I Finally Had My Trichotillomania Under Control Before The PandemicBut Now I'm Struggling in Quarantine

Curated by Claudia Shannon / Research Scientist / ishonest

While working from home recently, I remembered a Zoom conference call at the last minute. I knew I'd have to turn my camera on, so I grabbed a wig—the first one I could reach from my bed: a natural-looking one, short and dark-brown. I lazily pulled on a stocking cap, then the hair, not bothering to arrange it because I was sure no one would be paying much attention.

Not long after the call began, one of my coworkers remarked: “Kimi, did you cut your hair?”

Shit. I forgot the wig I usually wore to the office was a completely different color and went down to my waist. “Uh, I actually got it cut a few weeks ago," I said.

“Fair enough; I haven’t seen you in person for an entire month, after all," the coworker responded.

I hadn’t yet mustered up the courage to tell my coworkers I have trichotillomania, a psychological disorder similar to OCD that causes me to compulsively pull out my own hair. Trichotillomania─sometimes abbreviated to ‘trich’ by people who have it─is defined by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) as recurrent hair-pulling despite repeated attempts to stop, resulting in noticeable hair loss, as well as subjective distress or impairment in daily life.

I’ve had trich since I was a preteen, have tried both therapy and medication for it, and have come to accept it as part of my identity over the years. But boy, am I having a tough time in quarantine.

Before the pandemic—and after fourteen years of pulling my hair—I had finally come up with a game plan to get my trichotillomania under control, and it was working.

See, with trich, hair-pulling turns into a mindless behavior. While social distancing and working from home, I'd spend hours every day on conference calls, my fingers mindlessly trying to get rid of split ends or anything that felt "off" (think: a hair that's thicker or coarser than the rest). At, the end of the day, I'd find myself cleaning tumbleweeds of hair off of my bedroom floor. There was not a fifteen-minute interval in a day when I wasn’t pulling.

I looked in the mirror one morning a few days into quarantine and noticed one of the bald spots I’ve had for years now stretched across the entire crown of my head. I was gutted and deeply disappointed in myself.

I'm not alone right now—the pandemic may be worsening hair-pulling and skin- picking disorders for many others.

In a recent webinar hosted by the International OCD Foundation, Fred Penzel, PhD, a psychologist who serves on the scientific advisory board for the IOCDF and the TLC Foundation for Body-Focused Repetitive Behaviors, attributed upswings in hair-pulling and skin-picking during the pandemic mainly to extreme fluctuations in sensory or emotional stimulation.

Anecdotally-speaking, two of my friends who also have trich—Rebecca and Jude (who requested not to use their last names for privacy)—have found the self- isolation that comes with social distancing particularly difficult when it comes to resisting hair-pulling. "My stress levels had increased, and it was getting hard to deal with the pulling," says Rebecca. Jude was in the same situation: "At the start of lockdown, my scalp-pulling was off the charts."

To help with their hair-pulling urges during quarantine, both Rebecca and Jude took a pretty drastic step: They shaved their hair—and wound up pleasantly surprised. "It was a very hard decision to shave my head even though I had done it before," says Rebecca, who wasn't able to get her normal shorter haircut due to barbers being closed. "At first, I wasn't happy about it at all, but it's starting to grow on me again. It’s important to remember to be gentle with yourself during this time because it’s hard to live in a time with so many unknowns, and it’s important to take control of the things you can." Jude is also embracing her new look, which is more of an undercut than Rebecca's full- shave: "I decided to take ownership of my hair," she says. "The moment I did it, I had no regrets and I wondered what had taken me so long."

Since my previous strategy to reduce hair-pulling wasn't working in quarantine, I knew I had to come up with a new plan.

Another component of habit reversal training (HRT) that I've been implementing is called "competing response training," which amounts to doing activities that keep the hands busy to distract from hair-pulling. To keep myself entertained (which, to be honest, helps with trich urges and my overall sanity), I’ve been doing daily jump rope workouts, 1000-piece jigsaw puzzles, and putting on makeup for Zoom dates as self-care that engages my hands; friends of mine also play music, garden, or even sew masks.

Finally, I’ve been trying to take steps to minimize both sensory deprivation and stress, so I can reach a happy medium of stimulation. Engaging all five senses and routinely bringing in new sensations—the sound of stovetop popcorn, the scent of a candle or essential oil, the taste of a new recipe, or the look of the living room with all the furniture rearranged—keeps me from getting bored inside my little apartment during quarantine. For stress reduction, I’ve turned off notifications on most of my social media apps, try to identify something I’m grateful for every day, and try to meditate semi-regularly.

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