No, I Can’t Stop Pulling My Hair Out

I first started pulling out my hair in August 2014 and looking back at everything that happened that summer, it’s probably not surprising that I developed a compulsive behaviour. I was already struggling with my mental health and then, in the space of a few weeks, an important relationship fell apart and I had to have my cat (who I’d had all my life) put to sleep very suddenly. And I was just about to start university. I was overwhelmed by my anxiety and depression and in the lowest place I’d ever been. I was probably desperate to regain some control and when something started affecting the texture of my hair (my money is on the new medication, Phenelzine, which I’d just started taking), my inner perfectionist went into overdrive, tearing out the hair that felt different. At first I was fixing the problem – getting rid of the hair that felt different to the rest – but, of course, it grew back, creating a whole new problem. Then I was tearing out the regrowth, as well as the rougher stands, and the whole thing snowballed. Very quickly it reached a point where I felt like I physically couldn’t stop pulling, as much as I wanted to.

At that point in time, I didn’t know what Trichotillomania was and I’m still not entirely sure how I came across it but for those of you unfamiliar with it, I’ll give you a little summary. Trichotillomania is a condition where the person feels compelled to pull their hair out (whether it’s from their head or any other part of their body) and is unable to stop themselves from doing so. Although there are different theories (including mental illness, self harm, and addiction), there is still no known cause and there has been very little research into treating it. While checking my facts to write this, I came across a description on the NHS website which, for me, is very accurate to what it feels like: “They will experience an intense urge to pull their hair out and growing tension until they do. After pulling out hair, they’ll feel a sense of relief.” It feels like there’s electricity under my skin and it builds and builds and builds until I can’t bear it anymore; the only way to stop it is to pull out my hair. Then I can breathe again.

I tried to stop but I always ended up pulling again. It honestly felt like it would’ve been easier to break my own fingers than to stop pulling out my hair. It was only the discovery of a bald spot that shocked me into stopping. I don’t know whether it was vanity or anxiety about how out of control it had become but somehow that gave me renewed focus and motivation. I tried everything I could think of: sheer willpower, sitting on my hands, wearing a hat 24/7 (which, bizarrely, has become part of my image as a singersongwriter), fidget toys, jewelry that I could fiddle with. Ultimately I think it was a combination of these that helped me stop pulling.

I managed a whole year. The first few days were awful. The feeling of electricity under my skin magnified, so strong that I couldn’t concentrate, and I’m not sure when that started to fade. But it did. And slowly my hair grew back. But the urge never went away and just passed the year mark, I started pulling again. The relief was huge. And now, over a year later, I’m still struggling with it.

What I think many people don’t understand about this condition is that it’s not voluntary. I’ve had so many people tell me to ‘just stop pulling’ and that’s really upsetting to hear because I don’t want to pull out my hair. I don’t want to sit, surrounded by strands of my own hair. I don’t want this. I can feel myself doing it and I can’t stop. Sometimes I can stop that action but as the tension gets worse, I end up pulling again – it feels like an endless cycle of trying to stop but knowing that I’ll inevitably start again. It’s so hard. And if the bald patches, uneven length, and permanent damage to my hair weren’t enough, that’s only part of it. There’s an emotional impact; it’s not just ‘pulling out hair’. There’s shame, embarrassment, guilt, and frustration. I hate that I can’t stop, that I can’t seem to control my own body. (It’s also worth pointing out that I also struggle with physical pain in my arm and shoulder from the repetitive motion.)

But I’m not giving up. I’m not sure what I’m going to do next but I’ll find something new to try, a different angle to tackle it from. I won’t give up. I can’t, because I don’t want to live like this.

Coming Off Phenelzine

Just over a month ago, I decided to change medications. It was a long time coming but I eventually managed to speak to my psychiatrist and we came up with a plan. The first step was weaning myself off the Phenelzine and the second was going drug free for at least a couple of weeks to make sure it was out of my system before trying the new medication. I kept notes to track any patterns in mood and since I couldn’t find many accounts of coming off Phenelzine when I searched online, I thought I’d write about my experience. As always, this is only my experience, which will be specific to the dosage I took and the duration for which I took it.

Week 1

I was already on half of the prescribed dose so, to start the weaning off process, I went down to a quarter of the prescribed dose. Very quickly I felt very irritable, snapping at people over things that normally wouldn’t bother me. I was also overly emotional and ended up in tears a lot, sometimes multiple times a day.

Week 2

In the second week, I stopped taking the Phenelzine altogether. My anxiety skyrocketed and remained really high, higher than it’s been in a long time. My mood was also very fragile, so even small things made me very upset and depressed.

Week 3

In week three (the second week without any medication), I felt completely exhausted; some days, I was so tired that I could barely get out of bed. I was very depressed and felt blank, empty, completely disconnected. It was like everything just bounced off me. I’ve gone through periods of feeling like this before so, even though it isn’t pleasant, it wasn’t unfamiliar.

Week 4

Although I’d already been off the Phenelzine for two weeks, I decided to wait a little bit longer before trying the new drug. It was two weeks minimum and I’ve always been very sensitive to medication so I wanted to make sure it was completely out of my system before starting the next one. I didn’t want any chance of an overlap distorting that experience; I didn’t want to risk writing off something that could help over something as small as a few more days. For that last week, I was just really tired. My mood seemed to stabilise a bit and everything just felt less turbulent. It was that settling of my mood that made it easier to think more clearly and I felt ready to try the new medication.

It’s worth pointing out that my mood has been consistently low throughout all of this. I’ve had a couple of days where I felt a little bit lighter but on the whole, I’ve been feeling very depressed, hence the change in medications.

And now I’m onto the next stage: trying the new medication. I’m nervous but I’m really ready not to feel like this anymore.

Keeping A Personal Library

From a very young age, I’ve had a fear of forgetting things. Not little things, like what I need to take with me when I leave the house, or the door code at university, but the details of my life: how I survived the traumatic breakup of a friendship, how I felt at the concert of my favourite singer, what I was thinking when I started going to therapy. The little details of the big events, the things that have made me who I am.

To that end, I kept diaries. I’ve done so my whole life but the catalyst for my compulsive writing occurred just before I turned nineteen, when I was forced to take a gap year because my anxiety, depression, and social anxiety had become so bad that I just couldn’t cope with the course I’d intended to do. Suddenly I had a lot of empty time and a lot of chaotic thoughts to fill it. So I started filling notebooks, with stories, moments, quotes, and memories that I was terrified of forgetting. I would write non-stop for days, until either I fell asleep over the pages, or my hand cramped up so badly that I just couldn’t keep going.

While it was clearly an odd behaviour, no one, not even myself, thought much about it. I’d always been a writer, having written my first ‘book’ before the age of six. I’d gone on to write a twenty thousand word story at twelve, and since then, I’ve experimented with poetry, essay writing, blogging, and pretty much any other kind of writing you can think of. Now, at the age of twenty-three, songwriting is my true love, but my passion has always been for words: to express, to describe, to explain. So writing a lot wasn’t weird.

But as my anxiety in particular got worse, I tried to write even more. I’d write down the most minute details: what I ate at every meal, the plot intricacies of the TV show I was watching, the lyrics of each new song I listened to. I was absolutely terrified of forgetting each detail that had contributed to the person I was that I felt compelled to write everything down, so that I didn’t lose one single puzzle piece. It was taking up all of my time, literally, and that was without anything particularly significant happening.

When significant things did happen – the disintegration of an important relationship, the death of my much-loved cat, the introduction of a new medication – the writing became a serious problem. Over that period of approximately a week, I wrote about ninety pages, and over twenty thousand words. It’s true that I was working all the emotion out, figuring out how I felt – for me, writing is the best way of processing stuff since I can’t write as fast as I think, giving me the time to really think everything through as I write it down – but it was taking over my life. Still, I didn’t think anything of it. It was what I had to do to get through some really hard stuff. And even if I’d wanted to, I don’t think I could’ve stopped.

In September 2014, I started university. Suddenly things were happening. A lot of things. I was commuting to London, meeting literally hundreds of new people, and taking a load of new classes on subjects I’d never studied before. I also had a huge amount of homework; I felt like I was working all the time. So trying to write about everything that was happening became an impossible task. But not doing it caused me suffocating anxiety. It was a catch-22, and it took me months to catch up with myself. In January 2015, this was diagnosed as Obsessive Compulsive Disorder.

In the last four years, I’ve written over a million words. Over time, with some good medication, a fantastic therapist, and a lot of hard work, I’ve become better at managing the anxiety and I’ve become better at managing the compulsion. I no longer need to write down what I eat for every meal, what I do every minute of every day, although I still struggle against including every song lyric I love (I’m a songwriter – it’s research, right?!). But having said that, I still need to write a lot about how I’m feeling and how certain events make me feel. It really helps my frantic brain slow down and understand everything that’s happening to me. Of course, there are still certain things that cause my writing to go into overdrive. For example, I wrote more than twenty pages after a recent ninety-minute therapy session.

I have a complicated relationship with my writing. Writing is something I enjoy, and keeping a diary is a positive experience for me. But it’s the compulsion to do it, the unbearable anxiety when I don’t, the constant panic that I’ll forget things… These things make my life miserable. The longer I go without writing, the harder it feels to breathe. Having a complete history of your life, being able to go back to an important moment and remember how you felt… it sounds nice, right? Well, it would be if I had any choice in the matter.

13 Things That Don’t Make My Depression Worse

I’ve been struggling with depression on and off for about five years now and that’s added up to a lot of bad days. Over that time, I’ve tried a lot of things and talked to a lot of people. And the best advice I’ve ever been given is ‘don’t make it worse’. Well, step number one is ‘don’t make it worse’, step number two is ‘try to make it better’ and that always rang true with me. In my opinion, the most important thing about coping during periods of depression is getting through it.

You can worry about making things better when you’re feeling okay but when you’re feeling awful, that’s too big an ask. These things on this list aren’t life changing. They’re not going to banish the depression or quiet the anxiety. But they have helped me to feel better, even if it’s just the smallest amount. And that’s where you have to start. So I thought I’d list them here. Maybe they’ll help some of you too.

1. Journaling – I’m a huge advocate of writing stuff down, for two reasons. Firstly, I think it really helps with the processing of emotions. A lot of the time, I feel like my thoughts move very quickly and to write them out, I have to really slow down. That allows me to make different connections, explore the depth of the emotion, and really think things through. I find that so, so helpful. And the second reason is that it allows me to let go of everything that’s happening to me. I’ve been keeping diaries for a long time and this is something that has really helped me. All of these big emotions make my head feel very full and it can feel hard to breathe but when I write it all out, it’s like I can let it all go. I compare it to backing up my hard drive: I know it’s safe and I don’t have to actively hold onto it or worry about forgetting things, something that often feels like it takes up a lot of energy.

2. Looking at the sky – I’m serious. There’s a little park across the street from my house and recently, I’ve found myself heading over there in the early evening (when it’s empty and quiet) and taking a moment to lie in the grass and look at the sky. There’s something about it that really calms me. I can feel my ribcage opening up and it gets easier to breathe. It kind of feels like, with the sky above me, there’s finally enough space for my emotions to leave my body. I don’t know if this works for anyone else but humour me. Try it and see how you feel.

3. Playing with or stroking an animal – There’s something about animals that can be incredibly calming. They’re so mindful, so completely present in what they’re doing. Spending time with my dog or my cat is something that’s really helped me over the last few years. Focussing on them, for me at least, makes everything fade into the background for a little while.

4. Washing your face – Simple but true. Sometimes, washing my face just feels like a fresh start.

5. Buy something (cheap) online – I say cheap because I know money is a cause of stress for a lot of us, but when you’re having a bad day, having something to look forward to is important. And sometimes there’s nothing in the diary so you have to create it yourself, even if it’s something simple, like a pretty notebook. Knowing that something nice is going to arrive in a couple of days can help you keep going.

6. Doing something that takes all of your concentration – If you’re feeling up to it, doing something that takes great concentration is really good because it prevents you from thinking too much and ending up in a spiral of negative thoughts. My preferences are playing the piano or doing origami.

7. Doing something you don’t feel pressured to be good at – A while ago, a friend suggested trying something like painting because it was something I’d never really done and therefore it didn’t matter if I wasn’t any good at it. It was a good idea in theory but in practice, all I could focus on was how I couldn’t make it look how I wanted it to look. To me, it was bad. So that just made me feel worse. But when I picked up poetry, I discovered I didn’t mind what the outcome was. I just did it because I enjoyed it and I think that’s because it was linked to something I was already skilled at. I’ve been writing in some form or another for years so while this form of it was new, the basic skills weren’t. It was already something I was comfortable with. So, if you’ve had the same problem, perhaps try something similar to a skill you already have: a different art form, a different sport, even a different type of puzzle. I’ve found that doing something purely for enjoyment can help, giving you a sense of accomplishment at a time when you may not feel very accomplished.

8. Having fresh flowers around – I don’t know about the logic of this one but there’s something about having fresh flowers in my room that just gives me a little pick-me-up.

9. Watching a movie or TV show – Sometimes you just need a break from your own life and watching (or rewatching!) a TV show or movie and getting really involved with characters can do just that.

10. Take a break from responsibilities – This is obviously not a long-term strategy but giving yourself a period of time where you aren’t required to do anything can recharge you. For a little bit, you can avoid things that make you feel invalidated and not feel guilty about the things you should be doing. That takes up a lot of energy and having a break from that just allows you to recover some energy so that you feel more capable when it’s time to start again.

11. Organise something – Putting things in their proper place can help give you a sense of control in a time you where everything may feel completely out of your control. I actually find this quite helpful when I have to make big decisions. Jumping straight to the big things can send me into a panic so I kind of warm up by organising my computer desktop, putting everything in the correct files.

12. Going to concerts – This is obviously a harder one to orchestrate because you can’t just conjure up a concert when you’re feeling depressed (although looking forward to one can be helpful too). Concerts can be difficult (especially if you struggle with anxiety as well as depression, like me) but in my experience, there’s something about live music and that group emotion that can make you feel very alive. And you’re completely focussed on that moment in time. Emotions feel more vibrant, after feeling very faded by depression and they stay with you, allowing you to relive them afterwards. There’s something very special about going to concerts, especially when it’s an artist or band that mean a lot to you, and I’ve found those experiences can really lift me out of my depression, even if it’s only for a little while.

13. Changing your bed sheets – I don’t know about you, but there’s something about sleeping on clean sheets that just makes me feel better. If I’m in a bad place, I need someone to help me do it but it always improves my mood.

So that’s my list of things that don’t make my depression worse. Hopefully this has helped or given you some ideas for when you’re feeling really low. And if you have any suggestions, leave a comment below!

Finding Home and Finding Hope

Last night I got to see Cecilia Knapp perform her one woman show, Finding Home, for the second time. It’s a show that discusses some of the really big stuff, like family, growing up, loss, suicide, and hope, and again, I was completely blown away. She’s an incredible writer, an incredible poet. It’s a fantastic show and if you’re able to see it, you really should.

This post could easily be a list of reasons why I love Cecilia, and her writing, and I’d quite happily write that but that wasn’t why I wanted to write this post. I wanted to write this post because she’s doing something really important. She advocates using writing, and creativity in general, to share stories and to help us cope with the things that happen to us, and this is something I’ve always really thought too. I think it can change everything; it certainly has for me. Writing has given me a way to make intangible things tangible and process things that had always felt too big to think about. I can’t say it better than Cecilia does here, in her TED Talk:

And on the other side of that, I also want to highlight the power of art and words, and the effect they can have. I’ve been in a pretty bad place for the last few months and I’ve really struggled with feeling hopeless. But listening to those words, it kind of felt like all of the colour had rushed back into my life, all of the feeling back into my body. I felt alive again. And that was amazing.

Of course, one experience can’t alleviate depression but what is change but a series of experiences? And regardless of whether or not this feeling lasts, it won’t be any less special if it doesn’t. I’ll keep the memory safe and replay it whenever I need to remind myself of that moment, that feeling. Given this experience, I’m even prouder that this blog’s title was inspired by this show.

You can find out more about Cecilia and her work here.

Behind The Scars

A little while ago, I discovered Sophie Mayanne’s Behind The Scars photography project. I was scrolling through Instagram, probably procrastinating, when I saw a photo of a young woman unashamedly showing off her scars. I was intrigued by the story behind that post – while I’ve never been actively told to hide my own scars, it often feels like I’m expected to cover them up. This is particularly true of self harm scars, I think. As I said, I’ve never had someone specifically tell me to hide them but I still feel that there is an expectation that I should, either because I should be ashamed of them or because they might upset people. I protest this and so does Behind The Scars. This ever-growing collection of photos allows people to show their scars and tell the stories behind them. I don’t think I can describe it better than Sophie herself does: “Behind The Scars is a celebration of beauty, of flaws, of battles won and obstacles overcome. It is about survival, living beyond that and capturing the memories. It is a truly honest depiction of how our history, shown through these scars, does not define us but compels us.”

I was instantly a fan and applied to take part. It took a bit of planning and rearranging but come the day of the shoot, I arrived with only a little anxiety. I’ve had photos taken before, for my music projects, but they’ve always been taken by people I already know. So I was a bit nervous about that. I had also been nervous about my difficulty with eye contact (thank you for that, ASD) but Sophie was very reassuring and put that fear to bed very quickly.

The shoot itself was a very positive experience and made much easier by the presence of a little dog, Carla. Animals always put me at ease (to the point where both my cat and my dog frequently accompany me to therapy sessions) so that was a lovely surprise and did make me feel less anxious. Anyway. I had expected to feel very self-conscious but I didn’t. In fact, I felt strangely in control and comfortable in my body and that is something I’m really grateful for, grateful to this project for. And even though I often get very anxious about not knowing how to do something, I didn’t feel that as strongly as I sometimes do: Sophie was great, telling me where to stand and what she wanted me to do. I never felt judged and if a particular pose felt unnatural, we were on to the next one straight away. And suddenly we were done.

The other part of the project involves writing a little bit about your scars or your experience of having scars. I thought a lot about what I wanted to say and eventually, I came up with this:

“I’ve struggled with self harm on and off for about eight years but it’s gotten worse as my mental health has worsened. The compulsion, for me, is two fold. Because of my Autism, I feel emotions really strongly and when it gets completely overwhelming, the only thing that helps is self harming, like all the emotions can escape. It’s like my version of a pressure valve. I also do it when something very upsetting happens, like I’m trying to represent that distress in a tangible way and show that it’s changed me. I think a lot of people don’t understand it and almost don’t want to because it’s a hard thing to think about but I think the only way to help someone who is self harming is to try and understand it. I didn’t talk about it for a long time because I didn’t have the words but then I realised how much it would’ve meant to my younger self to know that other people were struggling with the same things. So it’s time to find the words.”

My lasting impression of Behind the Scars, and of Sophie, is sincerity, and personally, I can’t give it higher praise than that. It’s been a couple of weeks now since the shoot and I love the photos. They look like me. I know that sounds odd, but how many photos have you seen of yourself that just don’t look like you? But these do. These photos look like me.

“If these images help us to think differently about scarring, and for those that “wear” these scars, to look differently at not only the imperfections, but the individuality these marks might engender, then for me, I would deem the project a success.” – Sophie Mayanne

A massive thank you to Sophie for taking these photos and for the Behind the Scars project as a whole. You can see more of the photos from the project here and here and, if you’d like to help her get Behind the Scars to New York, you can find the Kickstarter here.

Farewell Phenelzine

It’s time for a change.

I’ve been taking Phenelzine, also known as Nardil, for almost three years now and while it’s been a great help to me, I need to try something else. The last few months have been very difficult and to cut a long story short, I’ve been diagnosed (for the second time) with Clinical Depression. I’ve been finding it really hard to take my medication, knowing the effects it will have on me. It might sound strange but, when I take the Phenelzine, my mood lifts and feeling the way I do at the moment, I’m really struggling with that. I find it really hard to try and feel ‘okay’ when everything is ‘not okay’. To me, this makes complete sense but I can also recognise that I’m waiting to feel better while avoiding things that actually might help.

I think my problem with Phenelzine is how familiar I am with how it affects me. Having taken it for so long, I know exactly how it changes my mood. That used to be a good thing but now… Now, the ‘happiness’ it makes me feel just feels fake because I know it’s caused by the Phenelzine. I think it’s important to point out here that, objectively, I know that there is no difference between ‘real’ happiness and happiness caused by medication, and that I have always been a real advocate for taking medication (if you need it and it’s recommended). That belief hasn’t changed. But my familiarity with this medication is now making it difficult for me to take it so I need a new approach. It’s time to try a different one. Hopefully not knowing whether it’s the medication affecting my mood or the world around me will make it easier to take and therefore help myself feel better.

So I thought I’d do a little review of Phenelzine as a goodbye.

I started taking Phenelzine in the summer of 2014, after meeting my current psychiatrist. I’d taken various medications before (I’ll write about those at some point), all of which I’d had bad experiences with. So my Psychiatrist suggested Phenelzine, a drug not commonly used (in the UK at least) because of the dietary restrictions but one used when the other options haven’t worked. I’d never tried an MAOI (a monoamine oxidase inhibitor, one type of antidepressant) so I was optimistic that I would react differently than I had to SSRIs (selective serotonin reuptake inhibitors, another type of antidepressant). And I really did.

Almost straight away, I felt completely different. I had previously been almost unable to get out of bed, let alone do anything else, and suddenly I had more energy than I knew what to do with. My thoughts were like fireworks going off one after another after another after another. It’s the closest to mania I’ve ever experienced and my family were genuinely worried about me. I could barely sit still and I couldn’t shut up. I’m not kidding, I couldn’t stop talking and that was pretty embarrassing as I was just starting university. It was a bit scary but at the same time, I was absolutely ecstatic to be feeling so much better.

It took a bit of messing around with the dose (with my Psychiatrist’s supervision) but that did calm down. After a couple of months, I felt a bit more normal: I had more energy, I could concentrate and complete tasks, and my anxiety wasn’t as overwhelming as it had been. On a lower dose, I wasn’t so manic but I could still function a lot better than I could before. My almost perfect attendance in my first semester at uni is a testament to how much it helped.

Since then, with the exception of the last few months, it’s been a massive help to me. I’ve managed to complete my degree and graduate with a First, while commuting up and down to London. I mean, it was freaking exhausting but it would have been impossible without the Phenelzine. As I said, before I started taking it, I could barely get out of bed. The exhaustion that I experience with Depression is awful and I didn’t have the energy to walk my dog around the block. So Phenelzine was a godsend.

Side effects wise, there was only one that I struggled with (although I was initially a bit light headed and nauseous but that passed pretty quickly). My main battle was with the insomnia the Phenelzine caused. It’s has an alerting affect so it’s not that surprising that I had trouble sleeping. I struggled to get to sleep and when I finally did, I never slept more than four hours a night. It was exhausting. On multiple occasions, I fell asleep on the sofas at uni during my breaks and I’m pretty sure I fell asleep during a lesson once or twice: I have a very vivid memory of ‘blinking’ and finding the white board covered in writing…

This has been an ongoing difficulty. I ended up going back to the psychiatrist and left with a prescription for Quetiapine. I still have to take it every night to get to sleep and while I’m definitely grateful for that sleep, it also has it’s own downsides. It’s incredibly difficult to wake up; it feels like my eyes are glued shut, like I’m swimming through deep, dark water with no idea where the surface is and it can take hours to shake off the drowsiness. And it’s scary to feel like you will not sleep without it. I’m hopeful that, when I stop taking the Phenelzine, the insomnia will disappear and so I can stop taking the Quetiapine. That’s both exciting and scary. I haven’t slept unaided in almost three years; I’m going to have to learn how to do that again.

It’s going to take a little while to wean myself off Phenelzine and I have no idea how the new medication will affect me. So the next few weeks are going to be interesting.

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