Up until 2012, I had a beautiful head of hair - long, thick, dark, and wavy, and I was incredibly vain about it. One day I woke up to find a bald spot the size of a quarter, just above my right ear. I fretted over it all weekend, and every time I ran my fingers over the area, more hair fell out. One month later, I was completely bald and diagnosed with a condition called alopecia totalis (AT). AT is a variant of an autoimmune disorder otherwise known as alopecia areata (AA), which is thought to have a genetic origin, but an unpredictable onset, course and prognosis. In other words, the world-class dermatologist who diagnosed me could not tell me why I developed this condition and if or when my hair would ever grow back. Treatments exist, but there is no guarantee that they work. There was nothing left to do but adapt to my new look (and single lifestyle), and fast. Circumstances forced me into radical acceptance. AT did not cause me any physical pain or discomfort (other than being colder), so I had no choice other than to continue with my regular routines and responsibilities. The thoughts that anchored me and enabled me to function were a personal variation on the Serenity Prayer, and that "All people are naturally naked and put on clothes every day. I am just a little extra naked." In the end, my hair grew back after about a year, but I had developed a very different relationship to my appearance.
Unsurprisingly, dermatological disorders are linked to psychological conditions such as depression and anxiety, and the relationship is bidirectional (Talaei et al., 2017). A description by Li and Sinclair (2016) of AA as a chronic, relapsing-remitting chronic disorder made it sound a lot like MDD. I wondered if, like many other psychological disorders, cognitive behavioural therapy and antidepressant treatment might be a viable option. Indeed, embracing radical acceptance was a necessity for me to cope.
Li, J., & Sinclair, R. (2016). Clinical observations in alopecia areata: Implications and hypotheses. Australasian Journal of Dermatology, 57(1), e29–e31. https://doi.org/10.1111/ajd.12227
Talaei, A., Nahidi, Y., Kardan, G., Jarahi, L., Aminzadeh, B., Jahed Taherani, H., Nahidi, M., & Ziaee, M. (2017). Temperament-Character Profile and Psychopathologies in Patients with Alopecia Areata. Journal of General Psychology, 144(3), 206–217. https://doi.org/10.1080/00221309.2017.1304889
In an exploration of factors that influence resilience and posttraumatic growth in children recovering from burn injuries, Ashley et al. (2020) underscored the importance of supportive family relationships that helped children re-integrate into everyday life at home and school. In their literature review, the authors identify that pragmatism and acceptance of pain were additional factors that promoted resilience in adults.
Although I was in my 30s when I lost my hair, I turned immediately to my parents for emotional support. I booked last-minute travel to be fussed over by my mom for a few days before returning to work. My partying lifestyle ended very abruptly with my hair loss, and my social life dropped off as a result. However, two additional factors supported my resilience. As I learned more about alopecia, I discovered the anguish that many mothers experience when their children develop alopecia as they fear their children will be bullied at school. This fact made me resolve to eat the initial embarrassment I would feel in response to others' shocked reactions to my appearance. I wanted to serve as a role model for any students in my school that might have a similar illness and quietly challenge anyone to make a negative comment. Another source of support, that is just dawning on me now, was befriending a new teacher in town. She had never known me before my hair loss, but her acceptance and caring upon meeting made a big difference in helping me realize my value as a human being. Thank you, Kristen J!!!
Ashley, V. N., Jacobs, R., Hornsby, N., Singh-Adriaanse, R., Sengoelge, M., & Laflamme, L. (2020). Enablers of psychosocial recovery in pediatric burns: Perspectives from the children, parents and burn recovery support staff. BMC Pediatrics, 20, 1-11. doi:http://dx.doi.org.csu.idm.oclc.org/10.1186/s12887-020-02180-z