Reader’s Question

I am 17 years old and have been having some problems. Ever since I was in 4th grade, I have had trouble with hair pulling. When I was around 11, I pulled out all my eyelashes and patches of my eyebrows. I also used to pull out my hair. To try and get over the urge, I had to limit myself to so many hairs per night. From about age 14-15 I didn’t have any problems with hair pulling, but then when I was almost 16 I started to become obsessed with split ends. I hunt for them and try to remove them from my hair for hours, and if I see them on other people I get the urge to pull them out; I know I can’t, so I feel sick. I believe I had, or have, trichotillomania but I’m not sure.

I also struggle with eating disorders. I go through periods where I eat absolutely nothing, then periods where I feel compelled to eat all the time because I am afraid people will judge me if I don’t. I am either addicted to not eating, or addicted to eating. I am never happy.

When I was 15, I suffered from depression because my parents got a divorce. Now, I simply don’t feel emotions. I feel like my life is ruled by desires to compulsively eat, not eat, pick out split ends or my hair on my head. I thought maybe I had OCD because I do feel weird compulsions, such as to run my car into things. Sometimes I get really worried I will actually run my car into a wall. I also have nightmares about accidentally killing people in my family, because I couldn’t help it.

My last issue is doing work. I was a perfectionist in elementary school and though I get good grades now, I feel like everything I do is sub-par. I avoid doing homework assignments like the plague because I am afraid of finishing them. I also worry I won’t ever finish them the way I want. So, I pick at my split ends instead.

Please help.

Our Clinical Psychologist’s Reply

It’s not uncommon for folks who suffer from various obsessions and compulsions to experience these problems in different areas, such as eating patterns and self-mutilation behaviors. It’s also not uncommon for depression and anxiety to accompany and/or exacerbate such tendencies. Lastly, unresolved emotional conflicts can sometimes complicate or even fuel many such problems.

Without question, the best thing to do is to secure quality professional assistance. The most important thing to consider is that whether you work with a single individual or a team of mental health experts, you need comprehensive care. Such care would involve possible medication to help you stabilize your mood, control your impulses, and lessen your symptoms, as well as behavioral and cognitive-behavioral therapy to help you reverse self-destructive habits, and possibly even traditional psychotherapy to address any contributing emotional factors. You might start this process by consulting with the counselor at your school and getting some recommendations about the professionals in your area capable of providing the care you need.