Alopecia Areata: Coping With Anxiety and Depression
Skin ConditionsAlopecia

Is Your Alopecia Areata Making You Anxious or Depressed?

Is Your Alopecia Areata Making You Anxious or Depressed?
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Published on November 19, 2025
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Treating Alopecia as a Superpower

Founders of the Alopecia Justice League share their mission to educate people about alopecia areata and create a community for those living with the condition.
Treating Alopecia as a Superpower

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Alopecia areata causes patchy hair loss on the scalp — a symptom many find distressing.

 Sometimes this distress can grow into anxiety and depression, which affects up to 17 percent of people with this autoimmune condition.

Many people describe an overwhelming sense of shock and loss when they first notice their hair falling out in patches, says Alan J. Bauman, MD, a hair restoration physician at Bauman Medical in Boca Raton, Florida. “It is not just about hair; it is about identity and confidence.”

Hair loss from alopecia areata can make you want to isolate yourself from social activities, which can worsen quality of life and contribute to mental health disorders like depression or anxiety.

 But support is available for anyone with alopecia areata who is having difficulty coping with their hair loss.

Emotional Reactions to Alopecia Areata

Losing your hair, even in small amounts, can provoke strong emotions. “The most common emotional reactions [to alopecia areata] are anxiety, depression, or grief,” says Catherine Schuler, PsyD, a clinical psychologist at the Center for Anxiety & Behavior Therapy in Bryn Mawr, Pennsylvania, who also has alopecia areata.

Alongside these emotions, people also report feeling:

  • Withdrawn and isolated
  • Fearful and angry
  • Embarrassed
  • Guilty

“There is so much uncertainty in receiving this diagnosis — you have no idea how much hair you will lose, at what rate, and if it will ever grow back,” says Dr. Schuler. “There is a sense of constant worry about how much hair is falling out.”

These feelings can affect your quality of life and stop you from doing things you enjoy. “For some, the unpredictability of the condition, which can flare and [get better] without warning, adds to the emotional burden,” says Dr. Bauman. People with alopecia areata can also develop post-traumatic stress disorder (PTSD), waiting for their hair loss to start up again.

Whatever you feel about your alopecia areata, your emotions are valid. And if negative feelings start to affect the quality of your life, you have options for support. Even if you don’t feel what you would call anxiety or depression, it’s important to have a safe space to discuss emotions surrounding your diagnosis.

How Do You Know if You’re Depressed?

Depression, a common mental disorder, changes the way you act or think by causing persistent sadness and loss of interest in activities you enjoy.

 It’s sometimes difficult to tell the difference between sadness and depression, but you can get clues from how this feeling affects your day-to-day functioning and how long it lasts, says Schuler.

“For example, if someone is sad and upset when talking about their alopecia or in moments where they are frustrated by it, but they are able to engage in their life — go to work, care for themselves and their families, do activities that they enjoy, spend time with friends — then this is likely more in the ‘normal’ range,” says Schuler. But if you isolate yourself, avoid work or school, or say no to enjoyable activities with friends and family, then Schuler says she would consider a depression diagnosis.

Depression symptoms can look different from person to person, but may include:

  • Sadness and irritability
  • Emptiness and hopelessness
  • Changes in appetite (eating much more or much less than normal)
  • Sleeping too much or not enough
  • Fatigue
  • Restlessness, pacing, and hand-wringing
  • Feelings of worthlessness
  • Excessive guilt
  • Trouble with memory and concentration
  • Difficulty with decision-making
  • Thoughts of self-harm
If you experience the symptoms above, let your provider know right away. They can help you find the support you need. If you have thoughts of self-harm, call or text 988 anytime, day or night, to speak with a trained counselor free of charge.

How Do You Know if You Have Anxiety?

Everyone experiences anxiety now and then — it’s a normal response to stress. “But anxiety disorders cause ongoing, excessive concern that is difficult to control,” says Bauman.

If occasional anxiety has turned into an anxiety disorder, you may have these symptoms:

  • Excessive worry about everyday things
  • Difficulty controlling nervous feelings
  • Irritability, restlessness, and difficulty concentrating
  • Trouble sleeping
  • Fatigue
  • Pain in your head, muscles, or stomach
  • Trembling or twitching
  • Heart palpitations
  • Excessive sweating
  • Feeling out of breath or breathing very fast
  • Difficulty swallowing
  • Nausea or diarrhea

Many people with alopecia areata avoid favorite activities, check frequently for hair loss, seek excessive reassurance from others, or spend a lot of time researching the topic, says Schuler.

“All of these reactions are very normal upon first getting the diagnosis, as well as at any big moments of change, like if someone decides to begin wearing wigs, shave their head, or there has been a big shift in the rate of hair loss,” says Schuler. “But if these symptoms persist, then it may be an anxiety disorder.”

If you experience anxiety symptoms above, let your provider know, and they can recommend treatment and support.

Treatment for Depression

Providers treat depression with medication and psychotherapy, and a combination of the two typically works best.

 Antidepressant medications like sertraline (Zoloft) and duloxetine (Cymbalta) improve depression symptoms by changing the way certain neurotransmitters (brain messengers) communicate.

Psychotherapy, also called “talk therapy,” can improve depression by helping you develop new habits and ways of thinking about any stressor, including hair loss. One popular therapy type, cognitive behavioral therapy (CBT), incorporates mindfulness, and it challenges negative thought patterns.

Depression treatment takes time to work, and if your symptoms get overwhelming during treatment, your provider or the 988 helpline can offer additional support.

Treatment for Anxiety

Anxiety treatment may also include medications, but typically centers on psychotherapy. CBT can improve negative cycles of worry and retrain your brain away from these thought paths.

Some antidepressants, like venlafaxine (Effexor) and sertraline (Zoloft) also treat anxiety. For severe bouts of anxiety, your provider may recommend short-term benzodiazepines like alprazolam (Xanax) or diazepam (Valium), but these medications are prescribed less often because of side effects like dependence.

Besides talk therapy and medications, many find mindfulness, yoga, music therapy, and acupuncture offer anxiety relief.

 Stress from anxiety can make hair loss worse, but you can break that cycle with treatment to help both your hair and emotional well-being, says Bauman.

Support for People With Alopecia Areata

Connecting with others who have alopecia areata can be tremendously helpful in navigating the uncertainty and fear that can accompany the diagnosis, says Schuler. “I would highly encourage anyone receiving an alopecia areata diagnosis to seek therapy, as well as seek out support from others with the diagnosis.”

You can find support groups in your area through the National Alopecia Areata Foundation in the United States. For support outside the United States, you can email info@naaf.org or visit Alopecia UK. These groups offer a community full of people who share your experience and can offer advice and guidance.

The Takeaway

  • Alopecia areata causes patchy hair loss, which can trigger strong negative emotions in anyone affected.
  • People with alopecia areata have a higher risk of anxiety and depression disorders, but treatment options are available.
  • If you have alopecia areata, you can find support through mental health professionals and community support groups.

Resources We Trust

EDITORIAL SOURCES
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Resources
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  3. Sibbald C. Alopecia Areata: An Updated Review for 2023. Journal of Cutaneous Medicine and Surgery. 2023.
  4. van Dalen M et al. Anxiety, Depression, and Quality of Life in Children and Adults With Alopecia Areata: A Systematic Review and Meta-Analysis. Frontiers in Medicine. November 2022.
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  7. 988 Lifeline: If You Need to Talk, the 988 Lifeline Is Here. 988 Lifeline.
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Angela D. Harper, MD

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Angela D. Harper, MD, is in private practice at Columbia Psychiatric Associates in South Carolina, where she provides evaluations, medication management, and psychotherapy for adults.  

A distinguished fellow of the American Psychiatric Association, Dr. Harper has worked as a psychiatrist throughout her career, serving a large number of patients in various settings, including a psychiatric hospital on the inpatient psychiatric and addiction units, a community mental health center, and a 350-bed nursing home and rehab facility. She has provided legal case consultation for a number of attorneys.

Harper graduated magna cum laude from Furman University with a bachelor's degree and cum laude from the University of South Carolina School of Medicine, where she also completed her residency in adult psychiatry. During residency, she won numerous awards, including the Laughlin Fellowship from the American College of Psychiatrists, the Ginsberg Fellowship from the American Association of Directors of Psychiatric Residency Training, and resident of the year and resident medical student teacher of the year. She was also the member-in-training trustee to the American Psychiatric Association board of trustees during her last two years of residency training.

Harper volunteered for a five-year term on her medical school's admission committee, has given numerous presentations, and has taught medical students and residents. She currently supervises a nurse practitioner. She is passionate about volunteering for the state medical board's medical disciplinary commission, on which she has served since 2015.

She and her husband are avid travelers and have been to over 55 countries and territories.

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