At her wedding in September 2015, Mary Mitton wore a cream-colored empire-waist dress and cream-colored flip flops, but not her own hair.
The dark-brown, chin-length wig had been a constant in her life for the previous three years.
It belied a lifelong challenge for the Westerville resident: Mitton (who now uses the last name Mitton-Sanchez) had pulled out so much of her hair — as much as 85 percent at times — that she no longer could mask it with creative hairstyling.
From a young age, she has suffered trichotillomania, the compulsion to pull out one’s hair.
Her family and close friends knew what she was doing. She saw various therapists to try to stop.
What prevented her from succeeding, though, was herself: She wasn’t truly committed to stopping.
“It just hasn’t seemed unusual to me,” Mitton-Sanchez explained. “For most of my life, it didn’t seem as harmful to me as something else I could be doing that would be so much worse.
“I understand now I was trying to rationalize it.”
Eventually, the catalyst for change was two-fold: In 2013, she began experiencing pain in her left hand and shoulder (symptoms consistent with repetitive-motion injuries) and she grew to detest the stifling, heat-trapping wig.
“At some point, I started to want freedom more than I wanted to pull out my hair,” said Mitton-Sanchez, 30.
This time, she succeeded.
These days, Mitton-Sanchez takes pride in her natural hair again, which she wears in a pixie cut. She debuted the new look in August at the start of the school year at Big Walnut High School, where she teaches English and journalism.
And she now wants to speak out about trichotillomania — a little-known condition that’s “taboo,” she says — in hopes of helping others who might be suffering in silence.
“I always knew once I started growing my hair out that I would want to say what has happened to me,” she said. “I think there are a lot of people who deal with this. How can they talk about it? And who can they tell about it?”
Estimates of how many people nationwide have trichotillomania (pronounced “TRICK-o-TILL-o-mania”) vary from 1 to 4 percent, with women as much as four times as likely to have it.
Current medical research points to a combination of genetic and environmental causes. The condition is typically treated through psychotherapy, specifically cognitive behavioral therapy.
People with “trich” describe a physical compulsion to pull, sometimes likening it to the need to scratch an itch. The act of pulling out hair brings relief.
“It can really warp people’s lives,” said Jennifer Raikes, executive director of the TLC Foundation for Body-Focused Repetitive Behaviors.
The foundation, based in Los Angeles, helps raise awareness and provides education and support for those affected by hair-pulling and skin-picking, another common compulsion.
“There’s a physical aspect of it that can be dangerous,” Raikes said. “But hiding it, feeling alone and shamed, that can be deeply impactful to your quality of life as well.”
Mitton-Sanchez grew up in Galloway with her parents, Jeff and Jackie, and younger brother, Tommy, now 27. Mrs. Mitton said Mary began pulling her eyelashes, eyebrows and hair out when she was about 6.
Mary thinks the trigger might have been a short bout of epilepsy that she endured at the time (and that disappeared in less than a year). The trauma for a young girl, she thinks, might have triggered the compulsion.
“At first, it was very hard to deal with, because we didn’t understand it,” Mrs. Mitton said. “ This was pre-internet, so we didn’t know where to turn for help.
“It was just kind of our thing, between Mary and the family. We tried to help her in our own way, but sometimes it wasn’t helpful at all.”
As she grew older, Mitton-Sanchez began covering up her thinning or bald spots by wearing her hair in a ponytail, or using multiple barrettes.
Several of her close friends, though, knew what she was doing.
“Mary is the type of person who, if you need something, call Mary, because she’s a ‘fixer,'” said Rachel Murdock, a South Side resident who has known Mitton-Sanchez since middle school.
“So it was an interesting juxtaposition: Here’s someone who seemed to have all her ducks in a row and yet there was something she didn’t know how to fix.”
At Westland High School, Mitton-Sanchez was a cheerleader and the president of the senior class of 2004. She earned a bachelor’s degree in language-arts education at Miami University in 2008, the same year she started at Big Walnut.
It was in 2012, while she was taking online classes toward a master’s degree in journalism education, that Mitton-Sanchez’s pulling worsened, prompting her to buy a wig.
“It’s hardest for me if I’m just sitting on a couch, or watching TV,” she said. “I have busy hands; I can’t just let them sit in my lap and rest.”
Her husband, Daniel Sanchez-Geraci, whom she met in 2010, described her then as almost trancelike: “It (hair pulling) was almost automatic.”
Sanchez-Geraci was puzzled but supportive.
“My thing was always, ‘How can I help you?’” he said.
Eventually, as Mitton-Sanchez said, she had to want to help herself. Using techniques she had learned in previous therapy sessions, she worked on mental retraining, focusing on “mindfulness instead of busy-ness.”
In August, she went to a Westerville salon for her first haircut in four years.
Several days later, she went to lunch with Murdock — the first time in 12 years, she estimates, that she had been in public with her natural, unaltered hair.
The lunch date was a test: If Murdock thought she looked good, Mitton-Sanchez was prepared to ditch the wig to start the new school year.
“She felt like everyone was looking at her,” Murdock said. “She thought maybe it was because they thought her hair looked weird. I told her they might be looking at her because she was smiling and looked awesome.
“She looks so beautiful. She glows now.”
Five months later, Mitton-Sanchez is doing well. She smirks when people ask whether she’ll ever grow her hair longer, thinking to herself they don’t realize how long her hair is now compared with that of several years ago.
She has recovered to the point where she can run her hands through her hair without pulling, and even joke about it.
“When my hair grew back, I discovered I have a few gray hairs now, and I’m mad,” Mitton-Sanchez said. “So I allow myself to pull one hair a week now — a gray hair.”