Talking to loved ones about trichotillomania (TTM) can be incredibly challenging. Many women hesitate to share their struggles because they fear judgment, misunderstanding, or a lack of support. Society's misconceptions and stigmas only make these conversations harder.
However, healing from chronic hair pulling requires understanding and help from those around you. Here's a guide to help you explain trichotillomania to your loved ones, in a way that can help them respond with empathy and support.
Trichotillomania is a complex condition with various causes and triggers. Sharing these with your loved ones can help them understand what you're going through.
1. Biological Factors:-
Genetics: Family history can play a role in the development of TTM.
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Brain Structure: Differences in brain structure, particularly in areas related to impulse control, may contribute to TTM.
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Glutamate Regulation: Abnormally high levels of glutamate, a neurotransmitter, can impact impulse control and compulsive behaviors, including hair pulling.
2. Psychological Factors:-
Emotional Stress: Anxiety, depression, and stress can trigger hair-pulling episodes.
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Trauma: Past traumatic experiences can lead to the development of TTM as a coping mechanism.
3. Environmental Factors:-
Environment: Certain unhealthy environments or stressful situations can increase the likelihood of hair pulling.
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Learned Behavior: Observing others with similar behaviors can contribute to developing TTM.
4. Habitual and Behavioral Factors:-
Sensory Satisfaction: Some individuals find sensory relief in hair pulling.
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Habit: Over time, hair pulling can become a deeply ingrained habit.
5. Nutritional Factors:-
Food Sensitivities: Certain foods and chemicals can impact TTM symptoms. For example, Monosodium glutamate (MSG) can affect glutamate levels in the brain.
Glutamate is a neurotransmitter that, when imbalanced, can impact anxiety levels and compulsive behaviors, including hair pulling. Avoiding foods high in MSG and focusing on a balanced diet can help manage these urges.
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John Kender Diet: This diet specifically avoids foods that are thought to exacerbate hair-pulling behaviors by affecting glutamate regulation. It emphasizes avoiding certain artificial additives and consuming foods that promote better neurological health.
While many people in the TTM community have discounted this specific diet, there are a growing number of scientific correlations that link inflammation levels in our body with the foods we eat, and the resulting flare ups that we experience. HFHP feels it is fair to share this as a consideration while encouraging you to speak with your healthcare professionals about what may work best for you.
While medication can sometimes help lower hair-pulling urges, it is important to note that there is no FDA-approved medication specifically for TTM that works for everyone. Treatment effectiveness varies widely among individuals.
It’s essential to work closely with your healthcare action team to find the best treatment plan for your specific needs, as medication alone is often not sufficient.
Managing trichotillomania effectively requires more than a single solution or magic bullet. Personalized action plans are crucial because they address your unique needs and circumstances. These plans incorporate a holistic care regimen that includes:
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Comprehensive Assessment: Evaluating the specific triggers, habits, and psychological factors contributing to hair pulling.
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Diet and Nutrition: Implementing dietary changes, such as the John Kender Diet, to help regulate neurotransmitters like glutamate.
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Therapeutic Interventions: Utilizing various therapies, including cognitive-behavioral therapy (CBT) and habit reversal training (HRT).
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Support Systems: Building an action team that includes family, friends, healthcare providers, and support groups to offer ongoing encouragement and assistance.
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Self-Care Strategies: Incorporating mindfulness, relaxation techniques, and self-compassion practices to manage stress and emotional well-being.
A personalized action plan recognizes that trichotillomania affects multiple aspects of your life and requires a coordinated approach to address all contributing factors.
The
UnTrick YourselfTM program offered here at HFHP helps women develop personalized action plans that cater to their specific needs, incorporating holistic care and an action team to support them in every area of their lives.
Before starting the conversation, it's important to address common misperceptions that your loved ones might have:
1. It's Just a Bad Habit: Many people mistakenly believe that trichotillomania is simply a bad habit that can be easily stopped. In reality, it is a chronic medical condition that involves complex biological, psychological, and environmental factors.
2. Lack of Willpower: Some people think that individuals with trichotillomania lack the willpower to stop pulling their hair. However, TTM is not about willpower; it's about managing a condition that involves compulsive behaviors.
3. Seeking Attention: There is a misconception that people pull their hair for attention. In fact, many individuals with TTM go to great lengths to hide their behavior due to shame and embarrassment.
4. It's All in Your Head: This dismissive attitude ignores the real and physical aspects of TTM. The condition involves neurological and biological components that make it much more than just a psychological issue.
5. It's Not Serious: Some may believe that trichotillomania is not a serious condition. However, TTM can have significant emotional, psychological, and physical impacts, including scarring and permanent hair loss.
Addressing these misperceptions is crucial in fostering a supportive and understanding environment for those with trichotillomania.
Understanding these factors can help your loved ones approach you with empathy and avoid dismissive or harmful remarks. Here are some supportive conversation examples you can share with them.
We also have a healthy conversation guide that you can download at the end of this article, to share with your loved ones when discussing your medical condition with them.
1. Instead of saying "Just stop pulling your hair," say "I'm here for you, no matter what."
Why it's important: Telling someone to "just stop" oversimplifies a complex condition. Offering unconditional support shows that you acknowledge their struggle and are there for them regardless of their challenges.
2. Instead of saying "Why don’t you just wear a hat all the time?" try "You’re not alone in this."
Why it's important: Suggesting a quick fix like wearing a hat can feel dismissive. Letting them know they are not alone reassures them that they have your support and understanding.
3. Instead of saying "It’s just hair, it’ll grow back," say "How can I support you today?"
Why it's important: Minimizing their condition by focusing on hair regrowth ignores the emotional and psychological aspects of TTM. Asking how you can support them shows empathy and a willingness to help.
4. Instead of saying "You're doing that just for attention," say "I believe in you."
Why it's important: Accusing someone of seeking attention can be very hurtful. Expressing belief in their strength and perseverance provides much-needed encouragement.
5. Instead of saying "Aren’t you too old to be doing that?" say "Your feelings are valid."
Why it's important: Telling someone they are too old to struggle with TTM dismisses their experience. Validating their feelings helps them feel understood and accepted.
6. Instead of saying "It’s all in your head," say "It's okay to talk about it, if you feel like it."
Why it's important: Dismissing TTM as "all in your head" invalidates the person's experience. Encouraging open conversation fosters a supportive environment.
7. Instead of saying "You’d look so pretty if you didn’t pull out your hair," say "You’re strong, and I admire your courage."
Why it's important: Focusing on appearance can make someone feel judged. Admiring their strength and courage emphasizes their inner qualities.
8. Instead of saying "I pull my hair when I'm stressed too; it's no big deal," say "Tell me more about what you’re going through."
Why it's important: Comparing TTM to a common stress response trivializes their condition. Inviting them to share their experience shows genuine interest and care.
9. Instead of saying "Just distract yourself. Then you won’t do it," say "I'm always here if you need to talk."
Why it's important: Suggesting distraction as a solution oversimplifies TTM. Offering a listening ear shows that you are available for support.
10. Instead of saying "You should be ashamed of yourself," say "Your worth isn't defined by your hair."
Why it's important: Shaming someone for their condition can be incredibly damaging. Reinforcing their self-worth helps them see beyond their struggles.
11. Instead of saying "Why can’t you control yourself?" say "It’s okay to seek help, and I’ll be here to support you."
Why it's important: Criticizing their self-control can feel like an attack. Encouraging them to seek help and offering support shows that you care about their well-being.
12. Instead of saying "That looks painful, why do you do it?" say "You are more than this challenge."
Why it's important: Focusing on the physical aspect of TTM can be hurtful. Acknowledging their resilience emphasizes their strength and value.
13. Instead of saying "You’re going to scar your scalp," say "Let's find ways to help you feel heal."
Why it's important: Pointing out potential scarring can cause additional stress. Focusing on comfort shows that you prioritize their well-being.
14. Instead of saying "There’s hair everywhere, can't you clean up a bit?" say "I'm proud of you for addressing this bravely."
Why it's important: Complaining about hair shedding can feel insensitive. Expressing pride in their bravery acknowledges their daily challenges.
15. Instead of saying "Are you sure you’re not doing it for sympathy?" say "You are important to me."
Why it's important: Accusing someone of seeking sympathy is hurtful. Affirming their importance shows that you value them beyond their condition.
16. Instead of saying "It can't be that hard to stop," say "Your journey is important, and I respect it."
Why it's important: Minimizing the difficulty of managing TTM invalidates their experience. Showing respect for their journey acknowledges their effort and perseverance.
17. Instead of saying "Have you tried meditation or yoga?" in a dismissive manner, say "You're beautiful, with or without your hair."
Why it's important: Suggesting quick fixes can feel dismissive. Reinforcing their beauty, regardless of their hair, promotes self-acceptance.
18. Instead of saying "People are going to think you’re weird," say "I appreciate your openness about what you’re dealing with."
Why it's important: Criticizing how others might perceive them adds unnecessary stress. Appreciating their openness fosters trust and support.
If you want to learn more about the causes and triggers of trichotillomania, as well as effective ways to manage it, consider enrolling in
HFHP’s UnTrick Yourself™ educational program.
Our comprehensive program provides valuable insights and practical strategies to help you and your loved one better understand and navigate this condition.
Healing from Hair PullingTM offers health education and customized support programs for women who have trichotillomania. We understand how chronic hair pulling makes you feel because our team members all have TTM too!
Our easy-to-understand guides teach women like us how to better understand their medical condition plus ways to lessen internal triggers in their body that may be making it worse.
Consider using our free self-assessment tool to check your symptoms.
HFHP’s evidence-based, peer-led educational program called
UnTrick Yourself™ incorporates personalized support plans and a friendly private community -all designed to help you better manage your symptoms while uplifting how you feel -physically, emotionally, and in spirit.
Our affordable, holistic education gets to the root of the issue, as we explain TTM causes and triggers, diet changes that can reduce flare-ups, daily self-care actions, and ways to create a caring support team who helps you heal, alongside therapy and medication.
Join us at
https://healingfromhairpulling.com.
Together, let's find what works best, for you!
1. Zhang, J., & Grant, J. E. (2022). Significance of family history in understanding and subtyping trichotillomania. Comprehensive Psychiatry, 119, 152349. https://doi.org/10.1016/j.comppsych.2022.152349
2. Roos, A., Fouche, J. P., Stein, D. J., & Lochner, C. (2023). Structural brain network connectivity in trichotillomania (hair-pulling disorder). Brain Imaging and Behavior, 17(4), 395-402.https://doi.org/10.1007/s11682-023-00767-5
3. Uhlmann, A., Dias, A., Taljaard, L., Stein, D. J., Brooks, S. J., & Lochner, C. (2020). White matter volume alterations in hair-pulling disorder (trichotillomania). Brain Imaging and Behavior, 14(6), 2202-2209.https://doi.org/10.1007/s11682-019-00170-z
4. Alexander, J. R., Houghton, D. C., Bauer, C. C., et al. (2018). Emotion regulation deficits in persons with body-focused repetitive behavior disorders. Journal of Affective Disorders, 227, 463–470.https://pubmed.ncbi.nlm.nih.gov/29156359/
5. Crowe, E., Staiger, P. K., Bowe, S. J., Rehm, I., Moulding, R., Herrick, C., & Hallford, D. J. (2024). The association between trichotillomania symptoms and emotion regulation difficulties: A systematic review and meta-analysis. Journal of Affective Disorders, 346, 88-99. https://doi.org/10.1016/j.jad.2023.11.010 
