I blatantly refuse to identify with the diagnosis of Trichotillomania. Why? It has nothing to do with the stigma or shame millions of other sufferers go through on a daily basis.
Nearly a decade ago, I was sitting in my psychiatrist’s office (referred to as “Dr. W” in FOREVER MARKED) waiting for the return of university forms she needed to fill out in order to prove that I struggled with a disability. With all of my mental health issues spiraling out of control, I took the leap in my second year of university to see if I could qualify for a grant due to my significantly severe struggles that had been well documented while in the adult mental health system. It was another nerve-wracking experience for me to look into getting additional funding for school because “my dirty little secret” would have to be revealed to another person and organization. I was particularly fearful that once this information was released on my financial/ educational record, my future employment would be compromised because the burden I had to carry would follow me for the rest of my life.
After going into my appointment and reading the completed form, the diagnosis read “Trichotillomania and OCD”. I was confused at this point because as far as I knew I had depression and a disorder called “Psychogenic Excoriation”, the term I first learned of when referring to what is now known widespread in the BFRB community as Dermatillomania. I asked my psychiatrist why my problem was boxed into these terms and the reason was because the current diagnostic manual for mental health (DSM) didn’t recognize skin picking as a disorder, only a symptom of another. At the time, skin picking was considered to be an impulse control disorder that wasn’t specified and had to adopt secondary labels, like many others, for insurance and [in my case] funding purposes. I didn’t know at the time just how closely related Trichotillomania and Dermatillomania were, so I found it more settling to accept the OCD diagnosis although I was unsettled by how skin picking and obsessive thoughts were my only real connection to OCD. Sure I have my “quirks” that fall on the spectrum but they weren’t the issues that were plaguing my existence or edging me closer to suicide the way that my skin picking and depression were.
Looking back now, the Trichotillomania diagnosis was more applicable to me because of the close correlation it has with Dermatillomania. Also, it was more fitting because… well… I have Trichotillomania. I do not feel comfortable admitting this or announcing this fact to the world, but I must so that the fine line between the two disorders can one day become more distinguished instead of interchangeable. Trichotillomania is the sister syndrome to Dermatillomania, characterized by similar (if not identical) urges to pull out hair instead of picking- one is just a different physical manifestation from the other.
I pick at any mark I see or feel should not be on my body. I do this during ritualistic and habitual “body-scanning” when I go to the bathroom looking to smooth over my skin and when I am mindlessly watching television without occupying my hands with my laptop. My hair is involved during the visits to the loo by the time my gaze reaches my legs- then comes time for me to pull out the tweezers. I see thick hairs or hairs with the “potential” of an engorged root being attached and the urge automatically takes over. I will do anything to remove the perceptively foreign entity out of my body to achieve an irrational perfection, one that ultimately results in my skin being more marked up than before touching it. During the pull, which sometimes takes place after I dig it out of my battered skin, I feel an indescribably intense release… the same one I get when I pop a pimple or slight raise in my skin.
For years I suffered with this same fixation concerning my eyebrows. Through the misfortune of my back health declining and removing all mirrors in the house except for the small medicine cabinet mirror in the bathroom, I do not try to “perfect” my eyebrows the way I did before. I used to compulsively trim them, pull hairs out from underneath of my skin, and plucked for the ridiculously impossible outcome of obtaining the best brow possible. Now I am unable to stand up for long periods of time due to my back pain so I have gratefully lost the chronic need to fix them, even by scarring underneath just to remove an impossible hair.
So why am I so uncomfortable talking about my Trichotillomania when the definition clearly explains that it is diagnosable by the need to pull out hair from one’s own body and that’s what I do? There are millions of men and women (mostly the latter) who are diagnosed with Trich and are embarrassed and ashamed of not having eyelashes, eyebrows, and hair on their head. I am lucky to have a full head of thick and, at times, unruly waves with virgin eyelashes and average eyebrows. For me to announce that I have Trichotillomania feels like I am undermining the challenges people with the typical Trich face, which is similar to when people declare having Dermatillomania because they pick a pimple every so often. I am lucky to not have this BFRB manifest into pulling socially mandatory hairs from my body so it’s well hidden under the guise of my skin picking. For this reason along with my history of skin-related issues, I do not accept that I have Trichotillomania… even if that tell-all piece of paper that assisted with tuition almost 10 years ago was, in fact, correct.