Trichotillomania at Work: Managing Urges and Getting Support

Work can be one of the hardest places to live with trichotillomania. You sit still for hours with your eyes on a screen and your hands free, and you may be putting a lot of energy into hiding it.

This guide covers practical ways to handle urges at your desk, how to decide whether to tell your employer, and the changes you can ask for. Trichotillomania (trich) is a recognised condition, not a bad habit or a lack of willpower, and needing some support with it at work is reasonable.

Why is trichotillomania at work so hard to manage?

Because many jobs combine the things pulling feeds on: long spells of sitting, focused screen work, pressure, and few chances to move. Much pulling is automatic, happening without you noticing while you read, type or listen. Other pulling is focused: pulling eases a building urge or tension. Our guide to focused and automatic pulling explains the difference.

In the Trichotillomania Impact Project, a large 2006 survey, many people said pulling interfered with their work, and roughly 1 in 4 spent between 15 minutes and an hour a day covering up its effects. Participants were recruited online and most were women, so the figures may not reflect everyone, but if trich affects your working day, you’re far from alone.

How do I manage hair-pulling urges at my desk?

Keep your hands busy, put small barriers in the way, and break up long stretches of sitting. Pick two or three ideas that fit the times you pull most.

• Use a competing response. This is something you do with your hands that you can’t do while pulling. Press your palms flat on your desk or thighs, or gently clench your fists, for about a minute or until the urge eases. Most people around you won’t notice.
• Keep a quiet fidget within reach, such as a textured ring, a smooth worry stone or a small stress ball, for meetings and calls.
• Add a barrier for your riskiest tasks. Plasters on your pulling fingertips, or hair tied back, make hairs harder to grip and help you notice your hand.
• Give your hands a job in meetings. Take notes by hand, or hold a pen or a mug. On video calls, some people hide their own camera view so they aren’t watching themselves.
• Move every hour or so. Stand, stretch or refill your water.
• Notice your work patterns. For a week, jot down when urges peak, such as a certain task, the afternoon slump or after a tense meeting, and plan for those moments.

If you do pull, stop when you notice and carry on with your work. One pull isn’t a failure, and being hard on yourself tends to lead to more.

Our guide to fidget toys and tools can help you choose something for your desk. Many of these ideas come from Habit Reversal Training (HRT), a behavioural therapy that teaches you to spot the moment before you pull and do something else with your hands. It has the most research behind it for trich. You can read more in our guide to Habit Reversal Training.

Do I need to tell my employer about trichotillomania?

Usually not. Whether you share a health condition at work is generally your choice, and many people with trich never do. But an employer can only make changes for something they know about, so formal support usually means telling someone.

If you tell your manager, you don’t need to show them anything or explain every detail. Something like this is enough:

“I have a condition called trichotillomania. It gives me strong urges to pull out my hair, especially when I’m sitting still or under pressure. I’m managing it, and a couple of small changes would help me do my best work.”

If you ask for a formal change, your employer may ask some questions about your condition, so it helps to write down what you’ll say first. For words to use with friends, partners and colleagues, see our guide on how to tell someone you have trichotillomania.

What workplace adjustments are possible?

Adjustments are changes to how, when or where you work that make it fairer for you. Some countries call them accommodations. For trich, they’re often small.

What the law says depends on where you live. This is general information, not legal advice.

In England, Scotland and Wales, the Equality Act 2010 counts a mental health condition as a disability if it has a substantial, long-term effect (usually 12 months or more) on your everyday life. Employers must make reasonable adjustments when they know, or could reasonably be expected to know, that someone is disabled, or when that person asks. A government scheme called Access to Work can also fund some support, including sessions with a mental health professional. Northern Ireland has its own disability law, which also covers mental health conditions.

Our guide to whether trichotillomania counts as a disability goes into more detail for each country.

When should I get help?

Get support if pulling is affecting your work, your confidence or your career choices, or if hiding it takes a lot of energy. You don’t need to wait until it feels “bad enough”, and online sessions can fit around working hours.

Many doctors and therapists have never worked with someone who pulls. Everyone in our directory has told us they understand trichotillomania and already help people who pull, in person or online. You can search the directory. Our guide to finding someone who understands trich explains what to ask on a first call. For a full picture of the condition, see our complete guide to trichotillomania.

If pressure at work is leaving you feeling very low or hopeless, please talk to someone today.

In an emergency, call 999 or go to your nearest emergency department.

• Samaritans — 116 123 (www.samaritans.org)

Questions people ask

Sources

1. Woods, D.W., Flessner, C.A., Franklin, M.E., et al. (2006). The Trichotillomania Impact Project (TIP): Exploring phenomenology, functional impairment, and treatment utilization. Journal of Clinical Psychiatry, 67(12), 1877–1888.
2. NHS. Trichotillomania (hair pulling disorder).
3. International OCD Foundation. Body-Focused Repetitive Behaviors (BFRBs).
4. GOV.UK. Definition of disability under the Equality Act 2010.
5. GOV.UK. Reasonable adjustments for workers with disabilities or health conditions.
6. Acas. What reasonable adjustments are.
7. GOV.UK. Access to Work: get support if you have a disability or health condition.
8. nidirect. Protection against disability discrimination.
9. US Equal Employment Opportunity Commission. Depression, PTSD, & Other Mental Health Conditions in the Workplace: Your Legal Rights.
10. Job Accommodation Network (JAN).
11. Citizens Information. Working with a disability.
12. Canadian Human Rights Commission. Workplace accommodation: A guide for federally regulated workplaces.
13. Australian Human Rights Commission. Disability Discrimination Act 1992: employee rights.
14. Employment New Zealand. Reasonable accommodation (measures).