There’s a lot about the disorder you won’t ever know unless you have it. Dictionaries, confessional Youtube videos, and news features will give you some portion of the truth, but never the whole of it. They’ll touch briefly on certain points, but never dig deeper. Sometimes they’ll even make the confessors look silly – as if they’re crying and baring their soul over an addiction to lip gloss, or something similarly shallow and aesthetic.

Merriam-Webster defines “trichotillomania” as “a compulsion to pull out one’s hair”, which is concise and altogether pretty painless-sounding. Clean, antiseptic. It makes the word sound cute, almost. Not like fluffy-puppies-and-kitties cute, more like an exotic sort of abnormal seahorse. Something bizzare, that if it wasn’t a bit adorable it would probably be grotesque, slightly alien.

It’s not adorable.

It’s a common disorder in toddlers, one that shows up out of nowhere and then disappears fairly quickly; doctors usually advise to just let it run its course, the child will grow out of it soon enough, no harm done. Nobody really knows why the child starts doing it, or continues to do so, or stops when he does, but since it’s not too terribly rare they let it be.

Adult onset trichotillomania, however, often doesn’t begin until the late teens or early twenties. Some people recall the exact instant they started pulling, that one hair that was bugging them, quickly removed as painlessly and thoughtlessly as if it were a grey. Sometimes the hair doesn’t have to be special, although many with the disorder confess that they tend to only pull certain types of hair.

And it starts there. You pull when you’re by yourself: reading a book, watching television, lying in bed waiting to fall asleep. Half the time you don’t realize you’re doing it. You pull in class, during lecture, self-conscious every time you catch yourself for fear that the instructor thinks you’re just playing with your hair, ignoring the lesson, even though you pull thoughtlessly. You hate sitting with friends in places with tile floors or light-colored carpets; when you get up from your chair after a half hour, or an hour, or more, there’s a pile of orphaned hairs, long and wispy, scattered about the floor near where your feet had been. The shame burns hot in your face, and you wonder if anyone else notices them. If they do, they never say.

Professors think you’re raising your hand in class repeatedly. What do you tell them? Just, “oh, no, I wasn’t” over and over again? Or do you explain, “Ignore me, I have this weird problem I can’t control”?

Friends and family might catch on after a while, after they see the thin spots on the back of your scalp or along your part. Family will suggest you get psychiatric help for your “self-mutilation problem.” Friends will swat your hand, bark “hair!” at you, ask you repeatedly why you continue to pull, as if you can help it. “Doesn’t it hurt?” they’ll ask. “Won’t it eventually stop growing back?”

You will develop more clever, surreptitious ways to pull. You might pluck at your eyebrows, or your eyelashes. Arm hair. Leg hair. If you are at the more extreme end of the disorder, you will pull out your pubic hairs in the privacy of your own bathroom, where no one can swat your hands or bark at you, and the wages of your sin can be efficiently disposed of. Few go this far.

You might have a ritual to accompany your pulling. You might simply run the hair through your fingertips before casting it away, feeling the ridges and the kinks in it, as if reminding yourself why it is you do this. You might bite the root of the hair before you drop it, feeling the tiny crunch between your teeth. You might eat the hair entirely, at which point you are likely forming what is called a trichinobezoar, which usually can only be removed with surgery.

Your therapist might give you medication, which will often make it worse, or maybe advise you to keep a scarf in your hands at all times, which doesn’t work, or maybe a marble to roll in your fingers to keep them busy. This will work for a while, maybe a few weeks. Then you will learn the skill and dexterity needed to hold the marble in your fingers and pull at the same time.

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