Don’t know why, but today was a weaker day with the bad habits. I’ve been doing well up until today. But today, while bored, I chewed several of my nails (on my right hand) down so far that they hurt. And just now while laying here with my laptop, doing some work on the computer, I started pulling my right eyebrow significantly.
Tomorrow… my welbutrin dose doubles to 200mg per day…
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.
Wednesday morning, on 9/21, I cut off all of my hair extensions. I decided to go back to being bald for awhile. I kind of missed having a shaved head, since I’m one of the few girls it seems to look good on. I’ve gotten a lot of compliments on it already!
I had mixed feelings during the process. Halfway through, I struggled, looking at myself in the mirror and thinking back to all of the times in the past when I’ve shaved my head because I HAD to. I didn’t “have” to this time, although after cutting the extensions off I never would have been happy with the short hair underneath. So in a way, all of the old feelings of failure came back while I was doing this.
But I’ve decided that since there seem to be no more interruptions in my treatment in sight, I’m going to give it all I’ve got, with a big push and instead of having the temptation right in front of me and struggling the whole way, I would simply remove the temptation and make things easier for myself. Now, my plan is to keep the hairstyle for a few months until the bald patches fill in, go forth with my CBT training plan, and hopefully begin to grow the hair by Jan or Feb.
I have also decided to try giving medication another shot, because recently, in the last several months I have developed another repulsive behavior… Dermotillomania .. it started with scratching my scalp because there was dandruff… I would look for this under my fingernails afterwards and eat it afterwards. Then I began causing sores because of the intensity in which I was scratching, and that soon led to searching for scabs, pulling them off, and eating them. Never in my life have I had this problem, and I am 29 years old right now. The fact that at this age, I have developed this kind of problem, signifies to me that my obsessive grooming issues are only getting worse, and that medication is not only a good idea, but could be necessary at this point. I am causing more self-harm than ever before, and I haven’t been able to get on top of it even with psychotherapy. I’ve also had to remove my acrylic nails for work over the last few months, and my nail-biting has become quite extreme again. So, I am going to try and work on all of these issues at once, with the help of my wonderful therapist.
And so I am meeting with my doctor on Tuesday to discuss a treatment plan and decide what medication to try next…. now that I’m no longer in a close relationship, the sexual side effects of the antidepressants won’t bother me … in fact, having a lower sex drive might actually be a GOOD thing for me right now, since I’m not in a relationship.
That is all for now… I hope to begin writing in here regularly again to keep track of my progress.
haven’t logged in awhile… but nothing really to report. not much has changed… hasn’t gotten better, hasn’t gotten worse. coping with a large amount of bald spots. trying to get back on track with my CBT therapist..
man. So I’ve had a better week with the hair pulling… however, while writing an email just now, and laying in bed (another trigger.. .I probably should have been more cautious about this even just due to those 2 factors…) I was stressing out over the situation… and barely even noticing that I was steadily pulling at my right eyebrow this entire time. Now… 20 minutes later… the email is written, and sent. And I am missing almost my entire eyebrow. =(On a regular basis I often think to myself, “It’s ok. At least I’ve had my eyebrows for a long time.” Eyebrows used to be a big problem for me…I hardly ever had full brows a year or two ago. I was constantly worrying about the drawn in eyebrows coming off in situations. Especially around my boyfriend. Now I’m going to see my boyfriend tomorrow for the first time in awhile. Spend the night… and be all worried about my one eyebrow smudging off, the whole time…into the night, and the morning. Now I have to carry around an eye pencil again and worry about putting on makeup for the next month until it grows back. =( The next MONTH! And I’m going on a vacation in 2 weeks with a friend… where we’ll be swimming… thank god this is a trusted friend who knows about my problem… so I don’t have to be as worried… but still… it looks awful……….. I look diseased again =(This just shows how dangerous and aggressive pulling can be when it’s a secondary action… my main action was writing the email, but there was stress involved, on top of a trigger situation… and I wasn’t able to work hard at resisting…. and it just happened so fast… now the aftermath is going to last for a long time. =( Blahhh. After I had such a decent week with the other hairpulling…This is the first time in I can’t even remember how long since I’ve had missing eyebrows…. dammit… I hope I can hold onto the other one and that isn’t the next target…..