March 6, 2024
Hello doctor,
I suffer from an embarrassing problem. I pull my own hair. Mostly it is from my head. Or eyebrows. Rarely from my private parts. I lost my father to Covid. I stay in a paying guest accommodation. I work as an HR manager of a reputable company in hybrid mode. I have started using an expensive wig nowadays to hide my bald patches. I don’t want medication doctor. Help me with some techniques to self - heal.
Anonymous
Dear Anonymous,
I am sure you know that this hair pulling disorder is also called as trichotillomania. It was initially conceptualised as an impulse control disorder. But currently it is thought to be an obsessive compulsive disorder like condition. Anxiety, undiagnosed depression, low self-esteem and in some cases complicated grief may be contributing to the condition. Habit reversal training and behaviour therapy are non- medication ways to treat this disorder. Wearing a wig may be counterproductive as it is an easy escape from actually trying to resist the compulsive hair pulling. Seek professional help of a psychiatrist to understand the severity of the problem and diagnose other comorbidities. You will then be referred to a trained clinical psychologist for behavioural intervention. If the condition is very severe medication will make a huge difference. Mild cases can be treated with therapy alone. Selfheal would include keeping oneself busy, to stay in public place at times when you want to pull own hair, cultivating a hobby, exercising regularly, taking breaks from work periodically and rewarding self when you are able to reduce hair pulling. The first step to healing however is acceptance. Best luck!
Dear Dr Supriya,
I am mother of a daughter who has not stepped out of the house since 6 years. I read about you online. We don’t stay in India. It started when she was in 12th grade. She is 37 years now. She started believing that her classmates were making fun of her. Initially we thought it was true. Later she said they were tracking her and following her home. We were initially not able to give her adequate medical attention as my husband’s job was unstable at that time and I had another special child to look after. She is on olanzapine 10 mg and has put on lot of weight. She occasionally still talks about her persecutors. But mostly she is by herself, does not talk to us much and avoids visitors. Is there any hope for her to get better? Should I get her for treatment? She has been diagnosed with schizophrenia by her previous doctor. Can I ever stop these medications?
Sherley
Dear Sherley,
According to the history given by you, it is a possibility that your daughter has schizophrenia. It’s a lifelong disorder which needs antipsychotic medication. Initially symptoms such as hallucinations and delusions will be prominent and slowly negative symptoms such as lack of motivation and social withdrawal predominate. As she has been on olanzapine for a long time which is on sub- optimal dose, it will be worthwhile to get her for treatment. Changing the dose or starting another antipsychotic may prove helpful. Option of adding medication which improve negative symptoms is also there. Stopping the medication will worsen the condition and functioning. There are non-medical options such as psycho social intervention techniques which might improve her day to day functioning. All the best!
Dear Doctor,
I am a divorced woman who wants to remarry. I was working in Oman for 10 years. I have now returned to India. I started chatting with this man online 2 years back who is on the verge of divorcing his wife. We have met few times. He is kind and affectionate. However he does not have a stable job. I have already lent him 5 lakh rupees to start a business. Recently I thought he was two timing me and I checked his phone. I was shocked to see that he was sexting with at least 2 more women. I was shattered. I have not confronted him. I am torn between the hope that he will change if I make him realise his mistake, and cutting him off from my life. I am quite lonely and have no friends. My siblings are abroad and I have no parents. Madam in your experience, what should I do?
Priya
Dear Priya,
You have very good insight. You seem to have understood the complicated situation you are in. He is cheating on his wife with you. He is also sexting others which is also a form of cheating. Have you considered confronting him with evidence in hand? Have you made any plans of how you want to get the money lent to him back especially if you are planning to let him go?
How will you keep yourself physically and emotionally occupied if you break-up? The other way of handling it would be confrontational with evidence, full emotional drama and if you continue in the relationship, constant fear of being cheated again. It’s up to you. Take care. Seek professional help with a psychiatrist to help you cope with this challenging phase in your life.