Someone that suffers from TM behaviors take all the precautions necessary to hide their behaviors from other people, family members included. They are often outcasts by choice because they are afraid that the interaction will bring notice to their behaviors or even worse, embarrassment. Shame is quite possibly the most destructive of all TM symptoms.
When a patient is confronted about their behavior, it is common, like most other disorders, for an individual to deny having the disorder. It is also not uncommon for people to make up lavish stories as to how they lost their hair, or as to why they have compulsive pulling behaviors. Medical conditions or reaction to a specific medication are common reasons people give to explain their condition away. Because of this reason, it is not surprising that a significant number of individuals with this disorder also suffer from depression, anxiety, and substance abuse problems. This creates a never ending cycle that is hard to break.
Many people do not realize just how common hair pulling really is within the non-clinical population. But despite this fact, persons with a disorder such as TM firmly believe that they are especially corrupt or odd for engaging in what many see as sick and disgusting behavior. Even more disturbing is that most suffers actually believe that any “normal” person has legitimate reason to reject them for having such a condition. This is when symptoms such as depression set in, it is the behavior that manifests itself from the shame they feel. In conjunction with self-loathing and social withdrawal, one’s mood can become very unstable and volatile. What is not known about this condition is whether or not the depression comes prior to or after the onset of TM. Unfortunately, shame, as it relates to a condition of TM, has been given very little consideration in relationship to treatment options of TM and other OCD related disorders. Isn’t it more than time to address helping people how to cope and live with their condition rather than loathe it? There has to be a better way to equip patients with the resources they need to get back into society.