Mental Health Impacts of Hair Loss: A Therapist’s Perspective (from someone who also has Alopecia)
It is no secret that any type of Alopecia diagnosis is life altering. My experience with Alopecia Areata is one of the biggest reasons I decided to become a therapist. Growing up with hair loss, I felt it in my nervous system, my relationships, my mirror, and just about any other aspect of my life. Clients tell me similar stories every week: the constant scan for shedding, the decision fatigue about hats and wigs, the ache of seeing an older photo, the frustration of weird comments and stares.
In this blog, I want to walk through the numerous psychosocial impacts of an Alopecia diagnosis along with associated research. I will also include some practical and evidence-based tips. However, I want to make it clear, that no simple tip or trick alone can take away the pain of this experience. As I tell my clients often, it is about looking for things that can help us feel a 1-2% shift. Overtime, these small shifts will accumulate and create lasting change… but it takes time, self-compassion and support. If you have a family member or friend with hair loss, I encourage you to give it a read! If you have hair loss yourself, I hope this can be validating… because it is not just hair.
Mental Health and Alopecia
Anxiety
Anxiety often arrives first. It can sound like: Will this get worse? Will people notice? What if my treatment stops working? Research backs up what many of us feel—people with alopecia areata (AA) have higher rates of anxiety disorders and clinically significant anxiety symptoms than the general population. In one systematic review and meta-analysis, 7–17% of patients had an anxiety disorder, and more than a third had anxiety symptoms that warrant monitoring. PMC
What helps:
Create “decision templates” for high-stress moments. Essentially, deciding ahead of time what support options you may need for stressful settings (e.g. having your favorite wig, bringing a hat in the car, bringing a trusted person with you to an event etc.)
Use body-based regulation (paced breathing, progressive muscle relaxation) before and after appointments or hair-related tasks.
Becoming a nonjudgmental observer of your anxious thoughts. Rather than going down the “what if” spiral, you will simply describe and notice what is coming up while providing compassionate validation that these feelings make sense.
Depression
Hair loss can challenge core meanings—identity, attractiveness, control—and depression can follow: low mood, withdrawal, sleep/appetite shifts, hopelessness. A large meta-analysis found similarly elevated rates of depressive disorders (7–17%) and a substantial burden of depressive symptoms among people with AA. PMC
A difficult but important finding: several population-based studies have linked alopecia areata with an increased risk of suicide attempts, even when accounting for other psychiatric diagnoses. If your thoughts move toward self-harm, that’s a medical emergency—reach out to local emergency services (911 in the United States) or a crisis line right away (988 in the United States). You deserve immediate care. KargerTaipei Medical University
What helps:
For those who have lost their daily routine since their diagnosis, slowly rebuild routines that align with your values (behavioral activation). Always start small (example: if you have stopped eating breakfast, you may start with adding this back into routine) I highly recommend behavioral activation to be done under the care of a mental health professional.
Ask for support from trusted people in your life, do not let depressive symptoms build up in loneliness.
Join support groups (you can find mine here) or follow others on social media who are going through the same thing.
Body Image
Hair frames how we recognize ourselves. Losing it can trigger appearance preoccupation, avoidance of photos, or hyper-focus on “flaws.” Studies in both alopecia areata and androgenetic alopecia show clear links between hair loss, body-image dissatisfaction, and lower quality of life. PMC
What helps:
Practice appearance-neutral self-talk: during Alopecia, positive self-talk or affirmations often feel unrealistic. Instead you can reframe with neutrality (example: reframing “I am so ugly” to “I experienced a large change in my appearance. It makes sense that I am struggling with how I look right now”)
Exposure, gradually: if you are struggling to leave the house due to fear of perceptions, you may benefit from small incremental exposures. I do not recommend this process without professional guidance if you are currently feeling overwhelmed. I often create small steps coupled with emotion regulation skills to support my clients.
Becoming aware of body checking (scanning hair, checking for spots in the mirror) and body avoidance (avoiding mirrors, sleeping in wigs etc.) behaviors so that you can reduce these behaviors overtime. I recommend doing this with a body image specialist.
Interpersonal Life (Dating, Work, Family, Social Media)
Hair loss affects how we show up with others. Patients report strain in relationships, higher work absenteeism, and social avoidance, particularly when hair loss is more severe. Recent research notes that people with greater than 50% hair loss often struggle more with well-being, relationships, and social situations; other studies document increased work disruption and social stigma. SAGE JournalsLippincott Journals
What helps:
Script your disclosure: a one-sentence share for acquaintances, a two-sentence version for dates or interviews etc. When strangers approach me about my hair loss, my go-to response is “It is called Alopecia, it simply means my hair can not grow” so that I am not overwhelmed with thinking of a response in the moment.
Boundary your bandwidth: decline image-heavy events when you’re not resourced, choose smaller gatherings, pick and choose who you disclose your hair loss with (not everyone is entitled to an explanation or your energy)
Recruit allies: ask one trusted person to be your “reset buddy” at events (eye contact, hand squeeze, quick break).
Identity & Stigma
Many clients (and I) describe a grief process: shock, bargaining (endless product research), anger, then meaning-making. Qualitative studies capture this lived experience—how visibility, comments from others, and daily management tasks shape emotions and functioning. Naming it as grief is often a turning point. PMCSpringerOpen
What helps:
Allow yourself to fully grieve, these feelings deserve to be felt.
Join communities where hair loss is normalized and discussed openly; co-regulation reduces shame and isolation.
Treatment Decisions
Medical options (topicals, oral meds, injections, devices) can support regrowth—yet the process of treating (monitoring, waiting, switching) is psychologically taxing. Emerging dermatology research emphasizes addressing quality of life and mental health alongside disease activity, not after. Oxford Academic
What helps:
Align treatments with your values (and having a doctor who encourages your autonomy rather than someone who feels pushy)
Create a “care cadence”: set calendar reminders for self-care after labs, check-ins with friends, and true rest days from research.
Give yourself permission to stop any approach that harms your mental health more than it helps your hair.
When to Seek Extra Support
You’re canceling plans, staying isolated, avoiding cameras/mirrors, or spending hours a day on hair checks/thoughts.
Sleep, appetite, routine, or energy are off for more than two weeks.
Thoughts of self-harm or suicide—seek emergency support immediately. (If you’re in the U.S., call or text 988 for the Suicide & Crisis Lifeline; outside the U.S., contact your local emergency number.)
Working with a therapist or hair loss coach who understands hair loss—because they’ve lived it—can make the process feel less clinical and more human. Hair may change. Your worth does not.
Where to Seek Support?
I can provide therapy to those who live in New York and hair loss coaching worldwide. If you are interested in working together, you can schedule a free consultation together here
I offer a free monthly peer support group for adults with hair loss. Sign up for our next group here
Not ready to speak with others? You may enjoy the Hair Loss Diary.
Key References
JAMA Dermatology meta-analysis on anxiety/depression prevalence in AA. PMC
Population-based cohorts linking AA with increased suicide attempts. KargerTaipei Medical University
Qualitative and patient-reported studies detailing social/emotional burden. PMCSpringerOpen
Body image & QoL research in hair loss, including androgenetic alopecia. PMC
Recent dermatology guidance emphasizing QoL/mental-health integration in AA care. Oxford Academic
