Hair is an important part of our identity. When people experience hair loss due to alopecia areata, it can significantly impact how they feel about themselves. This, in turn, can affect their quality of life, especially if they withdraw from social activities, or develop depression or anxiety. Those whose hair grows back could also develop post-traumatic stress disorder (PTSD) because they may be constantly on guard for when their hair might fall out again. Depression According to the National Institute of Mental Health (NIMH), having a chronic medical condition puts you at a higher risk of developing depression. It can affect anyone, even someone who least expects it. A study published in 2022 reported that adults with alopecia areata were 30 to 38% more likely to be diagnosed with depression. Depression doesn’t cause the disease, but the disease can cause depression. People with alopecia areata have reported that they may feel: Alone, withdrawn, isolated Loss, grief Fear that others may find out that they have no hair or are wearing a wig Embarrassment, anger That they are to blame for their disease Guilty that their condition is affecting loved ones That they must find an answer or cure If you experience these or any other negative thoughts related to having alopecia areata, know that there is no right or wrong about how you react. Your feelings are valid. But, if your feelings negatively affect your quality of life, you can get support. This can be in a group or one-on-one with a private counselor or someone you trust. Symptoms Of Depression Depression is one of the most common mental disorders in the U.S. overall. Scientists believe it may be caused by a combination of factors: our genes, the environment, our brain biology, and life experiences. And the symptoms vary because everyone experiences depression differently. Depression symptoms can include: Persistent sad, anxious, or “empty” mood Feelings of hopelessness, pessimism Feelings of guilt, worthlessness, helplessness Loss of interest or pleasure in hobbies and activities Decreased energy, extreme fatigue Difficulty concentrating, remembering, making decisions, “brain fog” Difficulty sleeping, early-morning awakening, or oversleeping Poor or increased appetite, unintended weight loss or gain Thoughts of death or suicide, suicide attempts Restlessness, irritability Persistent physical symptoms Self-medicating with alcohol or drugs Headaches, body aches, pain throughout the body Everyone can feel these things from time to time. But if you’ve experienced three or more of these symptoms every day for two weeks or longer, you may be depressed. You could have some symptoms or several. Regardless of how many you have, if you are struggling with your alopecia areata diagnosis, speak with your doctor. Treating depression at its earliest stages can profoundly impact your overall health and everyday life. Treating Depression Depression is treatable for most people. Most treatment options fall into two broad categories: medications and psychotherapy. Some people need medication to succeed with talk therapy; they may eventually stop the medication once they are comfortable with the therapy. Others use both medication and talk therapy (psychotherapy) as treatment. If you feel that you are in crisis, you may do self-harm, or have thoughts of suicide, please call the 988 Suicide and Crisis Lifeline. It is a U.S.-based service available to anyone in suicidal crisis or emotional distress. For TTY users: Use your preferred relay service or dial 711 then 988. Psychotherapy Psychotherapy focuses on helping by helping you: Identify triggers Disrupt negative thinking Work through troubled relationships Cope with stressful life experiences Psychotherapy can be structured and offered by mental health professionals, such as psychologists, therapists, and social workers. Many professionals focus on cognitive behavior therapy (CBT), which helps teach you how to change dysfunctional thoughts. This leads to changing how you feel and act. But there are many other options too. The best thing to do is reach out to a mental health professional and see what form of treatment works best for you. Talk therapy can also be informal. You could meet in a support group, either online or in person, or speak to a trusted advisor, like a cleric or rabbi. If a child has alopecia areata and is depressed, it might be helpful to have family and individual therapy. Some adults may also benefit from family therapy. Medications Whether you need medications to manage depression is a discussion you need to have with your doctor. Unfortunately, some people resist taking medications to treat depression because they believe they should be able to manage it on their own. But mental illness is as real and can be as incapacitating as a physical illness. If you had diabetes or high blood pressure, you would take medications to manage them. So why not take medications to manage depression? There are many types of antidepressants on the market. The medications work by boosting or blocking certain brain chemicals. Because everyone is different, a drug that helps one person may not help you. It can take some trial and error to find the right treatment. The important thing is not to give up. It can take several weeks for you to feel the effects. Keep in mind, it’s vital that you don’t just stop the medication once you’ve been on it for a while, even if you feel it’s not working. Many must be tapered slowly to avoid unpleasant side effects. Always speak with your doctor before stopping. Other methods of managing depression In addition to psychotherapy, talk therapy, and medications, there are some things you could try on your own to help manage your depression. Here are some suggestions: Set realistic and achievable goals. Goals could be simple, like starting a load of laundry or calling a friend. Increase them when you feel comfortable. Consider acupuncture, tai chi, meditation, or other complementary therapies. Consider music or art therapy. Get regular exercise, even if it’s only walking around the block once a day. Eat a healthy diet. Get enough sleep, but not too much. Avoid self-medication with drugs or alcohol. Get out, spend time with other people. Wear a wig or head covering that might keep you from feeling self-conscious. Don’t forget to be gentle with yourself. Give yourself a chance to get better. Finally, don’t make any major life-changing decisions, such as changing jobs or moving, if you can help it. These are very stressful life events and can be hard to manage if you are depressed. Please scroll down for resources. Anxiety As with depression, everyone gets anxious from time to time. But occasional anxiety and a diagnosis of anxiety are two different things. In the 2022 study mentioned above, the researchers found that about 33% of adults with alopecia areata have anxiety. Common symptoms of anxiety include: Restlessness, feeling nervous A feeling of impending doom Hyperventilating (breathing faster than usual) Sweating Shaking, trembling Heart palpitations, feeling like your heart is pounding Fatigue Muscle tension Difficulty concentrating on anything other than what is causing the anxiety Insomnia Avoiding things that may trigger anxiety Gastrointestinal problems, like feeling nauseous or having diarrhea As a rule, adults must experience a minimum of three symptoms most days over six months to be diagnosed with anxiety. Children only need one symptom. Treating anxiety Managing and treating anxiety is very similar to managing depression. It is essential to understand that anxiety doesn’t go away on its own if it’s lasted six months or longer. Seeking help is the best step you can take for yourself and your loved ones. Just as with depression, psychotherapy and talk therapy are beneficial for many people with anxiety. Scroll up to “Treating depression” and “Other methods of managing depression” to learn about treatment options. Medications There are several types of medications that can help treat anxiety, from anti-depressants and anti-anxiety medications to beta-blockers, originally developed to treat high blood pressure. Again, as with depression, getting the right medication or combination of drugs to help you can take some trial and error, working with your doctor. Please scroll down for resources. Post-Traumatic Stress Disorder Post-traumatic stress disorder (PTSD) is a condition caused by either experiencing a traumatic event or witnessing one. The severity of the traumatic event varies. What might not seem traumatic to one person may be to another. Doctors don’t know why two people can go through the same thing; one develops PTSD and the other doesn’t. With alopecia areata, PTSD could come from fear of hair loss again after it has regrown. There could be distress or panic if you think you are losing your hair again. Treating PTSD Treating PTSD is generally the same as treating anxiety or depression. Talk therapy, medications, or a combination can benefit people with PTSD. If you are experiencing depression, anxiety, or signs of PTSD because of your alopecia areata, there are resources to help you. Resources from NAAF Talk with others who have alopecia areata: Support groups Youth Mentor Program One on One Phone Support NAAF Annual Alopecia Areata Conference Other mental health resources Get immediate help Learn more about the types of depression and their treatments Learn more about the types of anxiety and their treatments Understand the different types of mental health professionals and what they offer Find a therapist Learn more about chronic disease and mental health
