The Emotional Effects of Trichotillomania

May 12th, 2013

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The physical effects that can be caused by trichotillomania are relatively easy to detect. Over time, the negative physical attributes associated with hair pulling can present themselves in the following manifestations:

  • Unusual patches of baldness on the scalp
  • Sparse eyebrows or eyelashes
  • Irritated patches of skin where hair has been routinely pulled

As distressing as the physical aftermath of hair pulling can be, the negative trichotillomania emotions that come with the disorder can be far more devastating to a person’s overall well-being. While trichotillomania’s physical effects are visible and exposed, the emotional fallout is hidden and internalized, which in turn may make it significantly more difficult to cope with.

The Emotional Impact of Trichotillomania

The short-term and long-term emotional impact that is associated with trichotillomania can be far worse than the disorder’s physical manifestations because it affects so much more than just the way a person looks. However, it should be noted that the physical effects of hair pulling play a large role in developing some of the emotional issues that drive the disorder.

For example, a person suffering from trichotillomania can carry a great deal of anxiety. This negative impact could be derived from being overly nervous and stressed out over being seen with the unpleasant physical attributes that the condition may cause. They may also feel extremely nervous by what others may think or say about them – in particular by those that do not realize that pulling hair is a condition that falls under the umbrella of Obsessive Compulsive and Related Disorders. By extension, these feelings of anxiety can translate into a person deciding to isolate themselves from friends and family, and it may lead to them withdrawing from as many social situations as they possibly can.

Another significant negative emotion that can be devastating to the person suffering from the disorder is a strong sense of depression. This emotion could develop out of a feeling of helplessness and self-doubt, as the person may wonder why they continue to pull hair and why they cannot stop. They may also get depressed because they may fell utterly powerless to control the urge that causes them to pull the hair. And even though a person may be able to personally acknowledge that trichotillomania is a disorder, they may feel the need to blame themselves for putting themselves in the kind of situation the disorder fosters. Furthermore, this feeling of depression may develop as a by-product of the isolation and societal withdrawal that a victim of trichotillomania may build around them. This type of depression can be particularly impactful, as it may lead the person to try and cope with the situations through unfortunate means like alcohol or drugs.

A cluster of the negative emotions that a person may develop because of trichotillomania manifests themselves immediately after the act of hair pulling has completed. Feelings such as guilt, shame, and embarrassment may present themselves as a trichotillomania sufferer realizes what they have done and they start to focus on the negative physical ramifications that come with their act. These short-term feelings can also help feed long-term emotional scars such as depression and the desire for isolation.

Finally, trichotillomania can have a significant impact on a person’s self-esteem. A person suffering from hair pulling may simply not feel good enough about themselves to engage in social interaction of any kind, or that they are not worthy of other people’s time, lest they get judged solely on their own disorder. In a way, this lack of self-esteem serves as the groundwork for the anxiety, depression, and most of the other negative emotional feelings that a person suffering from trichotillomania may feel.

The Vicious Cycle of Trichotillomania

In a way, the origin of these negative trichotillomania emotions is the very thing that causes hair pulling to develop in a person in the first place. Studies have shown that the onset of the hair pulling disorder can be triggered as a response to feelings of depression, stress, or anxiety. In this case, trichotillomania develops as a coping mechanism to provide a temporary relief from these feelings. However, the act of pulling hair causes a cycle effect that can perpetuate both the negative feelings and the urge to alleviate them. If a person starts to feel anxious or depressed, the person may turn to hair pulling as a means to cope with the feelings. However, once the hair has been pulled, the person may feel guilt or remorse over the act. These feelings of guilt can eventually turn into feelings of depression and anxiety, which could fill the person with the urge to pull hair in order to stop the feelings all over again.

While there is obviously a need to try and break this cycle, it does come with a “chicken or egg” effect, in the sense that it can sometimes be difficult to pinpoint the cycle’s origin. In this scenario, it is not easy for a person to determine if the depression caused the hair pulling, or if the hair pulling caused the depression.

Recognizing the Emotions

While there are many different therapies that a person suffering from trichotillomania can utilize in order to combat the negative emotions that are related to the disorder, the first step that should be taken is the realization that the sufferer is not alone in their journey to treat the condition. This realization will serve as a critical first step into the person gaining the confidence that comes in knowing that they do not have to fight this battle alone, and this recovery of self-esteem could help eventually lessen the negative emotional impact that trichotillomania can bring.


TrichStop’s editorial team is comprised of mental health professionals who specialize in research and treatment of BFRBs (body focused repetitive behaviors) such as trichotillomania (hair pulling) disorder. You can learn more about our team here.

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