Dr Moon Kitty 3: Trichotillomania

October 25, 2019

Dr Moon Kitty 3: Trichotillomania

Hello Wig Lovers! Our first question comes from Erin in Ohio, who asked:

What causes trichotillomania and how do you stop pulling?

Hi Erin! According to the Mayo Clinic, trichotillomania is “is a mental disorder that
involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of
your body, despite trying to stop.” Lots of people who struggle with this report feeling relief after
they pull their hair. There isn’t a clear cause, but medical studies suggest that there are both
genetic and environmental factors that increase risk like age (usually before or during early teen
years), family history, other biochemical mental issues like depression, anxiety, and obsessive-
compulsive disorder, and stress.
Having said all that, the first thing a person can do to treat trichotillomania is to go to the
doctor and find out if there is a medical or biological reason for their desire to pull out their hair.
As much as I’m not a fangirl of just medication for a LOT of issues, if there are serious
biochemical imbalances that go along with depression or anxiety of OCD (as mentioned above),
meds CAN help.

This part reminds me of a cute meme I saw the other day on Imgur: And it’s true. If your body doesn’t produce enough (or too much) of a neurotransmitter, there are still good options out there for medications that can work for you. I’ll never understand how so much stigma exists about taking medications that restore your brain chemistry to a natural state.  

Secondly, as a therapist, I may be a bit biased in this regard, but loads of studies say the same thing—meds AND therapy give people the best results. If pulling out hair is something that you do either consciously or automatically, talking to a trained mental health professional can help shed some light on the underlying anxieties, stressors, or thoughts that accompany the behavior. One thing that I will mention too that I think is a pretty exciting option right now for people who don’t feel comfortable going to see a therapist, is that there are online trained therapists who can video into your own home. In Georgia, this type of “tele-mental health” requires an additional certification above and beyond the standard licensure that is required of all professional mental health workers, so it can be a really good option if you find that you want to talk to someone, but don’t feel up for leaving the house. This email addy has a pretty good list of options (with prices) if that is something you are interested in.

In my own experience working with people who pull hair, cut, or burn, one thing that I have heard repeatedly is that, when they feel tumultuous inside, there is a sense of relief because they are able to both feel physical and see the effect of what they are doing. That tangibility is an important aspect of these behaviors for lots of people because it is a physical manifestation of their internal pain. One thing that some therapists have started to do that seems to help is to simulate the visual aspect of this by providing an alternative. For instance, if a person feels the need to cut to see the blood, providing something red and liquid (like a red paint marker or ketchup ((I know this part sounds weird)) can sometimes fulfill that need while allowing the patient’s skin to stay healthy. This isn’t a ‘fix’, but it can provide relief for people who are still working on the underlying issues. So for trichotillomania specifically, I wonder if buying a super cheap wig (probably don’t want to try this with the more expensive ones that you wear) and keeping it around to pull hair out of might relieve some stress while you work on getting the counseling and doctor visits set up.  

I may this was informative and helpful, Erin. Remember that changing behaviors (and thoughts) can take a little time, so try to be patient with yourself and/or others who are going through the process, and if this is something that you struggle with, there ARE people out there who care, want to help, and can make a difference. I’ll have to disagree with ol’ John Donne about this one—no person is an island. You AREN’T alone. And there is a help.

Until next time. Signing off,

Dr. Moon Kitty

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