Prateek Tanmay
When rapper Honey Singh recently revealed that he had become “completely bald” during his struggle with bipolar disorder and the medications used to treat it, his story highlighted how mental illness can produce physical consequences. Hair loss is one of them.
Certain mood stabilisers are scientifically associated with hair shedding but medication is one part of the story. Bipolar disorder can also disrupt sleep, alter hormone regulation, trigger chronic stress responses, worsen nutritional status and coexist with substance abuse, all of which can affect the hair growth cycle.
Hair follicles function in cycles. Most scalp hair remains in an active growth stage known as the anagen phase, while a smaller percentage enters the resting, or telogen, phase before naturally shedding. Under severe physiological or psychological stress, large numbers of follicles can shift prematurely into the resting phase, leading to excessive shedding several weeks or months later.
This type of hair loss usually does not permanently destroy follicles. Instead, patients experience diffuse thinning across the scalp, often noticing unusual amounts of hair on pillows, combs or shower drains.
Which mood stabilizers impact your hair
Among medications used to treat bipolar disorder, valproate — commonly prescribed in the form of sodium valproate or divalproex — has one of the clearest documented associations with hair loss. Clinical studies, like the one conducted by the Yenepoya Medical College, Yenepoya University, Mangalore, Karnataka, have reported varying rates of alopecia among users, with some estimates ranging between 5 and 20 per cent depending on dosage and duration of treatment.
Patients taking valproate sometimes report not only thinning hair but also changes in texture, brittleness or altered hair colour. Researchers believe the drug may interfere with biotin or Vitamin B7, a hair growth stimulant, and reduce levels of trace minerals such as zinc and selenium, all of which play important roles in hair follicle function. Some evidence also suggests that valproate can push follicles prematurely into the shedding phase of the growth cycle.
Lithium, another major treatment for bipolar disorder, can impair thyroid function. Hypothyroidism frequently causes diffuse hair thinning, dryness and increased breakage. Some antipsychotics may also contribute indirectly through hormonal and metabolic changes.
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Importantly, most medication-related hair loss associated with bipolar treatment is potentially reversible. Hair often regrows after dosage adjustments, treatment changes or correction of underlying deficiencies.
Bipolar disorder itself impairs hair growth
Even without medication, bipolar disorder can create biological conditions that disrupt normal hair growth. Severe manic or depressive episodes place enormous stress on the body’s endocrine and inflammatory systems. Researchers have increasingly linked psychiatric stress to cortisol release. Elevated stress hormones can interfere with the normal cycling of hair follicles, contributing to diffuse shedding. Dermatologists say they have observed how trauma impacts hair growth for years.
Sleep deprivation, which is one of the defining features of manic episodes, may also play a role. Modern research increasingly suggests that hair follicles are influenced by circadian rhythms and hormonal cycles linked to sleep quality. Persistent insomnia can increase oxidative stress and inflammation, both of which are associated with poorer hair health.
The role of substance abuse
In Honey Singh’s case, his public discussion of past alcohol and drug abuse is relevant because substance use can significantly worsen hair loss risk. Alcohol dependence is strongly associated with nutritional deficiencies involving iron, zinc, protein and B vitamins, nutrients essential for maintaining normal hair growth.
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Substance abuse can also impair liver function, increase systemic inflammation and disrupt hormone regulation. Stimulant drugs may intensify cortisol activation and sympathetic nervous system stress, while chronic alcohol use frequently worsens sleep quality and dehydration. Together, these effects create a physiological environment in which hair follicles struggle to maintain normal growth cycles.
Why nutritional deficiencies matter
Patients experiencing prolonged manic or depressive episodes often develop highly irregular eating patterns. Low iron levels are frequently associated with chronic shedding. Deficiencies involving vitamin D, zinc, protein and vitamin B12 are also commonly investigated in patients presenting with diffuse hair loss. In psychiatric populations, these deficiencies may remain undiagnosed for long periods because the primary clinical focus understandably remains on stabilising mood symptoms.
For this reason, dermatologists treating unexplained hair shedding often request laboratory tests evaluating ferritin, thyroid hormones and nutritional markers, particularly in patients with severe psychiatric histories.
Once the course of medication is over, hair regrows with patients being treated with topical minoxidil. However, psychiatrists strongly caution against abruptly discontinuing bipolar medication because the risks of relapse can be severe. As a result, physicians usually attempt to balance cosmetic side effects against the necessity of long-term psychiatric stability.
