Trichotillomania and Me: My Struggle over the Past 12 Years, and How Wigs have Helped

One morning in high school, I woke up, and all my eyelashes were gone from my left eyelid. This didn’t happen by magic. It wasn’t as if one second I had a full set of glorious lashes, and the next second they disappeared. If you looked closely at the floor or the couch cushion next to me, you would see stray eyelashes here or there, the hair-pulling remnants from the night before. This is how trichotillomania started for me.

Trichotillomania is an obsessive-compulsive hair-pulling disorder involving recurrent and irresistible urges to pull hairs out of eyelids, eyebrows, scalps, and other areas. Trich is part of a classification of body-focused repetitive behaviors (BFRBs), a term used to describe self-grooming behaviors that result in bodily damage. One study suggests that 13% of adults in the U.S. engage in at least one BFBR, including dermatillomania or skin picking. Per their research, an estimated 1 to 2% of the population has trichotillomania, and about 1.4% has a skin picking disorder. For most sufferers, it starts in adolescence.

It started for me around the time my parents almost got a divorce. I was in middle school. Maybe that’s when my latent genetic predisposition for anxiety first surfaced. I would hear them fighting through the door and internalized it as being my fault. I wasn’t a part of their conversation, couldn’t make out any of their muffled words through my bedroom door, and was still young enough to believe everything that happened around me was about me. So, I obviously assumed they were fighting about me, not any myriad of other things that humans and flawed adults could be fighting about. As an adult, I know better now.

Maybe it persisted because of the relationships I had throughout middle and high school with boys who didn’t have the emotional capacity to deal with the sheer amount of emotional range I suffered from at this young age.

The complete despair that emerges when you’re a high schooler who finished watching The Notebook for the umpteenth time fostered my anxiety. In her heart of hearts, this girl believed the boy who had just broken up with her was the last and only chance she had at being one of those married couples who were high school sweethearts. How were you supposed to properly support your wife with dementia if you hadn’t been high school sweethearts who kept a diary tracking your love from your first kiss to your final tombstone? That is what I believed. As an adult, I know better now.

After one of my episodes, I remember creeping into my parent’s bedroom one night after googling what was wrong with me. The term popped up immediately in the search engine.

“I think I have trichotillomania,” I whispered quietly to my mother as she lay in bed, trying to sleep. I wasn’t sure I believed it myself,  but I had an eyelid devoid of any eyelashes as proof, which was enough for me. The evidence is always there on your face for anyone who takes the time to really look.

I don’t remember what my mother said, but she didn’t seem too concerned. This is not because she wasn’t a loving mother, but probably because she was half asleep and thought I needed some rest.

It was only a few eyelashes after all. It wasn’t like I was eating my own hair; I was just leaving trails around the house, like bread-crumbs waiting to lead back to me, whenever someone decided to take the time to make that journey.

There is a photo of you standing next to your high school on-again, off-again boyfriend at a friend’s 16th birthday party. Your hair is pulled back in a ponytail, a headband flattening your hair to reveal a patchwork bald spot where your bangs should have been.

Proof of our high school photoshoots, a photograph from an album called ‘America’s Next Top Model Much?’ in which I am wearing a bump-it.

Anxiety can manifest itself in so many ways. I think it manifested as trichotillomania in high school because that is the time when young girls are becoming unhealthily preoccupied with the way they look. When you first learn to shave your legs, curl your eyelashes, and mold your young face into the maturity of a warped mannequin head of a woman by applying all the colorful makeup you can get your hands on. This was when I learned how to pluck, and how not to pluck, my eyebrows. No one ever told me that my eyebrows were perfect just the way they were.

Ninth grade was also when I first started dying my hair with my friends at home in our bathrooms, and doing hack-job haircuts on our bangs and Bratz dolls. Anything we could change, color, or alter about our bodies in the bathroom was fair game.

During high school was also when Myspace became popular. My friends and I would have photoshoots by the pond in my backyard as portrait assignments for our art classes. I was a young, budding graphic designer just learning how to push the button in Photoshop, so I would take our fashion shoot and alter the photos in any way I could: changing the tint, removing blemishes, bringing up the brightness to white-out the freckles or pimples on my skin. We posted our pictures on social media and watched the likes pour in.

Trich wasn’t the only way my anxiety let loose. I also experimented with cutting, using sharp rocks to slice the area of skin hidden by my underwear line to cover the scars. The pain was always connected to boys and belonging. Is there anyone who truly wishes to revisit their high school years? Luckily, that was one habit that didn’t stick for me.

Flash forward to graduate school, where I almost didn’t hit the apply button because I was so afraid of the public speaking aspect of a final thesis defense presentation. Luckily, I forced through that fear and was accepted into the MFA Design for Sustainability program at the Savannah College of Art and Design (SCAD). I relocated from Buffalo, NY to Savannah, GA, with my soon-to-be-husband. We didn’t know anybody when we moved. Soon I came to know a wonderful group of designers who were passionate about the same things I was. This period would come to be the most fulfilling and anxiety-inducing days of my life. 

One specific class in grad school was the most triggering for my anxiety and trich outside of my thesis preparation. SCAD has these classes called Collaborative Learning Center classes (CLCs). Students across disciplines apply to be selected to work with an outside client on a specific project. SCAD quarters are the shortest I’ve ever experienced, cramming an immense workload into a three month course, and working with a paying client only intensifies the experience. They’re paying the college, of course, not the students.

For this class, there were nights we stayed up working in our building until 3 a.m. One night, I sat at a table in a room by myself, trying to finish my part of the project while my classmates spread out across the building to do the same.

At one point, I zoned out, staring into a corner as my vision blurred, and my thoughts took over. I thought about everything I still had to accomplish for this project, not to mention the other two other classes I was taking, plus my marketing job for a magazine, plus the required internship, plus working on my thesis project to finish my two-year-long graduate degree on time. It was already 3 a.m., which meant I probably wouldn’t get home until 4. I had class at 11 a.m., so a full eight hours of sleep was out of the question, considering I had a presentation coming up for my thesis project in a few days and needed to do some work on that. Speaking of my thesis, what was that thing even about? What was my argument? Did I have enough interviews scheduled? I needed more secondary research. Maybe I should go to the library tomorrow after class, or just order books off Amazon. When was the last time I ate something? I think they have some candy in the CLC cabinet. Maybe I should go check.

When I came out of my reverie, I looked down at the desk. The entire tabletop around me was covered with hair I had pulled out of my head without noticing. I picked one up, half-sleeping at this point, and stared into the hair follicle sticking out of the other end that had just been inside my scalp.

I jumped out of my seat, brushing the hair off the table and onto the carpet before my classmates came back into the room. But what was the point in that? The evidence was right there on my head in the form of a new bald spot.

For a while, I tried using bobby-pins to mold my remaining hair around the bald spots so no one would notice the damage I inflicted on my body. I would use brown eyeshadow that matched my hair to cover in my bald spots. It might have helped convince others, but it didn’t help at all with my self-esteem. We would always be taking group pictures for process books and class projects, and I hated every one of them. I wanted to burn all those photos. Or at least, in the digital age, delete the files so they wouldn’t make it into our final project.

It seemed that none of my classmates noticed what was going on. Or if they did, they didn’t say anything out of respect. We all have our vices in graduate school — best not to mention them.

Sometimes I could learn to control the spots on my head that I would pull from. In pictures I posted on social media, I could control the angle of the camera. No one could see the large bald spot forming on the back of my head.

I would get messages on Instagram from people I went to high school with, saying, “It looks like you’re really enjoying Savannah, what a beautiful place!” I couldn’t possibly explain to them that the Spanish moss and Like Oak trees had no effect on my mental health.

I got up in the morning, went to the bathroom, and used our vanity mirrors to inspect the damage done the night before while I was up late working, studying, or practicing presentations. More bald spots, or more prominent bald spots, always awaited. Eventually, I gave up on bobby pins and started wearing hats instead, even though I never believed myself to have the head shape to be a hat person.

I guess I was a hat person now.

Figuring out how beanies work. Yes, there is a bald spot under there. Isn’t it amazing how social media works? I can convince you that my life is perfect.

During my final semester of graduate school, I had to shave my head.

The weeks leading up to my final thesis defense were the most anxiety-inducing things school offered me so far. The great thing about anxiety is how it manifests to become an additional source of stress. Each new or worsening bald spot was a detriment to my focus on school, and I couldn’t stop pulling. Since I had decided to ditch bobby pins for hats, I’d been wearing a yellow beanie to class for months now. But my final thesis defense was coming up in a few weeks, and it wasn’t professional to wear a hat to a final presentation.

I decided to take a trip to Supercuts to see if there was anything they could do to give me a haircut that would mask the damage I had already done. Getting a haircut in high school or college always used to be a fun experience in reinventing myself. Now it was torture. My anxiety trapped me in my house up to the last minute, not wanting to sit in that chair, watching the hairdresser inspect my hair and figure out how to salvage it. Hairdressers are trained to craft masterpieces out of ordinary people’s boring hair — not perform miracles. I would not be that client where they would post before-and-after pictures on their Instagram.

My beautiful haircut that was ruined, in short order, by trich — that relentless b****.

When I finally worked up the courage to get a haircut, the hairdresser did a fantastic job! When I got home, I had my own photoshoot and posted it to Instagram, finally feeling good about myself for the first time in months. But by the next week, I had already ruined it. It was back to the drawing board again.

What was I supposed to do now? There was only one option left, with my thesis defense just around the corner: I had to shave my head.

I texted my friend Gab and told her I had decided to shave my hair off, and would she please come over and use the clippers so I wouldn’t give myself a hack-job?

She dutifully showed up and shaved my head on my apartment’s balcony, my hair flying between the railing and down into the street below. With every buzz of the clippers, I felt a weight lifted off of me. I might finally fit in at this art school with a shaved head as some hipster girl breaking conformity with the status quo.

As long as they didn’t notice the topography of bald spots across my scalp, that theory might hold up.

After graduate school, arguably the unhealthiest period of my life, I started going through a severe self-help craze. I started eating better, walking to work to get my steps in, and doing yoga at home by watching YouTube videos. Eventually, I started going to yoga classes at a local studio to get my anxiety under control. A few months after going, one of the students came up to me and asked if I had alopecia. My head was still shaved at this point, and bald spots were visible. Not having any idea what alopecia was, I said:

“No, I just have a lot of anxiety and can’t be trusted with hair right now.”

If I didn’t know what alopecia was, she certainly wouldn’t know what trichotillomania was. I went home and googled alopecia, feeling instantly guilty that other people suffered from bald spots without pulling their own hair out.

If I had told her straight up that I did this to myself, would she have empathy for me? Did I have any empathy towards myself?

Almost twelve years since I started pulling, the amount of hair I’ve removed from my eyelids, eyebrows, and scalp could wrap twice around the earth or be used to crochet many thousands of blankets for children in need. To this day, I still struggle with hair pulling. As I’ve written this article, a pile of hair has slowly grown on the floor around my chair.

The most significant change came for me the month before my wedding on March 8th, 2020.

It was the last weekend before my world shut down for the pandemic. My hair had been growing out, but with the stress of the wedding coming up (an event that we put together in two months), a new roommate coming to live with us in two weeks, and the fact that all our friends and family would be in town momentarily — you guessed it! I was pulling my hair out again.

I had already spent the past two years of my life with little to no hair, sometimes feeling like a badass with a shaved head and other times feeling like an unattractive little boy. You should feel like a goddess on your wedding day, and my self-esteem was slim to none at the time being. We were about to drop a lot of money on a wedding photographer — and goddamnit! — I wanted to look good in my wedding photos.

One afternoon, I was on YouTube and came across a vlog from a girl my age who was suffering from trichotillomania too. She was wearing a wig. This was something I had never considered. I went over to Amazon and started searching for wigs, looking at all the users’ photos that had left comments in the reviews.

A wig? If I wasn’t a hat person, could I be a wig person?

The first photoshoot with my brand new wig.

I was so excited at the prospect of looking like a ‘real’ woman again that I ordered a bunch. As they started arriving in the mail, I opened each one like a gift, trying them on in the mirror, cutting the bangs to fit my forehead, and having photoshoots with myself again.

I felt like a goddess on my wedding day, wearing a foraged floral crown above my head of curly red hair that I didn’t even have to curl because it came packaged that way. I have even more wigs now that I understand what looks best on me, and I feel better about myself than I have in years.

The wig I wore at our wedding.

I still struggle with trichotillomania. Some days when work is especially stressful, on nights when I stay up too late watching TV, or when the relationships in my life aren’t optimal, I will look down at the floor to a pile of wig hair, and I still feel ashamed.

In some ways, the wigs are a Band-Aid to my problem. I have always been self-reflective, and I am continually interviewing myself to uncover the causes of my anxiety and talk myself through ways of combating them. I know the roots of my anxiety, but I don’t know what the solutions are yet. I’m not sure the scientific or psychiatric community does either.

In the meantime, I at least want to feel good about the person looking back at me in the mirror every morning, and that is as much internal as it is external. I want to feel sexy, to feel powerful, and like I can tackle whatever the world throws at me. If I wake up in the morning, shower, and put a wig on, I immediately feel great about myself without having to put makeup on. Before, when I was bald, I would over-compensate with eyeliner and smokey eye shadow to convince myself and others that I was ‘womanly enough.’

In some ways, the wigs are superficial, but mostly they are not. They significantly impact my feelings of self-worth on a day-to-day basis, and I can feel it compounding over time, like interest on my own stock. Since quarantine, I’ve been trapped in my house like the rest of you. But I’ve still been getting dressed in clothes that make me feel good and putting on whatever wig suits me that day.

The wigs are for me – no one else. And in that way, I have already solved my problems.

My newest wig makes me feel ready to take on the world!

One day, after grad school, I went to an art exhibit with a friend I had met doing litter cleanups in Savannah. I don’t remember how the conversation came up, but I expressed to her that I struggled with trichotillomania, which is why I always wore a hat.

She looked over at me with bug-eyes and said, “I struggle with that too.”

It was the first time in 12 years that I had met someone who expressed having the same struggles as I did. To top it off, she was someone I knew, loved, and admired. Telling me that she went through similar struggles helped me to not feel so alone.

That moment is probably what set me on this journey to writing about this today, so I just want to say: for anyone out there who is struggling, you are not alone either. And we are all just trying to figure it out, as best we can.