TW: Mentions of Trichotillomania, Dermatillomania, and self harm.

Over the last twenty months – the period dominated by my latest depressive episode – my hair pulling has been much less of a problem, something that tends to happen when I’m really depressed; it’s like I’m too depressed to pull. I guess that’s something to be grateful for while incredibly depressed (scraping the barrel but it’s something, or at least not nothing). But, over the last few months, my hair pulling (and other BFRBs) have returned with pretty frightening force.

As I said, it’s been a long time since I’ve been seriously pulling at my hair. But in the last couple of months, the urge has come roaring back with relentless intensity. Whether this is connected to starting the Phenelzine again, to beginning the escape from The Great Depression, or something else altogether, I have no idea but it’s a frustrating and exhausting to be back here again, back to pulling so much and so often that I have constant pain in my shoulder and arm. It hit me a while back that it will, in a couple of months, be ten years since I started pulling, which has been a pretty overwhelming realisation – I never thought it would become such a permanent part of my life.

I also started picking at my skin, which isn’t something I’ve ever really done and certainly not to the degree that I pull my hair. Frustrated by the imperfections of my fingertips, I ended up compulsively chewing on the callouses that had recently developed on my left hand (coming out of the depression, I’d started playing the guitar again and the callouses on my left hand – my string hand – had begun to reform); it got so bad and I’d gone through so many layers of skin that I couldn’t touch anything without pain. How they healed, I have no idea. I was also picking at my nails and the skin around them. My fingers were a mess, raw and painful and I ended up going through multiple packs of plasters in my attempts to stop. But, of course, I’d start picking at them as soon as I took the plasters off so they really did take ages to recover, and it was even longer before I could play guitar again.

And as if both of those behaviours weren’t enough, I was compulsively scratching at a half healed self harm cut on my face. It had started to heal but then suddenly I couldn’t leave the scab alone, reopening the cut and eventually making it bigger and bigger. I wasn’t trying to stop it from healing exactly but in my mind, the uneven, ‘imperfect’ edges needed to be fixed and so I kept trying to smooth them out, make them neater, make them symmetrical, or… something. It’s completely illogical because I was just making it bigger – just making the wound worse (and at this point, it really was a wound) – and more likely to get infected but I couldn’t help it.

I just could not stop myself. I tried so hard – trying every strategy I’ve ever used, every one I could find on the internet – but I still felt like I was losing my mind – and I mean that literally – if I didn’t do it, a feeling that got worse the longer I tried to stop myself. In the end, I always broke and my fingers found their way back to whichever of the three was their favourite at that moment in time. And it was always worse if I was extra tired or extra stressed. The only way to in way curb it – the behaviour if not the compulsion – was to cover the skin I was attacking, plasters over my fingers and a dressing across my face (that one was harder and less comfortable to explain). That didn’t stop me trying, constantly fiddling with the edges of them, and my hair bore the brunt of that coping mechanism. I ended up buying a hat that I could tuck all of my hair under but even with all of that in place, the urge to pull or pick got so bad sometimes that I simply gave in to it. Sometimes it was just too hard.

(On the left: before we found the correct dressing // On the right: in the early days when I’d only chewed on two callouses)

Jump to a few months later. My callouses finally healed and, after a period of using the wrong type of dressing before switching to a better one, my face recovered for the most part too although there’s still a scar. With those ‘imperfections’ ‘perfect’ again, hair pulling has become the main problem again. The urges are less than they were but still pretty relentless – perhaps a side effect of restarting the Phenelzine after all? – and I’m so fucking tired of the whole thing. I don’t know what to do, how to stop; I’ve seen so many people say that it’s not actually possible. But I don’t want to live like this. As I said, I don’t know what I’m going to do but I think I might try hypnotherapy; I’ve heard that some people have had positive results. So I guess we’ll see. Ten years is long enough.

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