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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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.

Tags: pull diary, cognitive behavioral therapy, anti-depressants, dermotillomania, skin picking, nail biting, trichotillomania, ocd, bald spots, trichster, trich by Isis
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still pretty bad.  the whole right side is becoming bald… starting to creep further around the back of my head and the top of my head where it’s reachable under the extension cap…

scalp is starting to get swollen from the trauma.  It feels so good that I can’t stop.  but it’s making me feel awful… knowing how long it’s going to take now for that to grow back.. it’ll start to look normal maybe 6 months from now..

it’s pretty constant now.  during class, in the car, and at night in bed are the worst times.  It feels like I’m always pulling.  There are piles of hair everywhere.  It’s gross yet doesn’t stop me from what I’m doing.   Thankfully I’ve been able to leave my lashes and brows mostly alone… although I plucked a little from those areas too.

at the point where I feel helpless and hopeless… =/   and so stressed out about it starting to become noticeably visible even under the extensions…  people are going to start asking any day now, I know it….

I think I’m going to give my therapist a call tomorrow.  I have an appointment to see her on Weds, but I don’t think I can wait that long .. I need some help….

Tags: pulling in class, follicle biting, sore, pulling in bed, pulling in morning, pulled all day, constant pulling, embarrassment, pulling at night, follicle obsession, trauma caused by pulling, hair extensions, ttm, trich, trichotillomania, pulling, relapse, trichster, bald spots, stress 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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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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