Pulling Her Hair Out

Dear Dr. Darcy:

My friend is very anxious and she behaves in some pretty strange ways.  For starters, she doesn’t really like to leave her house.  And she comes up with many reasons for why she can’t leave the house.  One of the things she does is pull her hair out of her head.  Over the years this has resulted in some balding spots on her head and now this is the most recent excuse for not leaving the house.  She also cannot/will not attend any social functions where she can’t wear a hat or a scarf to cover the bald spots.  We’re in our early 30’s and EVERYONE is getting married so we are ALWAYS invited to weddings and engagement parties and she’s literally losing friends because she never attends.  What should I do as her friend?


Your friend is very lucky to have you.  And she’s a hot mess.

You are correct:  She’s VERY anxious and really needs to see a therapist pronto.  What she has is a condition caused by anxiety called trichotillomania in which an individual compulsively pulls or twists their hair, resulting in hair loss.  It is fairly common for people with trichotillomania to have other anxiety-related issues, like social phobia or agoraphobia (fear/avoidance of leaving the house).  Sounds to me like your friend may have both, though I suspect that they are secondary to the trichotillomania.

I want to be clear that there’s no shortcut to a cure here.  She needs to get into individual counseling and see her therapist at least twice a week.  However, there are some things she can do immediately that will help begin the process of change that she’s going to experience in therapy.

For the last year and a half, I’ve personally used and required that each of my clients use a program created by Centerpointe.  It’s a meditation program that employs the use of binaural beats to create a host of positive neurological and emotional results, which include decreased anxiety, decreased depression and increased focus.  I would encourage your friend to request the free demo CD by clicking the ad that is on AskDrDarcy, but again, this is NOT a substitute for much-needed therapy:  It’s to use in addition to.

It sounds to me like you are attending the social events that your friend is avoiding.  Good for you.  The worst thing you could do is become her partner in crime, staying home with her holding her hand, enabling her to become more of a social recluse.  Furthermore, it’s important to your social and emotional health that you continue to maintain your relationships with your friends.

At the end of the day, all you can do is suggest to her that she needs therapy.  You can’t make her go.  And you can’t save her.