A 41 year old female patient consulted for c/o severe hair fall for the last 10 years. Her hair loss had become worse since the last 5 years. Her complaints started with weight loss and slight hair fall at the vertex. Hair started falling in circular patterns with the patch spreading to the occipital region. Gradually, the patient lost complete hair over her scalp. She had tried various treatments with practically no improvement. She entered the overcrowded OPD on a very warm and humid day, with her head fully covered with a scarf.It was obvious that she was extremely uncomfortable in the heat, yet, was very reluctant to take the scarf off even for examination. She said that she felt extremely embarrassed of her bald head and had stopped going out of home.Patient stated that her complaints began after the death of her family members. Patient experienced shock and took a long time to get over the loss.Past History:Patient is mild anaemic, non diabetic with normal thyroid function. She was diagnosed with high blood pressure on routine examination 7 years ago and had started takingantihypertensive (Telmisartan).Family HistoryBoth parents are aliveMother: HealthyFather: k/c/o hypertension and extensive Vitiligo since 15 yearsOne younger sister was diagnosed with Vitiligo, indicating a history of autoimmune disorders in the family.Personal HistoryPatient has marked craving for fish. She complains of dribbling urine on coughing.Life Situation and Mental StatePatient is very sensitive, emotional and highly self-respecting (in her ownwords). She is extremely sensitive to criticism and weeps when people talk abouther physical condition. She has stopped going to the local post office where she worked as a clerk for 10 years. She doesn’t not go for social functions and has recently stopped stepping out of home. She is married with 2 children and has become reclusive with her own family too. Feels guilty about her condition and blames herself for this state.