With her blonde hair tied back in a ponytail and dressed in a chic business suit that reeks of Chapel Street, Stephanie Carovella looks every bit the successful lawyer that she is. But as she takes her hair out of her ponytail, it’s obvious that things aren’t quite what they seem. Forget the blonde tumbling mane men often fantasize about. Instead Stephanie’s hair is thinner than most, strands are brittle, and bald patches that were covered up by the ponytail are now evident.
She doesn’t, however, have alopecia, the medical condition that causes sudden hair loss from shock, stress, or hormonal balances. Stephanie has something completely different, something that has caused her to pull out her own hair. She has Trichotillomania or TTM as it’s often called, and she’s not alone. Millions of people all over the world suffer from Trichotillomania, although it is mainly females that suffer from this condition.
Many may be asking right now, "Tricho what?" Deriving from the Greek word Trich (hair) tillein (to pull) and maniaor frenzy (morbid desire), Trichotillomania is a condition not unknown to doctors. Unfortunately it is one of very little understanding.
Its main characteristic is the compulsive urge to pull one’s hair out, with then an experience of released tension and relief after this is done. Sometimes people even express a degree of pleasure after having performed the act.
It tends to usually start at around five to eight years of age. Although it affects both males and females, by the teenage years and particularly among adults, more women appear to have this disorder, as boys tend to change their behaviour upon adolescence.
There is a ratio of five to ten women to every man. But these figures may be distorted due to the fact fewer men seek help, and natural balding can disguise hair-pulling in men.
Stephanie started pulling out her hair as a child, but it wasn’t until her teen years that her condition got worse. “I can recall twirling my mother’s hair when I was a baby, and then my own. I think I was about seven when I actually started to pull out my hair. At first it wasn’t a big deal, and I’d just sit there watching television and pulling,” she says.
“But then it became a habit, and when I got into my teen years it got worse. As the pressures of school and just being a teenager increased I’d lock myself in my room, and pull away. I started doing it while I was reading, then before I fell asleep at night. Almost as if it was a source of comfort.”
Although there are only one to two percent of the world’s population that are officially diagnosed with Trichotillomania, the stigma and shame associated with it suggests that an estimated two to three percent more suffer in silence. Widespread ignorance or misinformation about this disorder, even among professionals, often compounds this.
Article comments
1 - Anonymous
Thank you for this article. I have suffered with TTM since I was 3 years old, focused on my eyebrows and lashes, but I didn't know that it had a name, or that other people suffered this until I was 25. All of the shame and embarrassment you described are completely accurate.
2 - jmac76
there are definitely people out there and a few good websites, which are worth checking out. It was a personal article for me, as I also suffer from it so know the extent of how horrible it can be and the shame stigma.
3 - Leef Smith
Thank you for this excellent and informed article!
I would only add a note about all the amazing work that the Trichotillomania Learning Center does in helping to promote awareness around trich, advocate for research, and work toward ending the suffers of millions of people with trichotillomania
4 - Sarah
excellent article!
i'd just like to point out that SSRIs are NOT addictive(see Dr. Da Costa's comment).
however, you are correct in stating that they've been shown to have minimal effectiveness with hair-pulling behavior. SSRIs HAVE been shown to help a LOT with depression and anxiety.
right now, the best treatment that we know about for TTM is Cognitive Behavioral Therapy.
5 - iamrj
Good article. I enjoy reading it. I just wrote an article about alopecia (hair loss) and, while researching it, I ran across a comprehensive survey of Trichotillomania research. The information was compiled by Manjit Kaur Ubhi, who uses hypnotherapy, neuro-linguistic programming and cognitive behavioral techniques in her work with hair pullers. Her very informative survey is available online. Anyone wanting to delve deeply into sociopsychological aspects hair pulling should check out Manjit Kaur Ubhi's work.
6 - Tonia
I have just realized I have TTM, I can remember pulling out hair one strand at a time when I was a teen and even younger. But it has just reared it's ugly head just before my daughters wedding. Mine is a little different. I pull out my husbands facial hair. Has anyone else heard of this?
7 - kml
wow-i have had ttm since age 10..i am now almost 20 years old and i haven't been able to stop. it is true that medications don't really have the affect said intended..i have tried various medications with no luck. the embarassment and harassment of society makes having this illness even more unbareable. i have never personally met anyone with the same thoughts as mine...towards trich..i wish i could know why i started doing this..what triggered it..ttm has seriusly mad a HUGE IMPACT ON MY entire life...i can not picture my life without it.. it has sketched me out to be this person i am.. and i am fully ashamed of it. i would do anything to be able to stop..anything
8 - cc
i am 24 years old and have been pulling out my eye lashes since i was 12. recently i moved back to my home town a couple years ago back in with my divorced parents and i started pulling severely more and started using more drugs and drinking more. i guess i have family issues. i got treatment for my alcohol and drug problem and have been clean for 6 mnths now. i still have this trichotillomania problem tho i have to learn to deal with. i dont know how but i refuse to take ssris's. i generally pull n play with my eye lashes while driving in the car, watching tv or on the computer reading something. it's hard. i guess it's anxiety