Is someone afflicted with obsessive-compulsive disorder who pulls out hair (or harms their body in any way) considered sinful for their action, and does the ruling differ if they do not seek treatment due to circumstances preventing them?

One afflicted with obsessive-compulsive disorder (OCD) is not held accountable for actions over which they are overcome due to their obsessions. However, they are held accountable for what issues from their own will. Imam Al-Shafi'i stated that one whose intellect is overcome by illness is not bound by divorce, prayer, or legal penalties. He exemplified this with the mentally deficient, the insane, and the one suffering from obsessions. If such a person recovers and regains their intellect, then the religious rulings become binding upon them. There is no difference in this regard between one who is undergoing treatment and one who is not.