In a surprisingly large number of hair loss cases, stress or other mental health issues are found to be a main trigger for the condition. This can make hair loss conditions difficult to diagnose, as the problem is a psychological one rather than solely physical.
Stress-related hair loss
For conditions such as alopecia areata and telogen effluvium, it is often psychological or emotional trauma that causes the hair to start falling out. Excessive stress can cause more hairs than normal to enter the resting (telogen) phase, resulting in mass shedding a number of months later. Stressful conditions which can trigger this kind of hair loss include pregnancy, surgery and miscarriage.
Trichotillomania
This is a compulsive ‘hair pulling’ disorder, part of the impulse control group of conditions. It causes the sufferer to feel an irresistible urge to pull out hairs from their own scalp, eyelashes or eyebrows. Some people with trichotillomania often feel a sense of tension before pulling hair, or whilst trying to resist the behaviour, and a sense of relief or satisfaction afterwards.
A number of people with this condition also feel a sense of shame or embarrassment about their behaviour and attempt to hide it from others.