I am 39 and have been dealing with this since around 14. I do not pull my hair out at the roots but break it off. I have sections of hair in my worse spots that are only inches long and appear almost bald. I have been wearing clip in extensions for about 3 years, the major benefit is I mostly damage that hair and not my own but I need a new set almost monthly. Here are the things I have tried over the past 20 plus years that have netted zero improvement:
-Keeping a Log
One thing that helps slightly in ANC or Acrylic nails as they lesson the sensation that gives me the satisfaction and makes it harder to break. That said they limit the damage slightly but don't stop the activity at all.
About a month ago my doctor and I decided that this may play into my ADD more than my OCD and I started taking Adderall. The Adderall is helping a great deal with other ADD symptoms but I believe its making my Trich worse. So now I am trying to decide whether or not discontinue it and have also just this week started a high CFU Probiotic and Amino acid as I have read that these have been proven to help some folks. I am at my wits end. The piles of hair on my desk in my office and in my car are humiliating not to mention the odd looks I get when in meetings. I actually almost lost a job due to this a few years back. I would love to hear from people who were able to get this under control and learn how they did so.