Although talking about mental health is more acceptable today than ever before, it’s still not the most comfortable topic of conversation. Add hair loss to the mix, and you have a double whammy. Bald spots and thinning hair may be noticeable, but the grief that many people feel when losing their hair isn’t. You’re probably not going to go up to your co-worker and say, “Hey, see my bald spot? I’m upset about losing my hair, and it’s ruining my life.” So who can you talk to, and how can you get help if you’re feeling depressed or anxious about your alopecia? Read on to learn about the of invisible effects of alopecia on your mental health and what resources are available if you’re struggling.
Understanding How Hair Loss & Mental Health are Connected
Alopecia isn’t physically harmful, but it has been proven to have immense psychological effects. A qualitative research study conducted in 2020 confirms that anxiety and depression related to alopecia are not only real, they can be debilitating for some. (01) One study participant said, “It was devastating when it first started. And when I first lost it all four years ago, I cried a lot. And it took me about two years. I really had to mourn the loss of my hair.” It’s not uncommon for people with alopecia to experience an ongoing bereavement process. (02)
The study also categorized emotions and the triggers that people with alopecia often experience:
- Sadness and depression due to diagnosis
- Insecurity, inadequacy, and self-consciousness when hair thins or bald spots appear
- Helplessness, anxiety, fear and stress are often due to disease progression, recurrences, and failed treatment options
Given that hair is such a big part of our identity, it’s understandable that such strong emotions are evoked. People are often described and defined by the color or style of their hair. Before you were the perky brunette with the curly hair or the blonde dude with the buzz cut, and now you’re “the bald one.”
Why Depression and Anxiety Related to Alopecia Should be Addressed
Some people are so concerned about hiding their hair loss that they don’t want to participate in everyday activities. Work, birthday parties, happy hour, and even going to the gym can be tough.
When asked about how alopecia affects her social life, one respondent said, “Does it affect me physically? No. The ability to move around? No. To be around people? Yeah, it does. It does play a big role.” (03) Another mentioned that he missed his friend’s wedding because he was too embarrassed about the way he looked. “Once the alopecia was at its worst point that I had, I was just like, a homebody, you could say. I wouldn’t want to go out. [ …] I would avoid it. I wouldn’t go to, like, parties where you have to suit up. Yeah, I missed, like, my friend’s wedding.” Nobody chooses alopecia, and certainly nobody chooses to be debilitated by it. What’s the solution? Awareness and support.
How to Identify Whether Your Emotions are Manageable
The first step in getting help for anxiety and depression stemming from hair loss is being aware of your feelings. Everyone gets stressed out from time to time, and it’s only normal to be upset about losing your hair. After all, that’s a pretty significant change. How do you know if the amount of anxiety you’re feeling about your alopecia is appropriate?
According to the National Institute of Mental Health, “Anxiety disorders involve more than a temporary worry or fear. For people with an anxiety disorder, the anxiety does not go away and can worsen over time.” (04)
Symptoms of Anxiety and Depression Caused by Hair Loss
Androgenic alopecia, alopecia areata, or even telogen effluvium can trigger depression, general anxiety, and other mental health disorders in predisposed individuals. Although each of the mental health conditions is different, you can have multiple conditions simultaneously. Here are some general symptoms to look for (05):
Depression
Depression causes constant sadness and loss of interest in activities that you used to enjoy. People who are depressed may feel:
- Tearful, empty, or hopeless
- Angry, irritable, or frustrated
- Less interested in activities that they used to enjoy
- Tired
- Restless
- Less able to concentrate or make decisions
- Worthless
Generalized Anxiety Disorder
Generalized anxiety disorder (GAD) occurs when people with alopecia worry non-stop about their hair loss. The anxiety doesn’t cease and begins to interfere with everyday life. People with GAD are often:
- Restless, wound-up, or on-edge
- Easily fatigued
- Having difficulty concentrating
- Irritable
- Having headaches, muscle aches, stomachaches, or unexplained pains
- Difficulty controlling feelings of worry
- Having difficulty falling or staying asleep
Social Anxiety Disorder
Social anxiety disorder (SAD) makes people worry that they will be judged negatively by others because they have little or no hair. The embarrassment and shame are so extreme that they avoid socializing. SAD can often cause:
- Feeling self-conscious or fearing that people will judge you negatively
- Sweating, trembling, blushing
- Pounding or racing heart
- Stomachaches
- Difficulty making eye contact or being around people you don’t know
- Having things symmetrical or in a perfect order
How to Deal with the Psychological Effects of Hair Loss
There isn’t a one-size-fits-all approach to psychological treatment for alopecia. The key is to seek treatment if you feel depressed or anxious about your hair loss. Treatment options typically include (06):
- Psychotherapy (Talk therapy)
- Cognitive Behavioral Therapy (Teaches people to think differently)
- Acceptance and Commitment Therapy (Uses mindfulness and goal setting to eliminate negative thoughts)
- Medication (Antidepressants, anti-anxiety medications, beta-blockers)
- Support groups
- Stress management techniques
Your healthcare provider may recommend one or more of these approaches to help you cope with your condition.
Can Stress Cause Alopecia?
We’ve established that having alopecia can inflict emotional problems, but can being stressed or depressed cause alopecia? After all, chronic stress can cause heart disease, high blood pressure and a variety of other medical issues. Is hair loss one of them?
The answer is yes. In a study on mice partially sponsored by the National Institute of Health, researchers discovered a particular stress hormone that inhibits stem cells required to grow hair. (07) During the study, mice were subjected to mild stress for many weeks. The corticosterone levels in the mice increased, and hair follicles stayed in the resting phase longer than normal, reducing growth.
Two hair loss conditions in people that are known to be triggered by stress are telogen effluvium and trichotillomania.
Telogen effluvium
As in the research study with the mice, stress could push your hair follicles into a resting period causing hair loss. The good news is that telogen effluvium due to stress is not permanent and can reverse itself.
Trichotillomania
Among people predisposed to obsessive-compulsive disorders, stress can trigger a hair-pulling disorder called trichotillomania. Despite trying to stop, people with this mental disorder have an irresistible urge to pull out their hair.
Fortunately, as we mentioned above, you can alleviate stress. The faster you seek treatment, the sooner your hair can return to a healthy growth cycle. To get started on your hair loss journey with a Happy Head dermatologist, click here.
What You Can Do to Prevent and Negotiate a Hair Loss Crisis
The key to dealing with hair loss is getting to a healthy level of acceptance. Sometimes it takes hard work, and sometimes it takes a little inspiration. It doesn’t matter how you get there. There isn’t a clear-cut map because the journey is unique for each person.
In a Tedx talk, Jannica Olin, a Swedish actress living in LA, asks the thought-provoking questions, “If I’m not my body, who am I?” and “When that which defines you is gone, do you know who you are?” Jannica lost the hair on her head, her eyebrows, and her eyelashes to alopecia areata. When you watch the video, you can’t help but notice that Jannica gets a little choked up when she removes her wig. Even as a successful TedX speaker who has redefined herself, Jannica is emotional about her experience. The difference is that Jannica can focus on what she has gained through her alopecia rather than lost.
We hope that you find your new normal and take back your power. We’re proud to be your partner and to support you along the way, take the Happy Head questionnaire to get started on a custom hair loss treatment plan all online.
