Trichotillomania: Why We Pull Hair, How to Stop, and What I Learned from My Struggle

Naium Uddin

2 Jul, 2025

Hey there! I hope you're doing okay today. I wanted to sit down and share something pretty personal and often misunderstood—trichotillomania. It’s one of those topics where people either hear of it and misunderstand it, or they feel alone because nobody seems to talk about it openly. Well, I'm here to break the silence and share the low-down, sprinkled with a little real-talk, some quirks, and yes—my own humble opinions.

🤔 What Is Trichotillomania (TTM), Anyway?

Alright… imagine this: You're sitting in class or at work, and suddenly, you feel this tight tension in your chest or this itch in your brain. Before you even think about it, your fingers are fidgeting with your hair—tugging, pulling. Then—click—a wave of relief floods in. Sounds weird, right? That pull-relief thing is the essence of trichotillomania. It's much more than just “nervous picking”—it's a full-blown impulse control thing, classified in DSM‑5 as an obsessive‑compulsive related disorder.

A quick fact check if you're curious: according to the American Psychiatric Association, this condition involves recurrent hair-pulling, trying and failing to stop, and resulting distress or some form of impairment.

✨ My Own Story (Not Perfect, But Honest)

I first kinda realized I had this when I was around 15. I’d be binge-watching my favorite dramas after school, and my fingers would drift toward my eyebrows or eyelashes without me even noticing. I'd pull, pull…and pluck. Hours later, I’d catch my reflection and feel this weird combo of shame and euphoria. Total roller coaster.

At first, I thought it was just teenage stress or that I was weird (and believe me—I’ve got an emotional memory tied to every eyebrow follicle I yanked). Eventually, after a bit of googling and late-night googling, I found the word “trichotillomania.” That was the start of a long journey—one with a few missteps, a lot of little victories, and countless feelings.

🎯 Trichotillomania Causes: Why Do We Do It?

Real talk: the causes are messy. There's no one-size-fits-all explanation, but here are a few things the research and lived experiences (like mine and others) generally agree on:

Genetics & Brain Wiring: There's evidence it runs in families. Some folks have brains wired for impulse, or low impulse control.
Stress & Anxiety: Even though it’s not officially just an anxiety disorder, lots of people use hair-pulling to deal with stress—like a weird coping mechanism.
Emotions: Sadness, boredom, frustration, loneliness… it can show up when you're feeling stuck in some uncomfortable emotion.
ADHD Crossover: Believe it or not, many people with trichotillomania have ADHD. Same brain area. When focus drifts, your hands might start acting on habit. We’ll dive into that a bit more soon.

Is it OCD? Anxiety? Let’s talk about that…

Is Trichotillomania OCD or Anxiety? (Question #2)

Short answer: kinda, but not quite either.

It's classified in the same DSM‑5 family—but there are big differences:

OCD = you get intrusive, unpleasant thoughts, and you perform rituals to relieve those thoughts.
Trichotillomania = there's an impulse, tension, then pulling. It's more sensory-driven. Plus, once you're pulling, you often feel pleasure or relief.

Anxiety is often involved (yep) but TTM isn’t simply anxiety. Instead, anxiety can trigger it, and pulling can relieve it—making anxiety and hair-pulling dance in a weird loop.

🧪 Trichotillomania Test: How Do You Know?

If you're wondering, “Hmm, do I have trichotillomania?” here’s a little checklist to think about:

Do you pull your hair repeatedly?
Have you tried to stop or cut down but couldn’t?
Do you feel tension before pulling and relief after?
Does it cause distress or interfere with life?

To be sure, though, the Massachusetts General Hospital Hairpulling Scale (MGH-HPS) and Trichotillomania Diagnostic Interview-Revised (TDI-R) are professional tools. You can get them from a mental health provider. But hey, even just recognizing these signs is a powerful first step.

😌 Why Does Trichotillomania Feel So Good? (Question #3)

Honestly? It’s complicated. But the gist:

When you pull, there's a mini dopamine hit—a little reward wave.
You also relieve tension—kind of like shaking your leg when you're nervous. It's built into your brain’s stress circuit.
If you're coping with other emotions (sad, bored, anxious), pulling becomes a go-to option—even if you don't realize you're doing it.

Sounds bizarre when explained, but if you've experienced that moment… you know. It's a peculiar mix of guilty pleasure and relief.

🛑 How to Stop Trichotillomania: Tips That Actually Help

Look, I’m not gonna pretend it’s easy. It’s a tough cycle. But here are the tips that helped me—and many others—over time:

1. Become Aware of Your ‘Pull Moments’

Not always easy—but start to notice when your hand drifts. Use sticky notes or alarms on your phone. “Stop. Check.”

2. Find a Replacement

Some folks hold a stress ball, fiddle with clay, or use a twisty toy. If your fingers are occupied elsewhere—pulling can’t happen.

3. Practice Behavioral Tools (like Habit Reversal Training, HRT)

Awareness: Know when pulling is about to happen.
Competing Response: Do something else instead—maybe clench your fist, hold water, tap your feet.
Works really well, especially when combined with awareness.

4. Cognitive-Behavioral Approaches

Some therapists (especially TTM-experienced ones) use Cognitive Behavioral Therapy to help rethink and rewire pulling habits.

5. Mindfulness & Habit Journaling

Even 5 minutes of focused breathing can calm that tension wave. Journaling “When did I pull? How did I feel?” helps reveal triggers.

6. Join a Support Group

Finding other folks who get it changed everything for me. You realize you're not broken—you’re human. Reddit and Facebook groups have been a lifeline for many.

7. Medication (we’ll talk next)

💊 Trichotillomania Medication: Does It Help?

Medications aren’t cures—but they can support the journey, especially if anxiety or ADHD plays a role. Some include:

SSRIs (like fluoxetine): Mixed results—some find relief, others don’t.
N-acetylcysteine (NAC): A natural supplement. Some studies (e.g., by Grant et al) show it can actually help reduce pulling.
Antipsychotics or Mood stabilizers: Off-label, but used in severe cases.
ADHD Meds: If you also have ADHD, stimulant or non-stimulant meds (like methylphenidate, atomoxetine) might indirectly reduce pulling by improving focus.

📌 Important note: Always talk with a psychiatrist or doctor before trying meds. I’m no doc—just a fellow traveler sharing what worked (and what didn’t) for me.

🎯 Specific Concern: Trichotillomania Eyebrows

Man oh man, pulling eyebrows is something I—and many others—struggled with. It’s sneaky, because bangs or makeup can hide it… but the emotional toll? Real.

Tips that helped:

Let them grow out as much as possible—even if sparse.
Try microblading or eyebrow pencil as a temporary confidence boost.
Use a hand mirror to watch yourself pulling (I know it sounds weird), but awareness is clutch.
Celebrate small regrowths. Each new hair means you're making progress.

🧩 Trichotillomania and ADHD: The Overlap

Here’s some insight: research shows lots of TTM folks also have ADHD. Here's why that can matter:

ADHD can mean impulsivity, distractibility, and restlessness.
You might pick if you’re bored or fixating.
Some ADHD meds can help break up that autopilot pulling.

But there’s a catch: some stimulant meds even increase anxiety in some people, which might worsen pulling. So again—it’s best navigated with a professional.

🛑 Is Trichotillomania Curable? (Question #1)

Ah, the big question.

Can it be cured? It depends on how you define “cure.” For many of us, it’s more about management than 100% eradication. There are people who haven’t pulled for years. Others relapse during intense stress. The key is having tools, support, and self-kindness.

I like to think of it as learning a new dance with my impulses. Sometimes I miss a beat—but I'm learning new steps.

So, is trichotillomania curable? Maybe not cured in the traditional sense, but absolutely manageable, improvable, and worth fighting for. With time, therapy, meds (if needed), support—many of us build long stretches of relief.

🌱 Resources & Trusted Links

For treatment info and therapy techniques, check out the Trichotillomania Learning Center at the TLC Foundation: https://www.trich.org
For NAC studies, check out research by Grant et al, Journal of Clinical Psychiatrist
For ADHD & impulse overlap, Psychology Today’s TTM section has some great breakdowns

💬 Parting Words (My Real Talk)

Look, TTM sucks. It messes with your reflection, confidence, sometimes even your job or social life. But I want you to know: you're not broken. You're coping with a real, biological impulse.

Don’t beat yourself up if you slip. Even writing this blog, I got triggered at one point (dang!). That tension relief is powerful.

But here’s what I also know: there are tools that work. Small steps add up. One awareness note, one mindfulness pause, one dark chocolate snack instead of a pull.

If you feel stuck—reach out. Therapist, friend, trained coach, or forum. You don’t have to do it alone.

🚀 Call-To-Action

If any part of this resonated—share your thoughts below or reach out. Let’s create a space where we talk openly. Even if it’s just a sentence like, “Hey, today was hard but I didn’t pull.” I read every single one.

You’ve got this. One day, one pull-less minute at a time.

With empathy and hope,