Coping With Trichotillomania A Comprehensive Guide

Hey guys! Let's dive into a topic that might be new to some of you, but it's super important to understand: Trichotillomania. It's a mouthful, I know, but stick with me. We're going to break down what it is, how it affects people, and most importantly, how to cope with it. If you or someone you know is dealing with this, you're in the right place. This article will provide a comprehensive guide on understanding and managing trichotillomania. We'll cover everything from the basics of the disorder to practical coping strategies and long-term management techniques. So, let's get started and explore how to cope with trichotillomania.

Understanding Trichotillomania

Okay, so what exactly is trichotillomania? In simple terms, it's a disorder where someone feels an irresistible urge to pull out their hair. This isn't just about absentmindedly tugging at a strand; it's a persistent, recurring behavior that can significantly impact a person's life. People with trichotillomania might pull hair from their scalp, eyebrows, eyelashes, or other parts of their body. The urge can be so strong that it feels almost impossible to resist, leading to feelings of shame, guilt, and anxiety.

Trichotillomania is classified as a Body-Focused Repetitive Behavior (BFRB), which means it involves repetitive self-grooming behaviors that cause distress or impairment in functioning. Other BFRBs include skin picking (dermatillomania) and nail biting (onychophagia). These behaviors are often driven by a combination of factors, including genetics, neurobiology, and environmental triggers. Understanding the nature of trichotillomania is the first step in developing effective coping strategies. It's essential to recognize that this is a genuine condition and not simply a bad habit. People with trichotillomania are not doing it for attention or out of vanity; they are struggling with a neurological impulse that requires understanding and support. The repetitive nature of hair pulling can be both a coping mechanism and a source of anxiety. Many individuals with trichotillomania report feeling a sense of relief or satisfaction after pulling hair, which reinforces the behavior. However, this relief is often short-lived, and the cycle of urge, pulling, and regret continues. The physical consequences of trichotillomania, such as hair loss and skin irritation, can further contribute to feelings of distress and self-consciousness. Socially, individuals with trichotillomania may experience shame and embarrassment, leading them to avoid social situations or wear wigs, hats, or makeup to conceal hair loss. This can result in isolation and a decreased quality of life. Therefore, a comprehensive understanding of trichotillomania involves recognizing its psychological, emotional, and social impacts, as well as the neurological underpinnings of the disorder.

What Causes Trichotillomania?

This is a big question, and honestly, there's no single, clear answer. Like many mental health conditions, trichotillomania likely stems from a mix of factors. Genetics can play a role – if someone in your family has it, you might be more likely to develop it too. Brain chemistry is another piece of the puzzle. Imbalances in certain neurotransmitters, like serotonin and dopamine, might contribute to the urges. Then there are environmental factors, such as stress or trauma, that can trigger or worsen the condition. Understanding the potential causes of trichotillomania is crucial for developing effective treatment and management strategies. While the exact etiology of the disorder remains unclear, research suggests that a combination of genetic, neurobiological, and environmental factors plays a significant role. Genetic predisposition is a key area of investigation, with studies indicating that individuals with a family history of trichotillomania or other obsessive-compulsive spectrum disorders are at a higher risk. This suggests that certain genes may increase susceptibility to developing the condition. Neurobiological factors also contribute to the development of trichotillomania. Neuroimaging studies have revealed differences in brain structure and function among individuals with the disorder, particularly in regions associated with habit formation, impulse control, and emotional regulation. For example, abnormalities in the basal ganglia, prefrontal cortex, and anterior cingulate cortex have been implicated in the pathophysiology of trichotillomania. Imbalances in neurotransmitter systems, such as serotonin, dopamine, and glutamate, may also play a role in the urges and compulsions associated with hair pulling. Environmental factors, such as stress, trauma, and learned behaviors, can further influence the onset and severity of trichotillomania. Stressful life events, emotional distress, and anxiety can trigger or exacerbate hair-pulling episodes. In some cases, hair pulling may serve as a coping mechanism for managing negative emotions or relieving tension. Learned behaviors, such as associating hair pulling with relaxation or sensory stimulation, can also contribute to the maintenance of the disorder. Additionally, co-occurring mental health conditions, such as anxiety disorders, depression, and obsessive-compulsive disorder (OCD), are common in individuals with trichotillomania and may complicate the clinical picture. These conditions can interact with trichotillomania, exacerbating symptoms and making treatment more challenging. Therefore, a comprehensive assessment of individuals with trichotillomania should consider the interplay of genetic, neurobiological, and environmental factors, as well as the presence of any co-occurring mental health conditions.

Recognizing the Signs and Symptoms

The most obvious sign, of course, is hair pulling itself. But it's not always that straightforward. People with trichotillomania might try to hide their behavior, so you might not see them actually pulling their hair. Other signs include noticeable hair loss, bald patches, or thinning hair. They might also have repetitive behaviors related to hair, like twisting, twirling, or playing with it. Emotionally, they might experience a lot of distress, shame, or anxiety related to their hair pulling. Recognizing the signs and symptoms of trichotillomania is crucial for early intervention and effective management. The disorder typically involves a combination of physical, emotional, and behavioral symptoms that can significantly impact an individual's quality of life. The hallmark symptom of trichotillomania is the recurrent pulling out of one's own hair, resulting in noticeable hair loss. This hair pulling can occur from any part of the body, but the most common sites include the scalp, eyebrows, eyelashes, and pubic area. The amount of hair pulled out and the frequency of pulling episodes can vary widely among individuals. Some people may pull hair sporadically, while others engage in daily or even multiple times per day. The physical consequences of hair pulling can include bald patches, thinning hair, and skin irritation. Individuals with trichotillomania may attempt to conceal these physical signs by wearing hats, wigs, or makeup, or by avoiding social situations where their hair loss may be visible. In addition to hair pulling, individuals with trichotillomania often engage in repetitive behaviors related to hair. These behaviors may include examining the pulled hair, twisting or twirling strands of hair, or playing with hair in the mouth. Some individuals may also experience a tactile or sensory sensation associated with hair pulling, such as a tingling or itching feeling on the scalp. Emotionally, trichotillomania can be associated with significant distress, shame, and anxiety. Individuals may feel a strong urge to pull hair, followed by a sense of relief or gratification after pulling. However, this relief is often short-lived, and feelings of guilt, shame, and self-consciousness quickly follow. The emotional distress associated with trichotillomania can lead to avoidance of social situations, decreased self-esteem, and difficulties in interpersonal relationships. Many individuals with trichotillomania also experience co-occurring mental health conditions, such as anxiety disorders, depression, and obsessive-compulsive disorder (OCD). These conditions can exacerbate the symptoms of trichotillomania and make treatment more challenging. Therefore, a comprehensive assessment of individuals with suspected trichotillomania should include a thorough evaluation of their physical, emotional, and behavioral symptoms, as well as any co-occurring mental health conditions.

Coping Strategies for Trichotillomania

Okay, so you've got a better understanding of trichotillomania. Now, let's talk about how to cope with it. There are lots of different strategies out there, and what works for one person might not work for another. It's all about finding the tools that fit you best. Let’s explore some actionable strategies that can help manage the urge to pull and promote healthier coping mechanisms. These strategies encompass a range of approaches, from behavioral techniques to lifestyle adjustments, all aimed at empowering individuals to take control of their condition.

Behavioral Techniques

One of the most effective approaches for managing trichotillomania is through behavioral therapies. Cognitive Behavioral Therapy (CBT), particularly a technique called Habit Reversal Training (HRT), is often recommended. HRT involves becoming aware of your pulling triggers, developing competing responses (like squeezing a stress ball), and building motivation to change. It's like retraining your brain to react differently to the urge. Behavioral techniques play a crucial role in managing trichotillomania by helping individuals identify triggers, develop alternative responses, and break the cycle of hair pulling. Cognitive Behavioral Therapy (CBT) is one of the most effective approaches for treating trichotillomania, with Habit Reversal Training (HRT) being a core component. HRT involves several key steps: awareness training, competing response training, and social support. Awareness training is the first step in HRT, where individuals learn to identify the situations, thoughts, and feelings that trigger their hair pulling. This involves keeping a detailed log of pulling episodes, noting the time, place, emotions, and any preceding events. By becoming more aware of their triggers, individuals can anticipate and prevent pulling episodes. Competing response training is the next step, where individuals learn to engage in a behavior that is incompatible with hair pulling. For example, clenching fists, squeezing a stress ball, or knitting can serve as competing responses. The competing response should be something that can be easily performed in various situations and should be sustained for a few minutes each time an urge to pull arises. Social support is another important aspect of HRT. Enlisting the support of family members, friends, or support groups can provide encouragement and accountability. Social support can also help individuals feel less isolated and more motivated to stick with their treatment plan. In addition to HRT, other behavioral techniques can be beneficial in managing trichotillomania. Stimulus control involves modifying the environment to reduce exposure to triggers. This may include wearing gloves or hats, keeping hands occupied with other activities, or avoiding situations where hair pulling is more likely to occur. Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can also help reduce anxiety and stress, which are common triggers for hair pulling. These techniques can be practiced regularly to promote a sense of calm and well-being. Overall, behavioral techniques offer a structured and effective approach to managing trichotillomania. By learning to identify triggers, develop competing responses, and implement stimulus control strategies, individuals can gain greater control over their hair-pulling behavior and improve their quality of life.

Mindfulness and Acceptance

Mindfulness is all about being present in the moment, without judgment. For trichotillomania, this means noticing the urge to pull without immediately acting on it. Acceptance and Commitment Therapy (ACT) can also be helpful. It encourages you to accept your thoughts and feelings (including the urge to pull) without struggling against them. Instead, you focus on living a life that's meaningful to you, even with trichotillomania. Mindfulness and acceptance-based approaches have emerged as valuable tools in managing trichotillomania by fostering a non-judgmental awareness of urges and emotions and promoting psychological flexibility. Mindfulness, the practice of paying attention to the present moment without judgment, can help individuals with trichotillomania become more aware of their thoughts, feelings, and bodily sensations related to hair pulling. By cultivating mindfulness, individuals can learn to observe their urges without immediately acting on them, creating a space for choice and intentional action. Acceptance and Commitment Therapy (ACT) is a form of psychotherapy that combines mindfulness techniques with acceptance and values-based action. ACT encourages individuals to accept their thoughts and feelings, including the urge to pull, rather than struggling against them. The goal of ACT is not to eliminate urges but to reduce their impact on behavior and to help individuals live a life that is consistent with their values. In the context of trichotillomania, ACT can help individuals develop a more compassionate and accepting attitude towards themselves and their condition. This can reduce feelings of shame and self-criticism, which often exacerbate hair-pulling behavior. By focusing on values-based action, individuals can redirect their attention and energy towards activities that are meaningful and fulfilling, rather than being consumed by their urges. Mindfulness and acceptance techniques can be integrated into daily life through practices such as meditation, deep breathing exercises, and mindful awareness of everyday activities. Meditation involves focusing attention on a specific object, such as the breath, and gently redirecting the mind when it wanders. Regular meditation practice can enhance self-awareness and emotional regulation skills. Deep breathing exercises can help calm the nervous system and reduce anxiety, which is a common trigger for hair pulling. Mindful awareness involves paying attention to the present moment without judgment, whether it's during a conversation, a meal, or a walk in nature. By practicing mindfulness and acceptance, individuals with trichotillomania can develop a greater sense of self-compassion and resilience. They can learn to cope with urges and emotions in a healthier way, without resorting to hair pulling as a primary coping mechanism. These approaches empower individuals to live a more fulfilling and meaningful life, even in the presence of trichotillomania.

Creating a Supportive Environment

Your surroundings can have a big impact. Try to create an environment that supports your coping efforts. This might mean keeping your hands busy with fidget toys, wearing gloves while you're watching TV, or making it harder to access your hair (like wearing a hat). It's about setting yourself up for success. Creating a supportive environment is an essential aspect of managing trichotillomania, as it can significantly reduce triggers and promote healthier coping strategies. The environment encompasses both the physical surroundings and the social context in which an individual lives. By making thoughtful adjustments to these elements, individuals can create a space that fosters self-control and well-being. In the physical environment, several modifications can be made to minimize opportunities for hair pulling. One strategy is to keep hands occupied with alternative activities. Fidget toys, stress balls, or even small craft projects can provide a tactile outlet for nervous energy and reduce the likelihood of hair pulling. Another approach is to physically block access to hair by wearing gloves, hats, or scarves. This can be particularly helpful during situations when hair pulling is more likely to occur, such as while watching TV or working at a computer. Minimizing visual cues that trigger hair pulling can also be beneficial. This may involve covering mirrors, dimming lights, or rearranging furniture to create a less stimulating environment. The social environment plays a crucial role in supporting individuals with trichotillomania. Open communication with family members, friends, and partners can help create a supportive network. Sharing information about trichotillomania and its impact can foster understanding and empathy, reducing feelings of shame and isolation. Enlisting the help of loved ones in identifying triggers and providing gentle reminders not to pull can also be effective. Support groups and online forums offer valuable opportunities to connect with others who have trichotillomania. Sharing experiences, coping strategies, and encouragement can create a sense of community and reduce feelings of loneliness. These groups can also provide a safe space to discuss challenges and celebrate successes. In addition to the physical and social environment, the emotional climate is also important. Creating a calm and relaxing atmosphere can reduce stress and anxiety, which are common triggers for hair pulling. Relaxation techniques, such as deep breathing, meditation, and yoga, can be incorporated into daily routines to promote emotional well-being. Practicing self-compassion and self-care is also essential. This involves treating oneself with kindness and understanding, especially during moments of difficulty. Engaging in enjoyable activities, pursuing hobbies, and setting realistic goals can help build self-esteem and resilience. By creating a supportive environment, individuals with trichotillomania can significantly improve their ability to manage their condition and live a more fulfilling life.

Seeking Professional Help

Sometimes, coping strategies aren't enough, and that's okay. Trichotillomania can be a tough condition to manage on your own. A therapist specializing in BFRBs can provide guidance, support, and evidence-based treatments. Medication, like selective serotonin reuptake inhibitors (SSRIs), might also be helpful in some cases. There's no shame in seeking help – it's a sign of strength. Seeking professional help is a crucial step in effectively managing trichotillomania, especially when self-help strategies and lifestyle adjustments are not sufficient. Trichotillomania is a complex condition that often requires a comprehensive treatment approach tailored to the individual's needs. Mental health professionals, such as therapists, psychologists, and psychiatrists, can provide specialized care and support to help individuals overcome the challenges associated with hair pulling. One of the primary benefits of seeking professional help is access to evidence-based therapies. Cognitive Behavioral Therapy (CBT), particularly Habit Reversal Training (HRT), is considered the gold standard treatment for trichotillomania. A therapist trained in CBT can guide individuals through the process of identifying triggers, developing competing responses, and implementing stimulus control strategies. Therapy can also address underlying emotional issues, such as anxiety, depression, or trauma, that may contribute to hair pulling. In addition to therapy, medication may be beneficial for some individuals with trichotillomania. Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants, are sometimes prescribed to help reduce the urges and compulsions associated with hair pulling. Medication can be particularly helpful for individuals who have co-occurring mental health conditions, such as anxiety disorders or obsessive-compulsive disorder (OCD). A psychiatrist can assess an individual's symptoms and medical history to determine if medication is an appropriate treatment option. Support groups and peer counseling can also play a valuable role in the treatment of trichotillomania. Connecting with others who have similar experiences can provide a sense of community and reduce feelings of isolation. Support groups offer a safe space to share challenges, learn coping strategies, and receive encouragement. Online forums and social media groups can also provide a sense of connection and support for individuals who are unable to attend in-person meetings. The process of seeking professional help typically begins with an initial assessment. A mental health professional will conduct a thorough evaluation of an individual's symptoms, medical history, and psychosocial functioning. This assessment helps to determine the severity of trichotillomania and identify any co-occurring mental health conditions. Based on the assessment, a treatment plan is developed that may include therapy, medication, support groups, or a combination of these approaches. Regular follow-up appointments are essential to monitor progress and make adjustments to the treatment plan as needed. Seeking professional help for trichotillomania is a sign of strength and self-care. It demonstrates a commitment to overcoming the challenges of hair pulling and improving overall quality of life. With the guidance and support of mental health professionals, individuals with trichotillomania can learn to manage their condition and live a more fulfilling life.

Long-Term Management of Trichotillomania

Trichotillomania is often a chronic condition, meaning it can come and go over time. Long-term management is all about building resilience and maintaining the coping strategies you've learned. This might involve ongoing therapy, regular self-care practices, and staying connected with support networks. It's a journey, not a quick fix, and it’s essential to view long-term management as a continuous process of self-care, awareness, and proactive coping. This involves not only maintaining the progress made through initial treatment but also adapting strategies to address evolving needs and challenges. Let's explore the key components of effective long-term management.

Building Resilience

Resilience is your ability to bounce back from challenges. For trichotillomania, this means developing the skills to cope with setbacks, like a pulling episode. It's about recognizing that setbacks happen, learning from them, and getting back on track. Building resilience is a critical aspect of long-term management of trichotillomania, as it equips individuals with the skills and mindset necessary to navigate setbacks and maintain progress over time. Resilience is the ability to bounce back from challenges, adapt to adversity, and maintain a sense of well-being despite difficult circumstances. In the context of trichotillomania, building resilience involves developing strategies to cope with urges, manage emotional distress, and maintain motivation for change. One of the key components of resilience is self-awareness. This involves understanding one's triggers, patterns of behavior, and emotional responses related to hair pulling. By becoming more self-aware, individuals can anticipate challenges and develop proactive coping strategies. Self-compassion is another essential aspect of resilience. This involves treating oneself with kindness and understanding, especially during moments of difficulty. Practicing self-compassion can help reduce feelings of shame and self-criticism, which often exacerbate hair-pulling behavior. Emotional regulation skills are also crucial for building resilience. This involves learning to manage and express emotions in a healthy way. Techniques such as deep breathing, mindfulness, and progressive muscle relaxation can help calm the nervous system and reduce anxiety. Problem-solving skills are also important for coping with setbacks. This involves breaking down challenges into smaller, manageable steps and developing a plan of action. Seeking support from others is another key aspect of resilience. Connecting with family members, friends, support groups, or therapists can provide encouragement and validation. A strong support network can help individuals feel less alone and more motivated to stay on track with their treatment goals. In addition to these skills, developing a growth mindset can also enhance resilience. A growth mindset is the belief that one's abilities and intelligence can be developed through dedication and hard work. Individuals with a growth mindset are more likely to view challenges as opportunities for learning and growth, rather than as failures. Building resilience is an ongoing process that requires commitment and practice. By developing self-awareness, self-compassion, emotional regulation skills, problem-solving skills, and a growth mindset, individuals with trichotillomania can significantly improve their ability to cope with setbacks and maintain long-term progress.

Maintaining Coping Strategies

The strategies you learned in therapy or on your own are your toolbox. It's important to keep using those tools, even when you're feeling good. This might mean continuing to practice competing responses, staying mindful of your triggers, or creating a supportive environment. Maintaining effective coping strategies is a fundamental aspect of long-term management of trichotillomania. While initial treatment may provide significant relief from symptoms, it is essential to continue practicing and refining coping mechanisms to prevent relapse and sustain progress over time. Coping strategies for trichotillomania encompass a range of behavioral, cognitive, and lifestyle techniques that help individuals manage urges, reduce triggers, and promote emotional well-being. These strategies may include Habit Reversal Training (HRT), stimulus control, relaxation techniques, mindfulness practices, and cognitive restructuring. Habit Reversal Training (HRT) remains a cornerstone of long-term management. Regularly practicing awareness training and competing responses can help individuals maintain control over their hair-pulling behavior. Stimulus control strategies, such as modifying the environment to reduce triggers, should also be consistently implemented. Relaxation techniques, such as deep breathing, progressive muscle relaxation, and meditation, can help manage stress and anxiety, which are common triggers for hair pulling. Regular practice of these techniques can enhance emotional regulation skills and promote a sense of calm and well-being. Mindfulness practices, such as mindful awareness of thoughts, feelings, and bodily sensations, can help individuals observe urges without immediately acting on them. This can create a space for choice and intentional action. Cognitive restructuring involves identifying and challenging negative or distorted thoughts that contribute to hair pulling. By replacing these thoughts with more balanced and realistic ones, individuals can reduce their emotional distress and improve their coping abilities. In addition to these specific techniques, maintaining a healthy lifestyle is crucial for long-term management of trichotillomania. This includes getting regular exercise, eating a balanced diet, getting enough sleep, and avoiding substance use. These habits promote physical and emotional well-being, which can enhance coping abilities and reduce the likelihood of relapse. Ongoing therapy or support groups can provide valuable support and guidance in maintaining coping strategies. Regular check-ins with a therapist can help individuals address any challenges they may be facing and refine their treatment plan as needed. Support groups offer a sense of community and provide opportunities to share experiences and coping strategies with others. Long-term management of trichotillomania requires a proactive and consistent approach. By maintaining effective coping strategies and seeking ongoing support, individuals can sustain progress and live a fulfilling life.

Staying Connected

Isolation can make trichotillomania feel even harder. Staying connected with friends, family, or support groups can provide a sense of community and understanding. Sharing your experiences with others who get it can be incredibly validating and helpful. Staying connected with supportive individuals and communities is a vital component of long-term management of trichotillomania. Isolation and loneliness can exacerbate symptoms and make it more challenging to maintain coping strategies. By fostering strong social connections, individuals can create a supportive network that provides encouragement, understanding, and a sense of belonging. Family and friends can play a crucial role in supporting individuals with trichotillomania. Open communication and education about the condition can help loved ones understand the challenges and provide empathy. Enlisting the help of family and friends in identifying triggers and providing gentle reminders not to pull can also be effective. Support groups and peer counseling offer valuable opportunities to connect with others who have trichotillomania. Sharing experiences, coping strategies, and encouragement can create a sense of community and reduce feelings of isolation. These groups can also provide a safe space to discuss challenges and celebrate successes. Online forums and social media groups can also provide a sense of connection and support for individuals who are unable to attend in-person meetings. These platforms offer a convenient way to connect with others, share information, and access resources. Therapists and mental health professionals can also provide ongoing support and guidance in managing trichotillomania. Regular check-ins with a therapist can help individuals address any challenges they may be facing and refine their treatment plan as needed. Teletherapy, or online therapy, can be a convenient option for individuals who have difficulty attending in-person appointments. In addition to these formal support systems, engaging in activities that foster social connection can also be beneficial. This may include joining a club, volunteering, or participating in community events. These activities provide opportunities to meet new people, build relationships, and engage in meaningful activities. Staying connected also involves setting healthy boundaries in relationships. This may include communicating one's needs and limits to others and avoiding relationships that are toxic or unsupportive. Building and maintaining strong social connections requires effort and commitment. However, the benefits of staying connected are significant. Social support can enhance emotional well-being, reduce stress, and improve overall quality of life. By fostering strong relationships and engaging in supportive communities, individuals with trichotillomania can create a foundation for long-term success.

You're Not Alone

If you're dealing with trichotillomania, please remember that you're not alone. This is a real condition, and there are people who understand and want to help. With the right strategies and support, you can manage trichotillomania and live a fulfilling life. Remember, seeking help is a sign of strength, and there is hope for recovery and long-term management of the condition. Let's recap the key takeaways from this article and reinforce the message of hope and empowerment. Trichotillomania is a complex condition characterized by the recurrent pulling out of one's own hair, resulting in noticeable hair loss. It is classified as a Body-Focused Repetitive Behavior (BFRB) and is often accompanied by significant emotional distress and social impairment. The causes of trichotillomania are multifaceted, involving genetic, neurobiological, and environmental factors. Understanding the underlying causes of the condition is essential for developing effective treatment strategies. Coping strategies for trichotillomania encompass a range of behavioral, cognitive, and lifestyle techniques. Habit Reversal Training (HRT), mindfulness practices, stimulus control, and relaxation techniques are among the evidence-based approaches that can help individuals manage urges and reduce hair-pulling behavior. Long-term management of trichotillomania requires a proactive and consistent approach. Building resilience, maintaining coping strategies, and staying connected with supportive individuals and communities are crucial for sustaining progress and preventing relapse. Seeking professional help is a sign of strength and self-care. Mental health professionals, such as therapists, psychologists, and psychiatrists, can provide specialized care and support to help individuals overcome the challenges associated with hair pulling. Support groups and online forums offer valuable opportunities to connect with others who have trichotillomania. Sharing experiences, coping strategies, and encouragement can create a sense of community and reduce feelings of isolation. Remember, trichotillomania is a manageable condition, and recovery is possible. With the right strategies, support, and self-compassion, individuals can live a fulfilling life, free from the grip of hair pulling. Take the first step towards healing by reaching out for help and embracing the journey towards well-being. You are not alone, and there is hope for a brighter future.

I hope this helps you guys understand trichotillomania better and gives you some tools to cope. Take care of yourselves!