Anxiety, Depression, and Hair Loss

Young man with a blank expression leaning against a wall.

Hair loss can have a significant impact on an individual’s psyche and self confidence. And understandably so! Hair is part of an individual’s sense of self, so it’s no surprise that losing hair can result in a multitude of mental health difficulties. But once these struggles start to affect you, it becomes a bit of a chicken-egg situation: The stress, anxiety, and depression hair loss causes can actually make the problem worse. 

Hair loss can be emotionally devastating, but it’s important not to lose hope. Balding, depression, and anxiety don’t have to come hand in hand. There are lots of ways you can cope with hair loss.

Can Anxiety and Stress Cause Hair Loss?

There are many different factors that can cause hair loss. The most common type, pattern hair loss, is caused by genetics and hormones. But other forms of hair loss can be caused by a wide range of other factors, including physical and mental stress.

Telogen Effluvium

Telogen effluvium, also known as stress-related hair loss, is a form of hair loss caused by trauma or stress. The trauma may be emotional, like a very stressful life event, or physical, like childbirth, medication withdrawal, or a severe illness. (4) However, hair loss doesn’t occur immediately following these events. Symptoms usually appear about 3 months after the trigger occurred. (4,5) 

Telogen effluvium disrupts the hair growth cycle. An increased number of hairs move from the growing phase (the anagen phase) to the shedding phase (the telogen phase). This is what causes the increase in hair shedding and unexpected hair loss. (4) 

There is no specific treatment for telogen effluvium. Instead, treatments revolve around resolving the trigger and reducing stress. Often, hair grows back on its own. If not, it usually starts to grow back once the trigger is dealt with. (4) 

Telogen effluvium can cause significant emotional distress. Unfortunately, the distress caused by the hair loss can perpetuate the problem, causing a cycle. It can also aggravate other hair loss conditions, such as androgenic alopecia. (4,5) 

Androgenic Alopecia 

Androgenic alopecia, also known as pattern hair loss, is the most common form of hair loss. It affects up to 50 percent of males and females across the world. (1) 

As its name implies, androgens play a key role in the progression of androgenic alopecia. Androgens are hormones found in the human body. They support male sexual development, puberty, and hair growth. 

In pattern hair loss, an androgen called dihydrotestosterone (DHT) binds to hair follicles. This causes the hair follicles to shrink over time, a process known as miniaturization. As a result, the hair growth cycle is shortened, leading to the production of thinner, weaker strands of hair. Over time, this condition causes people to go bald. (2) 

Androgenic alopecia is known to cause psychological distress. In fact, studies have linked male pattern baldness to depression and anxiety. (3) Unfortunately, these negative effects on your mental health can exacerbate hair loss, causing telogen effluvium and speeding up the progression to baldness.  

Alopecia Areata

Alopecia areata is a form of hair loss caused by an autoimmune reaction. In this condition, the body’s immune system attacks hair follicle cells. When this occurs, hairs produced by these follicles move from the growth phase (anagen) to the shedding phase (telogen) prematurely. 

Alopecia areata usually causes round, smooth bald patches. They can occur on the head and anywhere else you grow hair, including your eyebrows, beard, and body. (6)

Alopecia areata can be short-lived and easily treatable. Other times, it’s a hard to treat, recurring problem. And in certain cases, alopecia areata symptoms can get much worse. What starts out as a small bald patch may turn into someone losing all of their hair – both on their scalp and their body. This form of alopecia areata is called alopecia universalis. 

Sudden hair loss is often very traumatic for people, especially if it becomes extensive. It can impact people’s sense of self and confidence, leading to severe anxiety and depression. Major depression, generalized anxiety disorder, and paranoid disorders have all been linked to alopecia areata. (7) Like with androgenic alopecia, telogen effluvium can occur concurrently with alopecia areata, worsening its symptoms or prompting further episodes. 

What’s the Relationship Between Hair Loss and Mental Health?

For most people, hair is a big part of personal identity: It plays a part in the way we see ourselves and our confidence. Think back to the last time you had a bad hair day. Even an easily resolvable situation caused by wind, rain, or humidity can put you in a bad mood. 

But what if every day was a bad hair day? When people experience hair loss, it can cause severe emotional distress. This can impact an individual’s mental health, causing increased stress, low self-esteem, and poor body image. Over time, this starts to take a toll. Research shows that people experiencing hair loss have much higher levels of depression, as well as a reduced quality of life. (3) 

Stress, Anxiety, and Hair Loss

Stress is the body’s reaction to feeling threatened, and in the short term it can be helpful. It enables us to deal with potential danger and keep ourselves safe. However, when stress becomes chronic it can take a toll on both your mental and physical health. Over time, stress can lead to anxiety. (8) 

Stress and anxiety are words that are often used interchangeably, but they’re not the same. Stress is caused by an outside trigger, including problems with a loved one, pressure at work, or in this case, hair loss. On the other hand, anxiety is a mental health disorder causing excessive ongoing worry and fear – even when there’s no external stressor. (8) 

Both stress and anxiety cause similar symptoms, including problems with concentration, fatigue, a feeling of doom, muscle tension, mood issues, and insomnia. These symptoms can make it difficult to function, regardless of whether you’re at work, in bed, or trying to relax. (8) 

Stress and Hair Loss

The stress caused by hair loss can cause individuals to withdraw. It’s common to feel like an outsider and to feel like people are judging you or laughing at you. This can make you avoid social situations, and can have an impact on both platonic and romantic relationships. (9) Research has shown that stress may play a part in causing hair loss, including androgenic alopecia and alopecia areata. (10) 

Anxiety and Hair Loss

Anxiety and hair loss are very much linked. Research shows that the emotional burden caused by hair loss is as severe as that caused by severe chronic or life-threatening diseases. (10) The sudden hair loss caused by alopecia areata can be particularly disturbing, with patients being three times more likely to experience anxiety than the general population. (7) 

Since ongoing stress and anxiety can lead to telogen effluvium, they can also perpetuate hair loss caused by other conditions. (5,10) Thankfully, there are many effective treatments for anxiety and stress, ranging from medication to lifestyle changes. (8) 

Depression and Hair Loss

If you’ve suddenly started going bald, depression is not uncommon. Research shows that people experiencing hair loss have much higher levels of depression than those without hair loss. They experience low self-esteem, poor body image, and have a reduced quality of life. Many people feel embarrassed, especially if their hair loss is particularly visible. (3) 

Withdrawing socially is common but can worsen depression. You might feel isolated and alone, even if logically, you know this is far from the case. You might become frustrated, irritable, and annoyed. 

Over time, this can lead to relationship and career issues. Some research suggests this can affect women more than men, although it can be a problem for anyone affected by hair loss. One study found that 40% of women with alopecia had marital problems and 63% had career-related problems. (3) 

Some studies have shown that dealing with alopecia causes similar emotional distress to grieving the loss of a loved one. The more severe the hair loss, the more likely an individual is to experience depression. (3) 

There are very effective treatments for depression, including psychological therapy and medication. But you should  know that there is a risk of hair loss as a side effect of certain antidepressants. It’s important to do your research and talk to your doctor before choosing a treatment. (11) 

How To Cope With Hair Loss

Depending on the type of hair loss you’re experiencing, there are many highly effective treatments that can help with hair regrowth. These include oral medications, topical foams and solutions, and even hair transplants. Just keep in mind that hair loss treatments take time to start working, and not every type of hair loss has an FDA-approved treatment.

Rather than trying out lots of treatments, some people may choose not to treat their hair loss, and instead learn to embrace their appearance and build confidence. Often, with therapy and an increase in self esteem, people can learn to accept themselves for who they are, even after losing hair. (12) 

Consider Exploring Hair Loss Treatments

When you think about going bald, are depression and anxiety at the forefront of your mind? The good news is that you probably don’t have to. Most people can stop their hair loss from getting worse. If you have androgenic alopecia, the most common type of hair loss, the FDA has approved several options that can help prevent you from balding.

If you’re experiencing another type of hair loss, your doctor can talk to you about other treatment options. Most other forms of alopecia need to be treated with medicated prescriptions, and different options will be recommended to you based on the type of hair loss you’re experiencing. 

Finasteride Pills

Finasteride is an oral DHT blocker that can help stop the progression of male pattern baldness. It lowers DHT levels to reduce the amount of DHT binding to the hair follicles. This helps stop the miniaturization process that occurs in androgenic alopecia and prevents further hair loss. (1) 

Liquid and Foam Minoxidil 

Minoxidil is a topical treatment applied directly to the scalp. It works by increasing blood flow. This increases the size of the hair follicles and helps them produce thicker, stronger hairs. (1) This treatment is FDA-approved for androgenic alopecia, but is sometimes used off-label for alopecia areata and other forms of hair loss. (18) 

Steroid Creams and Injections

Alopecia areata treatments often include steroid cream and injections that can help suppress the immune system locally, at the scalp. Creams like clobetasol and betamethasone reduce inflammation and can fight hair loss caused by an overactive immune response. They can also be used to help hair loss caused by skin conditions, like psoriasis. (16,17)

How To Reduce Anxiety From Hair Loss

If you’ve just started trying out a new hair loss treatment, you might feel a lot of anxiety while waiting to see if it will work. Or if you’ve been trying out different treatments for a while with little success, you might also be struggling with depression and feeling discouraged.

Your mental health is just as important as your physical health. Finding ways to reduce hair loss anxiety and overcome baldness depression is an important part of the journey. Thankfully, there are a lot of excellent treatments that can help. 

Try Psychological Therapy 

Talking therapies, such as counseling, cognitive behavioral therapy (CBT), and psychotherapy can be really helpful in managing anxiety and depression. These therapies help you to deal with how you’re feeling and enable you to replace negative thinking patterns with positive thinking strategies. (13) 

You can access talking therapy through your doctor or you may be able to self-refer depending on where you live. You can also seek therapy privately. If you do so, make sure your chosen therapist is registered and qualified. 

Attend a Support Group 

Support groups for people with hair loss can help you to connect with other people who understand what you’re going through. This can make you feel less alone and allow you to form connections with others so you can support one another. (13) 

Ask your doctor about local support groups or search online to see if there are any near you. Mental health organizations and hair loss charities often run their own groups. If you can’t attend sessions in person, you may even be able to join a support group virtually. 

Consider Medication 

Medication for your mental health can be helpful, especially if you’re trying out talk-therapy at the same time. Medications work to change the way your brain uses chemicals known as neurotransmitters, which help control your mood and emotions. (13)

Antidepressants are often prescribed to help treat depression and anxiety, but there are many other options available, including more natural solutions. Also, certain antidepressants have the potential to aggravate hair loss symptoms. Make sure you talk to your doctor about your options and any potential side effects. (13) 

Positive Lifestyle Changes Can Improve Mental Health

Lifestyle changes can help you feel more positive and will set you up for success. They’re often referred to as self-care, which simply refers to taking care of your physical or mental health. (14) 

Exercise Regularly

Endless research shows that exercise can benefit your mental health, helping release ‘feel good’ hormones, increase confidence, and reduce stress. (14) You might look at people running or at the gym and feel like those activities aren’t for you, but that’s fine. There are many types of exercise, and the activity doesn’t have to be strenuous. Start out slow and experiment with different options, like cycling in the park, swimming in the ocean, and taking a walk in the forest, to see what you enjoy. 

Eat Well

The food we eat is the fuel we give our body and mind. It’s important to eat a healthy diet to help your body function properly. 

A healthy diet gives you more energy, improves your mood, and can even help you think more clearly. Plus, a healthy diet is important for your hair, since certain types of hair loss have been linked to nutrient deficiencies. Keep in mind that eating well doesn’t mean you can’t have the foods you enjoy. Instead, focus on balance and make sure you’re getting all the nutrients your body needs. (14) 

Keep a Sleep Routine

How well you sleep impacts your mood, as well as your physical health. When you don’t get the right amount of sleep, it can worsen depression and anxiety. Having a consistent sleep routine can help support good mental health. All you need to do is go to sleep and get up at roughly the same time every day. (14) 

Be Social

As humans, we need connections with others to thrive. Try to socialize when you can and surround yourself with people who build your confidence and make you feel positive. (14)  

Practice Self-Compassion 

It’s so easy to be hard on yourself, especially when you’re feeling low. However, this only contributes to poor mental health. Try to practice self-compassion, treating yourself as you would treat a loved one. Be gentle with yourself, encourage yourself, and celebrate every step forward, even if it seems small. (14) 

Build Your Confidence 

There are many things you can do to build back your confidence. Focus on the things you like about yourself, both in regard to your looks and who you are as a person. It might help to write down three things each day that you feel proud of or that made you feel good about yourself.

Make sure that you’re dressing and presenting yourself in a way that makes you feel comfortable and confident. Try not to compare yourself to others or dress for other people. 

You can also practice positive self-talk in the mirror. All you need to do is look at yourself and list off the things that you like. You can do this out loud or in your head. Practice affirming mantras while you do this, like ‘I look great’, ‘My hair loss doesn’t define me’, or ‘I am perfect as I am’. 

It can be helpful to try new things, including new styles of dressing, new hobbies, or new activities. Getting out of your comfort zone can help you rebuild confidence. 

Consider Making Aesthetic Changes

If you’re unhappy with the way hair loss makes you look, you might want to consider changing your appearance. It’s fine if an old-school aesthetic approach to hair loss, like a toupee or wig, is not for you. Modern day aesthetic changes have far more options, including permanent and semi-permanent makeup, head coverings, and even just styling changes. 

Use Wigs or Hair Pieces 

Some people choose to wear wigs, hair extensions, and hair pieces to conceal their hair loss. Research shows that wearing a wig or hair piece can boost your confidence and have a positive impact on your mental health. (19) But exercising and socializing while wearing a wig can be anxiety inducing, as you might worry about it being noticed or falling off. 

This is a common theme, with many patients turning to avoidance for fear of their hair loss being noticed. It’s crucial to pair aesthetic changes with other strategies to help boost your confidence. 

Make a Styling Change

Depending on the extent of your hair loss, you may be able to change how you style your hair to make you feel more confident. Some people can style their hair to cover areas of hair loss, or color it to distract from bald spots. You may also be able to get your hair cut shorter or add in layers to make it look thicker. Certain hair styling products also add thickness and texture. 

Masculine presenting individuals might choose to cut their hair very short or shave it to hide their hair loss. If they’re experiencing symptoms of pattern hair loss, they might choose to grow out a beard to help build their confidence. 

Use Hats or Headwraps

You might feel more comfortable wearing a hat, headwrap, or headband to cover your hair. There are lots of different types on the market, so you can easily find something that suits your style, personality, and lifestyle. Just make sure you choose a head covering that fits over your scalp loosely and don’t wear them all the time. Wearing tight-fitted coverings regularly can chafe your skin and may worsen hair loss. 

Apply Makeup

Some people use makeup to conceal their hair loss, especially when it affects their facial hair. If you find applying makeup tedious, you can also turn to modern methods, like microblading. (12) This process might be particularly suitable for someone with alopecia areata.

Micropigmentation, known as semi-permanent makeup or cosmetic tattooing, is another option. Micropigmentation can be done to mimic facial hair or to fill in thinning areas of the scalp. Small, layered dots are applied to replicate the look of a natural shadow on your scalp. Since this process lasts for years and can have risks, it’s important to do your research and think it through thoroughly. (15) You can also use micropigmentation to enhance the results of certain hair loss treatments, like hair transplants. 

Hair Loss Doesn’t Have To Affect Your Mental Health

Hair loss of any kind can be upsetting, stressful, and significantly impact your mental health. And to make things worse, it usually takes a while before any treatment begins to work. But it’s important not to lose hope. There are so many ways you can cope with your hair loss. 

Lifestyle changes, including self-care, exercise, practicing self-compassion, and building self-confidence, can make a big difference on the way you see yourself. Aesthetic changes, like styling your hair differently, wearing makeup, or getting a semi-permanent tattoo, can also be useful.

Whether you choose lifestyle changes, a cosmetic procedure, or an FDA-approved therapy, keep your mindset positive while you explore hair loss treatments. Talk-therapy, medications, and support groups can help you improve your mental health while dealing with hair loss.

Improving your mental health is all about figuring out what’s best for you as an individual and understanding what makes you feel more confident. Over time, you’ll begin to feel like yourself again.

References

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  17. Abd Elazim, N. E., Kamal, A., Abdel Gaber, R. M., Fathy, E., & EL‐Deek, H. E. (2021). Efficacy of topical calcipotriol betamethasone dipropionate as a new adjuvant therapy to follicular unit extraction technique in treatment of stable vitiligo: clinical, dermoscopic and immunohistological study. Journal of Cosmetic Dermatology.
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Published on August 27, 2022

Last updated August 2022

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