I've Lived With Trichotillomania For A Decade & Here's What I Want You To Know
I am exceptionally good at applying false eyelashes. It’s a talent I share with my friends who danced competitively, or competed in pageants, or simply subscribe to the Geordie lass approach to makeup. But they practised in dressing rooms or at pre-drinks, magnifying mirrors in one hand and a vodka cranberry in the other. My talent is a lonelier one. I rehearsed alone, applying and reapplying and adjusting and repositioning until the lashes concealed the bare pink strip where I’d pulled out my eyelashes. I’ve pulled for over a decade now. I want you to know what living with trichotillomania is like.
Trichotillomania is an impulse control disorder, defined by the urge to pull out your own hair. According to OCD-UK, its classification has been contested — “it may seem, at times, to resemble a habit, an addiction, a tic disorder or an obsessive–compulsive disorder,” the charity explains. A spokesperson for AnxietyUK told me, "People with trichotillomania are likely to also have anxiety, stress, depression, and other OCD-like behaviours such as compulsive skin picking." Conveniently, I've accrued all of those diagnoses, as well as OCD. My makeup bag boasts an assortment of colour-correctors and concealers, used to disguise the evidence after I've turned a tiny blocked pore into a bleeding crater; in my bathroom, there's a small arsenal of acid peels, retinoids, and essential oils, each purchased in the hope that they'll erase my picking scars.
I’ve been pulling out my hair — typically my eyelashes and eyebrows — since I was 14; at 25, I can barely remember what life was like before.
"Trichotillomania seems to be more prevalent in children and young adults, and may be down to a change in hormone levels during puberty," the AnxietyUK spokesperson said, continuing, "Women are more likely to be treated for trichotillomania, but this may be due to the reluctance of men at seeking treatment." I’ve been pulling out my hair — typically my eyelashes and eyebrows — since I was 14; at 25, I can barely remember what life was like before.
I hesitate to discuss my trichotillomania. It's easier to talk about the OCD I was diagnosed with at the same time, though the latter has proved a far more definitive aspect of my life. It’s difficult to explain, or to understand myself, why I’m compelled to repeat such a nakedly destructive action. My friends and family flinch when they see the lash spring out of the follicle, or frown as they attempt to determine, after a particularly brutal spate of pulling, what looks weird about my face. I believe, resolutely, in the deconstruction of the stigma attached to mental illness. But it’s difficult, when faced so bluntly with other people’s discomfort, to apply that to myself.
I began picking as an unhappy teenager, miserably convinced of my own worthlessness. I picked absentmindedly in class, but deliberately at home, ripping my lashes and brows out with a fury that made my eyes water. I didn't know how better to cope with the self-loathing that threatened to overcome me other than to wear it, plainly, across my face. It looked wrong, ugly, when I looked back in the mirror — and it matched, I thought. It fitted all the wrongness and ugliness inside.
It’s hard to admit — to others, or to myself — that I still experience feelings of self-loathing as an adult sometimes, so completely and so viciously that I’m afraid to go outside. I am vain, and shallow, I tell myself in the mirror. I am a bad feminist. And then I pull out an eyelash, and roll it in my fingers, and I don’t go out the house.
Of course it's untrue, I've been told by friends and family and psychologists alike. My rational brain believes it too. I'm not self-obsessed, not shallow, not a disappointment to the feminist movement. But anxiety disorders don't deal much in rationality. Anxiety disorders convince you of anything but the truth.
Mental health professionals haven’t always taken my condition seriously. As a teenager, first receiving counselling for OCD, I pointed out my naked eyelids to my clinical psychologist and asked if I could have trichotillomania. She devoted less than five minutes to the topic, told me not to diagnose myself, and left me wincing in teenage shame. Seven years later — after a period of suicidal crisis — I watched my counsellor write, on a faded yellow pad, that I looked healthy, in part because I was wearing make-up. She didn’t notice that my eyeliner was tailored to the gaps in my lashline; that my foundation was concealing dark red scabs where I’d clawed relentlessly at my face.
Last week, I proudly directed my mam's attention to my full set of lashes; today, I'm nursing several sparse patches, plus an eye infection brought on by the pulling.
But treatment is available, and I've benefited from it, at times — though too often, I've languished on NHS waiting lists, bumped down to the bottom when I moved to and from university. The AnxietyUK spokesperson explained the treatment options thus: "Cognitive Behavioural Therapy is recommended for those with trichotillomania, especially a form of CBT called Habit Reversal Training, and has been used in treating stammering, nail biting and skin picking."
They added, "Items such as stress-balls, tangle toys and fidget cubes can be effective tools for reducing the frequency of hair pulling by redirecting the compulsive behaviour into something less destructive. Some find keeping a record or diary of their hair pulling helps them identify when the impulses are at their strongest." There's no universal trichotillomania experience, of course. Your GP should be committed to figuring out what's best for you.
I keep a hair tie around my wrist at all times, a habit picked up from a forum when my first psychologist dismissed my concern. On bad days, I snap it against my wrist, hoping the pain will overpower the desire to pull. On better days, it's just a hair tie around my wrist. It's a relief, sometimes, just to blend in.
My trichotillomania is manageable now, though I'm cautious about becoming complacent. Last week, I proudly directed my mam's attention to my full set of lashes; today, I'm nursing several sparse patches, plus an eye infection brought on by the pulling. The damage only took a single stressful day.
But I remember, still, the secondary school History class, when I filled a gap in my lashes with eyeliner in the back of the classroom and prayed no teacher would notice it. The time I plucked out every last lash with tweezers, and refused to leave my flat in daylight until they began to grow back. And the first date I wore a cat-eye to, and hesitated before we kissed, for fear my make-up would smear away. I've recovered before, I reassure myself. And this time, I'll recover again.