Bald at 18 after I pulled my hair out
Ruth Walters started pulling as a reaction to being assaulted but soon found it dominated her life. Here she tells her story to Reveal magazine.
A vicious attack at 14 left Ruth Walters; now 24, from Grantham, Lincolnshire, with a condition that caused her to rip her hair out until there was nothing left.
Everyone in my family has a habit of playing with their hair. No matter what we're doing, we'll be twirling, twisting or stroking.
But what started as harmless became something that conpletely took over my life.
I was a wild teenager and, when I was 14, my parents were in the middle of getting divorced. I struggled to cope with the change in my home life.
My friends took me out one evening to cheer me up, and my drink was spiked. That night I was sexually assaulted.
Afraid to tell the police or my parents at the time, I kept my pain hidden inside. And because I couldn't cope, I started pulling my hair out.
It wasn't planned but, when I felt low, my hands naturally went to my head. It was like a ritual. First, I'd find the right hair - it had to be frizzy and have a kink - then, I'd tug it out of my scalp. After playing with it, I'd line it up on my laptop and start the whole process again. It was like I was in a trance and nothing could snap me out of it.
At first, I only did it when I was alone but, try as I might, I couldn't hide the patches from my parents.
I was finally diagnosed with trichotillomania - known as TTM - at 15. I learned it was a body-focused repetitive behaviour and people with the condition experience a strong, physical urge to pull.
Seeing how depressed I was my dad sent me for counselling. By this point I felt suicidal. Although therapy helped me process my feelings, it didn't stop me. Even when I had cognitive behavioural on the NHS, I still yanked my hair out.
I spent every waking moment on edge, either fighting the impulse or worrying someone would notice my bald spots.
Headscarves, hats and extensions - I tried everything to cover it up.
People would ask, 'Why do it if you don't want to?' They couldn't understand it was the only thing that made me feel safe. It hurt when I removed a hair, but it was a soothing pain, a release.
Aged 18, I went to university and TTM continued to rule my life.
Just before I started my third year, I went to Spain with my twin, Kate, to visit our older sister Susan. By now the bald patches were bigger than ever and my hair was so thin, it barely covered my clip-in extensions.
Leaving the house was a struggle - I hated my appearance. Susan saw I was in distress and sent me to her hairdressers who made me a hair-piece to cover my bare bits.
Immediately my confidence was back - I almost felt like the old Ruth. But my hands could still get to my scalp and, unable to break the habit, I continued to pull.
Shortly after, I started dating Josh, 25. We'd known each other for years and I'd always told him I had alopecia.
But, a year ago, I'd had enough. With only a few strands left on my head, I was tired of matching outfits with the grey beanie hat I couldn't leave the house without.
'It's not alopecia, I've been pulling my own hair out,' I told Josh. He was so supportive and grabbed the clippers. 'If you don't have any hair, you can't pull,' he said.
Hoping shaving my head would be liberating, I put on a brave face and rocked the skinhead look, but it wasn't me - I wanted to be the girl with long brown locks.
A documentary called Girls on the Pull gave me a ray of hope. It featured Lucinda Ellery's hair loss salon which helps women with alopecia and TTM restore their hair.
My mum took me to her studio in Manchester, but there was no way I could afford the £2,000 fee. And, when the NHS turned me down for funding, I was crushed.
But, after four years of saving, I finally booked an appointment this July. By putting an Intralace over my scalp and pulling what little strands I had through, the stylist was able to to attach long extensions of real hair - giving me a full head of hair for the first time in a decade!
I'd gone into the salon practically bald but. eight hours later, I had a sweeping fringe and shoulder-length brown mane.
Confident, happy, self-assured - I'm barely recognisable from the woman I was last year. And, best of all, I can't pull. The intralace is so tight, I'm unable to get to the scalp.
As repeated pulling can damage the follicles, I know my hair may never grow back. I can only wait and see. For now, working towards becoming a counsellor is keeping me on track. My dream is to help others and learn about mental health.
And I'm more content than I've been in 10 years. Pulling is something I will always be battling, but I won't let it win.