What life is like struggling with this little-known mental health disorder.

By Christina Oehler
April 19, 2019

While many women spend hours trying to make their hair as thick and long as possible, Megan Prosser, a 19-year-old from Long Island, New York, does just the opposite.

She spends nearly three hours a day pulling out her hair due to a mental health condition called trichotillomania, which triggers an irresistible urge to pull hair out of the scalp, eyelashes, or other areas of the body.

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Prosser’s compulsive hair-pulling began when she was eight years old, she tells Health. She began pulling out her eyelashes as well as clumps of hair from her head.

"First I was diagnosed with Tourette [syndrome] because the doctors couldn’t pinpoint exactly what was wrong with me. Eventually that same year they diagnosed me with trichotillomania," Prosser recalls. 

More than a decade later, Prosser still suffers from the condition. She says that when she experiences a “pulling attack” she pulls out so much hair, it'll leave her bald over most of her head. 

"This condition effects me all throughout the day," she says. "I am constantly fighting the urges. Sometimes I can fight through them, other times I fail. It has become such a habit I sometimes don’t even realize when I’m doing it."

"I’ve avoided lots of social situations because some days I would just want to curl up and hide," Prosser continues. "It’s humiliating when the people you care about see the damage caused by your own hands. Throughout the years it has been easier to accept myself and be proud of who I am, but at the end of the day I would be lying if I said it doesn’t effect my daily life."

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Prosser has used social media to speak out about her condition and explain trichotillomania. In an Instagram post from February, she shared two shots of herself taken five minutes apart. The first shows her with a buzz cut. The second shows the detrimental effect the mental illness has on her hair. 

“The reality behind shaving my head with trichotillomania. First photo was taken 5 min before the second,” she wrote. “These past 3 years i slowly lost more and more control of my hands, and I can’t even begin to tell you how terrible this feels. I do not have control over my own hands. As the pulling got worse, so did my mental state. It’s really hard not to hate yourself when you are destroying yourself.”

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Keeping her hair in a buzz cut actually helps her manage the condition, as she explained in her post. “I shaved my head and I can’t even describe to you how good it feels,” Prosser wrote. “For the first time in a long time I feel hopeful, something I lost when I was 8 years old and pulled out my first eyelash. I finally feel hopeful again.”

“This has not cured my trichotillomania nor do I think it will ‘cure’ it in the future,” she continued. “This is something I will have to battle everyday just like I’ve been battling for the past 11 years. But with that being said, I truly believe that shaving my head was just one step closer in the right direction.”

Trichotillomania is a little-known condition that's hard to understand. While it can be mild and manageable for some, it can be overwhelming and thought-consuming for others, bordering on an obsession. 

"Trichotillomania body focused repetitive behavior (BFRB) is related to OCD," Talia Wiesel, PhD, assistant professor of psychiatry OCD and related disorders program at Icahn School of Medicine at Mount Sinai, tells Health. OCD is obsessive-compulsive disorder, which causes people to experience compulsive recurring thoughts and behaviors. "The cause is unclear; it’s likely a combination of genetics and environment."

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Wiesel says certain risk factors make people more likely to develop the condition. A family history of trichotillomania and other mental health disorders such as depression, anxiety, or OCD might increase a person's odds. Trichotillomania usually strikes during the early teen years (between ages 10 and 13) and can be triggered by severe stress, she adds.

Pulling hair out isn’t the only symptom. Other signs of the disease can include feeling a sense of satisfaction after a hair-pulling episode, chewing the pulled hair, and distress in social situations due to the loss of hair. Limited treatment is available for those who suffer from trichotillomania, including cognitive behavior therapy (CBT), which can help break the habit.

"This behavior therapy is the primary treatment for trichotillomania," says Wiesel. You learn how to recognize situations where you're likely to pull your hair and modify the environment to make pulling more difficult and make you more mindful of pulling, and [you learn] how to substitute other behaviors instead. For example, you might clench your fists to help stop the urge or wear certain clothes that make pulling more difficult."

Prosser says that she hopes that by going public with her story, she's increasing awareness about trichotillomania and helping others with the condition. 

"I know it is hard for people who don’t struggle with trichotillomania to understand this disorder," Prosser says. "It is definitely different, but so so much more common than so many people think. People with this disorder are all over but they hide because they are scared. I just want anyone who reads this who is struggling to not be afraid anymore. Life is so much brighter once you get yourself out there!"

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