to them that I was so stressed that I was pulling my own hair out.
How would I even explain it to them? They’ve probably never heard of that. They’ll think I’m crazy!
Despite educating myself over the past 11 years on how common this disorder is, the fear of judgment and stigma still linger. Mental health still carries a significant stigma, even for well-known conditions like anxiety, depression, and obsessive-compulsive disorder. But for lesser-known disorders like TTM, opening up to others can feel even more daunting. For those affected, it often feels like no one else could possibly be experiencing this, especially since most people have never even heard of the disorder.
Reaching out to a medical professional for help with TTM was one of the hardest things I’ve ever done—it took me nine years to build up the courage. However, when I finally did, I was met with nothing but kindness and compassion from my provider. Although she didn’t understand the disorder from first-hand experience, she was more than willing to listen and work with me to navigate this journey together. If you’re struggling with TTM and feel nervous about reaching out for help, I encourage you to take that step. The world is often more compassionate than it might seem.
Like most addictive behaviors, the common question I get asked about TTM is, “Why don’t you just stop?”
Unfortunately, it’s not that simple. TTM is part of a group of conditions known as body-focused repetitive behaviors. For me, hair-pulling has become a habit—one that still comforts me despite the damage it causes. This habit helps me regulate intense emotions by providing a momentary distraction and a small source of dopamine. After 11 years, pulling has become such a natural action that I sometimes don’t even realize I’m doing it.
The problem is, this all becomes a cycle. Pulling gives me a momentary sense of relief, but almost immediately, I feel stress over the harm it causes. The distress over patchy or bald spots makes me want to pull more, just to feel some sense of relief, and the cycle continues…over, and over, and over again
I wish I could say I overcame TTM and that’s why I am sharing my story, but unfortunately, I can’t. My journey with TTM is ongoing, and I continue to navigate the challenges it presents every day. But I hope that sharing my experience and spreading awareness can not only help my healing journey, but those who also struggle with this disorder. As a community, let’s bring more attention to TTM and its complexities, so that those affected feel less isolated and misunderstood.
To those struggling with TTM in silence, please know that you are not alone. It’s okay to reach out for help and to seek support from those who care about you. But most importantly, please be patient with yourself.
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