Stress And Hair Loss: Physical Impacts Of Mental Health Troubles

While many people think of mental health as something that mainly affects people psychologically, science is making it increasingly clear that the mind and body are connected. Severe psychological strain can take a toll on your physical health. One way this can manifest is through sudden and widespread hair loss following a challenging experience. How exactly can stress cause hair loss, and can better mental health care help?

Research suggests that stress-related hair loss may manifest in several ways. Rapid, widely distributed thinning and breakage of hairs can be caused by elevated cortisol levels triggering extended dormancy in hair follicles. Some people may also experience stress-driven autoimmune responses that cause hair shedding. These responses can cause further emotional distress and may signal a need for mental health assistance. 

Stress and telogen effluvium

Telogen effluvium, one of the most common forms of hair loss, can result from a shift in the hormones regulating the hair growth cycle. 

Under typical circumstances, each hair follicle passes continuously through a series of phases including:

• Anagen (growing stage)
• Catagen (transition stage)
• Telogen (resting phase)
• Exogen (hair shedding stage)

Some experts blend the telogen and exogen phases, believing that shedding begins during the telogen phase. Usually, only around 9% of the follicles on an individual’s scalp are in this state at any given time. 

Prolonged, intense stress can change the hair life cycle by causing an overproduction of the hormone corticosterone. Among its many other effects, this molecule suppresses the biological signals that promote hair growth. When corticosterone levels remain high for an extended period, around 70% of the individual’s hair may enter the telogen stage, which can lead to hair loss. 

Affected hairs typically become fragile and loose, usually beginning to fall out in large clumps around two or three months after the shift into the telogen phase. This effect usually causes even thinning of hair rather than distinct bald patches. 

When the underlying cause goes away, growth usually resumes as normal, though severe and persistent stress could cause chronic telogen effluvium. This condition can persist for years in a fluctuating pattern of hair regrowth followed by widespread loss. 

Still, most people do eventually recover. Telogen effluvium generally does not cause total baldness or permanent hair loss. 

Stress-induced trichotillomania

Another way that an emotional strain may cause hair loss is by triggering a form of compulsive behavior known as trichotillomania, in which an individual repeatedly plucks out strands of hair from their body. The scalp is the  of hair pulling, but some people also pull out eyebrow hairs or body hairs. 

Trichotillomania may be caused in part by genetic and neurological factors related to obsessive-compulsive disorder (OCD). However, some patients report that episodes of hair pulling are brought on by periods of stress and anxiety, suggesting that psychological factors may also play a triggering or causal role. 

A person experiencing trichotillomania usually exhibits patchy hair loss rather than the diffuse thinning of hair seen in telogen effluvium. Patients may have irregular bald spots on their scalp, eyebrows, or otherwise hairy regions of their bodies. 

Stress-related alopecia areata

Estimated to affect around 2% of the global population at some point in life, alopecia areata is a disorder in which the immune system mistakenly targets hair follicles and disrupts their functioning. An affected individual’s hair most commonly falls out in round patches, typically on the head and face. Rarer forms can cause more widespread hair loss across the entire scalp or body. 

Normally, anti-inflammatory cytokine proteins protect hair follicles from harmful immune activity, but some circumstances can suppress these molecules. These can include various infections and medications, but research suggests that emotional stress and mental health disorders can also trigger this effect.

According to the National Institutes of Health, most people with this condition eventually see their hair grow back. However, they may experience further episodes of hair loss in the future.

Mental health impacts of hair loss

While hair loss may sometimes result partly or completely from emotional difficulties, it can also be a significant source of further stress. Many people exhibiting this symptom experience considerable worry, embarrassment, and loss of self-esteem. 

Results from many research studies suggest that the conditions described above can pose a significant risk to psychological health. 

• A 2024 study reported that telogen effluvium increases the risk of anxiety, depression, and social anxiety disorder and may interfere with social function.
• While trichotillomania commonly co-occurs with conditions like obsessive-compulsive disorder, depression, and post-traumatic disorder, many patients told researchers that their hair pulling caused them more distress than these associated mental illnesses. 
• Studies assessing the impacts of alopecia areata found that between 30% and 68% of affected individuals showed signs of anxiety and depression, and many reported considerable difficulty in navigating daily life as a result of their condition. 

Loss of hair can cause significant concerns about health, appearance, and social stigma. Many people impacted may avoid going out in public or attending work and social functions. Others may expend considerable effort to disguise their hair loss using wigs and other cosmetic techniques. Attempting to maintain and manage these concealment tactics can impose additional stress.

Gender and the psychological effects of hair loss

Although people of any gender may find hair loss distressing, studies indicate that the mental health impacts  for women. Hair health and thickness are often associated with attractiveness, but they may be seen as especially linked to concepts of femininity, fertility, and female desirability in many cultures. 

This effect can be seen even in forms of hair loss that don’t involve an underlying disorder. While both men and women can experience hair loss with advancing age, female pattern hair loss .

Treating mental health challenges arising from hair loss

Since hair loss is often linked with stress, untreated psychological symptoms may interfere with recovery. However, mental health treatment may significantly reduce the impact of hair loss on well-being and quality of life. 

Self-care for stress-related hair loss

Making lifestyle changes to reduce your overall stress may help if you’re experiencing conditions like telogen effluvium and alopecia areata. Research has identified a variety of healthy habits that may reduce the negative impacts of stress on the body, including:

• Eating nutritious foods
• Engaging in physical exercise several times a week
• Spending 30 minutes or more in natural surroundings on a regular basis
• Maintaining a healthy sleep schedule
• Practicing mindfulness meditation, yoga, deep breathing, and other calming mind-body exercises
• Engaging in relaxing sensory activities like aromatherapy or listening to calming music

Making time for rest and relaxation may also help, especially if your stress is related to your career or other obligations. Taking even short periods throughout the week to consciously focus on other things besides your worries could help you maintain a greater sense of well-being. This may be especially effective if you spend time with close friends or loved ones, which may provide a buffer against the physiological effects of stress.  

Finding therapy for stress-induced hair loss

Evidence-based therapy can also be an effective tool for reducing stress and coping with the psychological impacts of losing hair. However, finding a qualified mental health professional and attending therapy regularly may seem like a daunting task, particularly if your busy schedule is part of what’s driving your worry and anxiety. 

Many nonprofit organizations and government agencies provide tools to make locating licensed therapists easier. Examples include:

• Substance Abuse and Mental Health Services Administration
• American Psychological Association
• American Psychiatric Association (to find a psychiatrist)
• American Academy of Cognitive and Behavioral Therapies
• National Register of Health Service Psychologists

Restore your self-esteem and peace of mind after hair loss

Get help from a licensed therapist

You may also be able to find online therapy more easily than in-person treatment. Internet therapy platforms eliminate the need to travel to sessions and often provide more flexible scheduling options so that you can more readily fit treatment into your schedule. You can typically communicate with a therapist in a way that’s most comfortable for you, whether via audio, video, or live chat.

Research supports the effectiveness of online treatment for reducing psychological strain. A 2022 meta-analysis that included 13 clinical studies found that online cognitive-behavioral therapy can produce significant improvements in stress, depression, and anxiety symptoms. Working with a therapist online may help relieve the mental pressures related to unexpected hair loss.