Hair pulling and bulimia

Originally Published: November 1, 1994 - Last Updated / Reviewed On: July 1, 2010
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Alice,

Ever since I was in junior high, I have been pulling out my hair. I can remember not being able to pull my hair into a ponytail because the hair at the nape of my neck wouldn't reach. I still have this awful and shameful habit. I don't see it so much as just a habit, like the way one might bite one's nails, it's more like an obsession. I'll just sit and stare into space and pull clumps of hair out of my head. I remember having seen a program on T.V. which dealt with this habit as a medical problem that is curable with medication. Unlike the men and women represented on this program, I am not stripping myself bald — yet. I tend to consider it a form of self-punishment, perhaps. Just to give you some background information, I have a tendency towards bulimia (cycles of bulimia occur when my depression is at its worst) and am in general not a happy camper. What can you tell me about this?

Signed,

Me

Dear Me,

The classification that you are asking about sounds like it could be trichotillomania. Trichotillomania is a condition characterized by a failure to resist impulses to pull out one's hair, and was first described more than a century ago. People with trichotillomania describe experiencing either mounting tension before pulling out their hair or gratification or relief after pulling out their hair. It is a chronic condition, primarily affecting young females, with onset usually occurring in early childhood or adolescence. Approximately one to two percent of college students have past or current experience with trichotillomania. It's not clear if more men or women in college have trichotillomania, but more women seek treatment for it. This could be because more women are affected, or it could be because women are more likely to seek treatment than men.

You are certainly not the only person to have these experiences. As well, trichotillomania commonly coexists with other illnesses, such as eating disorders and other psychiatric conditions. People with trichotillomania often have a greater lifetime prevalence of anxiety and affective and addictive disorders than the general population. The behavior, associated with low self-esteem, high anxiety, and poor body image, is an impulse disorder not elsewhere classified. Treatment standards have not been established, but behavioral therapy is often recommended, as well as hypnosis, and various forms of medication, including antidepressants.

Nuances necessary to classifying a psychiatric problem cannot be accurately noted over the Internet. This information will better inform you, but a health care provider is recommended for diagnosis of trichotillomania. If you are at Columbia, you can make an appointment with a therapist at Counseling and Psychological Services by calling x4-2878. Be honest and open with him/her about your hair pulling, periods of bulimia, and depression, even if you feel embarrassed or ashamed. These could be linked, and providers will more thoroughly understand your situation to provide the most appropriate treatment. You may find that you'll feel better from professional assistance with some work on your part.

Alice

January 8, 2007

21176
Dear Me,

I'm a hair puller too. Just try to sit on your hands when you're watching TV or just sitting. This will send a message to your brain that you're fighting back. I did that for a while and...

Dear Me,

I'm a hair puller too. Just try to sit on your hands when you're watching TV or just sitting. This will send a message to your brain that you're fighting back. I did that for a while and it slowed down. A lot. I'm now just occasionally pulling here and there, but I can't wait 'til it stops. Also, try wearing a bandana so when you go to grab, and you don't know it, you'll hit the fabric instead of the hair. I wear it every time I get home from school and it works!!!

May 7, 2004

20600
Dear Alice, RE: HAIRPULLING AND BULIMIA: THANKS, ALICE, FOR PUTTING IT OUT THERE TO THE PUBLIC RE: TRICHOTILLOMANIA. I AM FORTY-YEARS-OLD AND HAVE PULLED MY HAIR OUT SINCE AGE 11. I HAVE READ/...
Dear Alice, RE: HAIRPULLING AND BULIMIA: THANKS, ALICE, FOR PUTTING IT OUT THERE TO THE PUBLIC RE: TRICHOTILLOMANIA. I AM FORTY-YEARS-OLD AND HAVE PULLED MY HAIR OUT SINCE AGE 11. I HAVE READ/HEARD IT CALLED EVERYTHING FROM AN "OBSESSIVE-COMPULSIVE DISORDER" TO "BORDERLINE-PSYCHOTIC." BEING A PROFESSIONAL HAIRPULLER MYSELF, HERE'S MY VIEW ON IT: IT IS NOTHING BUT A STRESS-BUSTER. METAPHORICALLY, I'VE READ HAIR-PULLING IS A SYMBOLISM OF "NOT FEELING SAFE OR LOVED." AND YES: WHEN I FEEL SAFE, WHEN I FEEL LOVED: I DON'T PULL. WHEN I AM IN CRISES (IN COLLEGE, BEFORE FINALS; IN LIFE: BEFORE A BIG JOB INTERVIEW, HOT DATE, BOYFRIEND BREAKUP, END OF A RELATIONSHIP, ETC.) — I PULL LIKE CRAZY AND END UP LOOKING LIKE A MONK... THE "FRIAR TUCK LOOK." WHEN I AM IN THAT HAIR-PULLING FRENZY, I DO NOT THINK ABOUT ANYTHING ELSE... THE ENDORPHINS RELEASED FROM THE PULLING OF EACH INDIVIDUAL HAIR IS EUPHORIC AND PROBABLY, MY GUESS, MUCH RESEMBLES A HEROIN HIGH. WHEN I AM IN THAT FRENZY, THAT SELF-INDUCED EUPHORIA: I DO NOT CARE... ABOUT ANYTHING... JUST THE INCREDIBLE SENSATION OF THE HIGH. THAT IS WHY, I BELIEVE, HAIR-PULLING IS SO HARD TO STOP. I HAVE TRIED THE ANTI-DEPRESSANTS, THE COGNITIVE THERAPY, THE BEHAVIORAL MODIFICATION TECHNIQUES... AND HAVE EVEN AT POINTS IN MY LIFE HAD A FULL HEAD OF HAIR... THEN SOMETHING CHAOTIC HAPPENS, LIKE I LOSE MY JOB, MY BOYFRIEND TO ANOTHER WOMAN, GET EVICTED FROM MY APARTMENT AND RUN OUT OF MONEY, SO AM FORCED TO STOP SMOKING — COLD TURKEY — I WENT FROM A FULL HEAD OF HAIR TO LOOKING LIKE A FREAKY MONK OVERNITE. OVERNITE! IF I DIDN'T HAVE HAIR-PULLING TO ALLEVIATE ALL THAT EMOTIONAL PAIN, I PROBABLY WOULD HAVE KILLED MYSELF! OUR BODIES AND OUR MINDS ARE HIGHLY PROGRAMMED COMPUTERS ALWAYS OUT TO PROTECT US... HAIR-PULLING USUALLY STARTS FOR A REASON... AN ALLEVIATION OF SEVERE STRESS... AND BECOMES ADDICTIVE, JUST LIKE HEROIN OR NICOTINE. IT IS OUR MINDS' WAY OF SEEING US THRU A ROUGH TIME. I AM LEARNING TO ACCEPT MYSELF, REGARDLESS OF SOCIETIES' SO-CALLED 'NORMS.' THANKS, ALICE, FOR CREATING PUBLIC AWARENESS AND EMPATHY ON THIS HUMILIATING NERVOUS DISORDER. SIGN ME, BALD BROAD IN ILLINOIS

May 7, 2004

20601
Dear Alice, This is in addition to the hair-pulling question. I, too, have been a hair puller all my life. I started when I was eleven. It was incredibly stressful in my life. I would search my head...
Dear Alice, This is in addition to the hair-pulling question. I, too, have been a hair puller all my life. I started when I was eleven. It was incredibly stressful in my life. I would search my head for a suitable, coarse hair, pull it out, rub it on my face or arms, and sometimes put it in my mouth. I wouldn't even realize I was doing it. I would just zone out. My mother noticed me doing it one day and noticed I had a bald spot on the top of my head. She, in turn, whacked me in the head and said I was crazy. So I became more discreet. I began pulling out my pubic hair. I am also a picker, picking at any blemish or bump on my body and again zoning out while doing it. I was in a bookstore recently and saw a book called, Help for Hair Pullers. It was so good to see that I'm not the only person that does this. It can be so embarrassing. Just thought I would share my story with other hair pullers so they, too, know that they are not alone.

February 8, 2002

20400
Dear Alice, It's about time I read about someone who suffers from the same problem as I. I have been pulling out my hair since I was a child (now in my 20s). I did not realize about my problem until...
Dear Alice, It's about time I read about someone who suffers from the same problem as I. I have been pulling out my hair since I was a child (now in my 20s). I did not realize about my problem until I got older. It has gotten so bad at times, I would wear a hat to hide all of the bald spots. I am now seeing someone who helps me control these urges. This makes me feel better knowing that I am not alone, and hope that this will help in my recovery along with yours. Thank you :)