Sanitywarp.org:: Diary of a Trichster

Over the last couple of weeks I’ve been talking with my doctor about trying medication (again) for my severe trichotillomania, which has been persisting since age 14.  (I am now about to turn 30, so this has been going on over half my life.)  In the past I tried Cymbalta, and Zoloft, and Naltrexone.  After 4 months on Cymbalta, I didn’t notice much of a reduction in my pulling urges, or in my OCD symptoms, either.  So I discontinued that.  Discouraged, I didn’t try another medication until last year, when I tried Zoloft.  After a few months of this, I didn’t like the sexual dysfunction side effects and discontinued that medication as well - I was not seeing any benefit from this medication either.   I gave Naltrexone a shot for 3 months and didn’t notice any improvement with that either.

I have been doing Cognitive Behavior Therapy for 1.5 years now - it shouldn’t have been for this long, but I had several interruptions in the treatment (changing of doctors due to them leaving, going on pregnancy leave, etc)

At this point in time I feel that I’ve somewhat exhausted some of the CBT methods to the point where they aren’t as meaningful, so I am going to try the combination of CBT and medicine now.

After reviewing more choices, my choice now seems to lie between Clomipramine (which seems to have show the highest success rate for Trich) and Welbutrin, which has also been shown to be effective for some.  I’ve been going back and forth between these 2 for some time.  It’s hard to decide … I’d like to go for the Clomipramine because of it’s documented success rate - however, I have other additional problems as well, including anxiety, attention deficit disorder and depression - all of which Welbutrin can impact positively.  The clomipramine focuses solely on the OCD-like symptoms… less on the depression and concentration issues.

Then again, do I really want to be on one of these long-term?  I feel as if I don’t, but the attention issues are certainly a problem that will persist for some time.  If the Welbutrin does help with that, then perhaps I would want to continue taking it for at least a few years.  The clomipramine I’d be more likely to want to discontinue sooner, probably.  My OCD symptoms alone aren’t bothersome enough to really interfere in my life, but I am skeptical that a year on medication and some CBT will cure a life-long problem.  So then.. perhaps it WOULD be better to stay on a medication long-term (a few years)… and if so, it might as well be one that’s beneficial in other ways…  like the Welbutrin.

The sexual side effects, well… I’ve decided that this time.. that’s not worth it.  A few years ago I was younger and that sort of thing seemed more important … orgasms were something I refused to give up then.   This happens to be a good time to try again though, because I am not in a relationship, for the first time in awhile… so I feel that any sexual dysfunction now wouldn’t be as much of an issue.

So then.. I guess the decision has been made… I hope it is a good one.  I will begin on Welbutrin (Bupropion) .. 100mg… today. At the moment I am still with a shaved head to avoid all temptation of pulling.  In a few months, the bald spots currently present, should be filling in… and by then, hopefully the medication and the CBT will be working well.

I hope this will help me…   here goes.

Tags: cognitive behavioral therapy, trichster, zoloft, naltrexone, welbutrin, clomipramine, ocd, depression, medication, cymbalta, trich, ttm, trichotillomania, Uncategorized by Isis
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The extension cap has moved further back and is exposing the crown, which I’ve already caused a lot of damage to.  The snow DID indeed cause my appointment last week to be cancelled, and my only other option was to wait an entire week to schedule for the following Wednesday.  Thanks a lot, New England.

In this time I’ve been particularly bad.  I haven’t seen my temporary therapist in some time now and I don’t much see the point of even going to see her at this point as my regular therapist is almost back from her leave.  I will probably see the temporary one more time in the interim.   And hopefully my appointment this Weds will be kept, although it looks like we’re getting even more snow soon. Wonderful!    If not for my appointment getting cancelled last week, none of this severe crown damage would have happened. I am very upset about it.  =(   It’s going to take a very long time for that to grow back now.

The hair on my sides is entirely missing again, as it usually is, but thankfully the extension cap does a good job at hiding this.  The pain and soreness of my scalp is a depressing reminder of the tearing and ripping ..  which I did some of… but usually, it was the singular pulls, and that’s really what kept me locked into doing it for so long.  Everything about it…  the feeling of the hair.  The pleasurable feeling when the hair was pulled… the sound it makes.  Somehow even the sound is good right now.  And of course the biting of the follicle.I just try to remember that right now I’m in a pulling state … and that for awhile, my mind was completely removed from all of this and in a more normal state.  I will be able to get back there again, but I’m going to need the help I was getting before.  And until then, all I can do is try and hide it.  =/

Tags: pulling in bed, obsession, follicle obsession, sore, follicle biting, embarrassment, pulling in morning, pulling in class, follicles, relapse, trichotillomania, hair extensions, ttm, depression, pulling from scalp, crown, trichster, bald spots, trich by Isis
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The disease is once again spreading.  The extension cap has become loose on top and I’ve been able to get at the crown.  :(    It is very bare in some places now.

Getting the cap re-sewn on Wednesday unless the snow storm causes the salon to be closed… I really hope not…

Kind of depressed.  Wanting this month to go by faster so my usual therapist is back from leave and I can resume work with her..

Tags: crown, depression by Isis
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Still doing poorly.  The urges are frequent and usually very strong.  The side areas on both sides are now very bare… once again.  The only reason the crown isn’t in the same state is because of the weave cap covering the top.  It’s itching now as I speak.  I hate wearing these things, but without them… I’d have no hair.

and so the struggle continues.  The depression regarding the situation is said to make me more prone to pulling episodes, so it’s like a vicious cycle.  I need to re-find that motivation that I had so much of for awhile, not so long ago.  Quitting hair pulling is such hard work.  Although, I’ve taken note of the fact that for me, a lot of the temptation of pulling has to do with biting the hair follicle afterwards.  I’ve been aware of how much I liked this aspect of pulling all along, but didn’t stop to think of how much less I want to do it, if I CAN’T bite the follicle afterwards.  The follicle itself is such an obsession.  The way it looks… the plumpness of a “good” one… the little pop it makes when you bite it… and sometimes, the irregular ones… with a red tip (that no one seems to know exactly what it is…) that makes the follicle harder and pop more when it’s bitten. It’s like a sick kind of “prize”.  (If the hair is white, follicle or not, that seems to be another reinforcement of the behavior…as it’s another irregularity)

This whole part of the ritual is quite powerful.  I’ve tried gum before but it’s too easy to push it to the back of the mouth to bite with the front teeth.  As silly as this sounds.. during Halloween time, I had my custom vampire fangs in, the kind that just fit over the two front teeth… and it made it impossible to close my mouth all the way while they were in.  There were several times I went to pull a hair and then stopped, mid-reach, thinking, “I can’t bite it…”  and this actually stopped me.   I told my temporary doctor about this and she very seriously suggested that I wear the teeth more often, when I am at home alone and most vulnerable to pulling.

so… I guess I’m going to try that although it’ll take some getting used to.  I need a crutch until I can find my strength again. =/    gloves help too… but only for awhile until my hand gets unbearably sweaty and I take them off…

Tags: follicles, self esteem, white hair, trauma caused by pulling, follicle biting, follicle obsession, relapse, trichster, hair extensions, ttm, trichotillomania, depression, bald spots, pulling, trich by Isis
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well, it’s been a month now since I started cognitive behavior therapy (CBT).I am sad to say that I don’t see much of a difference yet.  My awareness has been increased a bit, but it has gotten no easier to stop the behavior, despite coming up with a list of incompatible behaviors (putting a hat or gloves on, clasping hands, moving around, etc) … the urge is just too strong for any of that to work.

so, I am taking the plunge and trying medication to go along with the CBT, which is the most successful way of going about this…….I am not sure which medication will be tried first, but I am sure there will be a period of unpleasant trial and error, and I’m sure I’m not going to like the side effects of whatever SSRI I am taking… but… at this point, I am willing to sacrifice other things (like my sexual functionality, which is what the Cymbalta / Duloxetine messed with when I tried it, and the main reason I stopped taking it) to try and conquer this…  if there’s any time to really try medication again, it’s right now.. I seem to have no other choice.  It’s becoming incredibly difficult and frustrating to hide my scalp, which is at least 50% bare, especially from my significant other.  It actually distresses me quite a lot when he wants to spend the night with me now, because it’s extremely uncomfortable to sleep with clip-on extensions (they pull at the hair I do have, making my scalp very sore in the morning)  aside from the fact that the hair is all gross and poor quality now because of sleeping on it so often.  I like seeing him but I find myself wishing he didn’t call me so much, just because of the hair thing…  *sigh* I should be happy to spend time with him =(

I had a massive session just now while writing a final paper for school.  It was just awful… I couldn’t stop.  I even pulled my pubic hair (after I tried putting on a hat, the trich monster just moved along somewhere else) for over 20 minutes which is something I haven’t done in a REALLY long time.  :(

I did dye my roots last night in hopes I won’t get stuck in the mirror pulling all my numerous amounts of grays anymore….

I really hope I can get better.  :(

I will update as things progress..

Tags: school stress, pulling at night, pulling at desk, follicle biting, peer pressure, embarrassment, mgh trich clinic boston, pubic area, significant other, anxiety, cognitive behavioral therapy, treatmeant, restlessness, white hair, trich, ttm, medication, stress, cymbalta, hair extensions, trichotillomania, bald spots, crown, pulling from scalp, pulling, depression, duloxetine by Isis
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