Monday, March 28, 2011

A confession of sorts

I thought today, pretty much out of the blue, I'd try and be really brave.  I wanted to talk about something that's totally embarrassing for me.  As in embarrassing enough that I never even mentioned it to the various therapists I've seen for my eating disorder.  (On a side note, can I just say how ridiculous it is to be embarrassed to talk to someone you're already paying to listen to your craziness.)  And it's silly that it's this hard to write but that it's not hard for me to write about anorexia symptoms.  I guess it's the same as how I have trouble talking about the binge-eating I've suffered.  Anorexia is just more socially acceptable.

Anyhow, here goes.

I suffer from trichotillomania. 

It's a scary name and don't worry if you haven't heard of it.  Most of my brother's psych major friends haven't even heard of it.  Basically, it's a psychological disorder charaterized by repetitive hair pulling.  (Wikipedia is good if you want to know a little more.)  So when I'm stressed or bored or sometimes for no reason at all, I pull my hair out.  It really takes the phrase "tearing your hair out" to a new level!  I'm lucky in that I've always had incredibly thick hair (seriously, I used to have my hair dresser thin my hair), that I only want to pull a strand at a time (some people pull clumps), and that places where I feel the urge to pull from are in the middle of my head so it's never been noticeable to anyone but me.  But I know.  I can look at my hair and tell, based on the number of short strands growing back in, how stressful the past few months have been for me.

I was around 14 or 15 when it started, long before the anorexia, though years after some of the other food issues.  But I definitely think it's all connected.  I find when I'm under stress, even if I manage to keep the eating under control, the hair pulling ramps up.  And I've often compared the two, as in both should feel bad but somehow for me they don't.

I saw a therapist for trichotillomania, before the anorexia.  He talked about how it was impulse control disorder, like pyromania or kleptomania.  I remember nodding along but somehow it never seemed to fit me.  I didn't feel a sense of rising tension before I did it and a release afterwords.  A recent journal article really made it make so much more sense to me though.  Basically, they say that hair pulling in people with eating disorders seems to have more in common with OCD-type compulsions than impulsive urges.  And although I've never been diagnosed with OCD that really clicked.  For me this reduces anxiety, the same way repetitive handwashing does for other people.  The problem is that it's not a real fix for the anxiety, even though it makes me feel better.

So, I guess this isn't completely out of the blue.  It's probably not a surprise that this has been a particularly stressful couple months with the boyfriend's grad school stuff and all the uncertainty.  And I've noticed that while the eating has been okay for the most part, the hair pulling hasn't been great.  I need to be utilizing my healthy techniques for handling anxiety more.  And keep thinking about whether or not more therapy could be useful at this point in my life.

My parents obviously knew about the hair pulling but I think, like the anorexia, they like to assume that it's behind me.  And that's about it.  I've told my boyfriend "I have some obsessive-compulsive issues related to the eating disorder".  But I've never told a friend or other family member.  I still wouldn't.  I'd be way too ashamed.  And yet, I've told more that a few people about the eating disorder.  But I feel good about having talked about it here.  It's good to get some things out in the open I think.  It removes some of their power.

And I'm not even going to reread this because I think if I do I won't post it.  So apologies for the rough draft but I'm hitting publish.