‘My coping mechanism for stress? I pull my own hair out tuft by tuft’

In stressful situations, some people keep calm and carry on. Others scream and punch the walls. My coping mechanism is more . . . idiosyncratic. Under the cosh, I pluck my hair – tuft after tuft (after tuft).

The condition has a name, I recently discovered. Trichotillomania is defined by Wikipedia as “an impulse control disorder characterised by a long term urge that results in the pulling out of one’s hair”. This newsflash didn’t bring much relief. It just made me feel like a weirdo (I am not a weirdo).

But perhaps science has been on my side all along. In a new book, science writer Sharon Begley argues compulsive behaviour – whether hair pulling or therapeutic wall-punching – is a subconscious coping strategy. Ours is an increasingly unstable world, where even something as apparently straightforward as opening the correct envelope at an awards ceremony is freighted with complications. Maybe we act crazy to prevent ourselves going crazy (I am not going crazy).

"The insecurity inherent in 21st-century global capitalism permeates every corner of life, which seems to be cartwheeling beyond our control: play by the rules, act responsibly, and you can still wind up jobless, partnerless, and unfulfilled. How can we not feel anxious?," Begley writes in Just. Can't. Stop.: An Investigation of Compulsions.

“Parents a couple of generations ago did not,” she continues, “stress out over getting their children into the ‘right’ preschool, nor did yesterday’s teenagers and new graduates agonise over once-trivial choices such as what summer job to get or extracurricular activities to sign up for.”

Compulsiveness, she contends, is an outlet valve – not an indication of the imminent loss of one’s marbles. When we meticulously arrange our books or records we are asserting dominance over that tiny sliver of the universe it is in our gift to control. The individual agonising over a unevenly hung photograph or tooth-paste smudges in the sink or is obsessed with having the “perfect” Instagram feed is attempting to bring order to their life. It’s impossible – yet simply trying makes us feel better.

“Suffused and overwhelmed by anxiety, we grab hold of any behaviour that offers relief by providing even an illusion of control . . . We cling to compulsions as if to a lifeline, for it is only by engaging in compulsions that we can drain enough of our anxiety to function,” Begley argues.

I have never regarded myself as especially anxious. Obviously, I worry about the usual things (the mortgage, the kids, the fact that the Wifi signal constantly drops when I’m watching Netflix). But I don’t lie awake at night staring at the ceiling. Yet, I’ve been a hair-puller all my adult life. What might be churning under the surface? And ought I investigate – or are some things best left simmer in secret?

Trichotillomania is uncommon but hardly unusual. One in 200 individuals struggles with hair-pulling, according to Anxiety UK, with women in a majority (actress Olivia Munn has the dubious privilege of being the highest profile “trich” sufferer).

Typically the habit manifests in adolescence and is especially common among those preparing for exams (mine first became an issue in the months leading to my Leaving Cert). Side-effects include lower self-esteem and, also, not having much hair (when you’ve removed your eyebrows, sweat has a habit of flowing uninterrupted into your eyes).

On the positive side, there are worse urges one might suffer. Trichotillomania is just one among several impulse control disorders. Related conditions include substance abuse and – hurrah – kleptomania. At least I’m not typing this from a crack-house or on a laptop I acquired by stuffing down the front of my tracksuit at PC World.

The big mystery is how and why my trichotillomania is triggered. After all these years, I can't give you a straight answer. Stress is an occasional factor. At other times, the compulsion simply drops from thin air, like an anvil in a Looney Tunes cartoon.

And, as with many obsessive habits, when it has you in its grip you experience it as a curious duality. You are aware what’s going on but powerless to exert any control. It’s as if someone else is pulling the hair and you’re a helpless onlooker. The levers are being manipulated – but not by you.

“I realised about four years ago that I had “Trich” although I have always twirled and pulled my hair since I was so young,” say Lesley Stevens, who writes about her struggles with the condition at Trichotillomaniablog.

“It really just hit me that I couldn’t stop this behaviour as adult. I began to do some research and it didn’t take long before I realised what I was dealing with. I cope with it by trying to keep my hands busy and my hair tightly clipped back so I can’t touch it.

“I had it my whole life before I ever realised. I can remember being very little and dealing with this but it was natural to me. Suck my thumb and pull my hair – they were simultaneously always happening.”

“A person who approaches me for treatment of trichotillomania is very likely to be highly anxious and to have certain cognitive obsessions – what other people think of them and time worries,” adds UK-based Dr Neomie Da Costa, who treats those with trichotillomania with hypnotherapy and behavioural therapy.

“However, this is not the case in everyone. Five per cent of people I work with do not appear anxious and don’t claim to be. Social anxiety is more common in an English trichster than someone from somewhere else in the world so there is definitely also a cultural element.”

Because you are deeply invested in the state of my eyebrows, I will tell you I’ve been “pull free” for several weeks now. But who knows when and how the compulsion might be triggered? It comes and goes. The schedule remains entirely mysterious to me.

Obsessive traits can seem at odds with our idea of who we are and how we should act. Maybe that’s why they impact on us so profoundly. We are forced to hold a mirror to ourselves. What we see is not always flattering.

"Underlying every compulsion is the need to avoid what causes you pain or angst," writes Begley in Just.Can't.Stop. "Compulsive behaviour is not necessarily a mental disorder. Some forms of it can be, and people in its clutches deserve to be diagnosed and helped. But many are expressions of psychological needs we all feel: to be at peace and in control, to feel connected and to matter. And if those are mental illnesses, we're all crazy."

Just. Can’t. Stop.: An Investigation of Compulsions is published by Robinson Books