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Trichotillomania | Making Sense of Unique Hair Pulling Disorder

Trichotillomania | Making Sense of Unique Hair Pulling Disorder
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Trichotillomania (pronounced trik-oh-till-oh-MAY-nee-uh) is as mysterious a medical condition to mental health professionals as it is to pronounce. But what exactly is the seemingly strange condition known as trichotillomania? Officially classified as an impulse control disorder, trichotillomania falls into the same category as pyromania (a pattern of deliberately setting fires), kleptomania (the inability to refrain from the urge to steal) and pathological gambling. In its most basic form, people who suffer from this extraordinary condition consistently pull out their hair to a point of noticeable hair loss.

The Onset of Trichotillomania

The compulsive hair-pulling of trichotillomania typically begins around the ages of 12 and 13 along with the onset of pubertal hormonal changes. However, it is not uncommon for trichotillomania to surface at a much younger or older age. In most cases, a stressful event marks the onset of the condition. Changes in school, family conflicts, abuse and the death of a parent are among the most common stressful events associated with the onset of trichotillomania.

Trichotillomania Sign and Symptoms

The main symptom of trichotillomania is the recurrent pulling out of one’s hair. Still, people of all ages experience the additional underling signs and symptoms of the impulse control disorder including:

  • Pleasure, gratification or relief when pulling out the hair
  • An increasing sense of tension experienced when resisting the behavior or immediately before pulling out the hair
  • Lack of an additional mental disorder or general medical condition such as a dermatological one
  • Significant distress or impairment in important functioning areas including occupations and social situations

Trichotillomania in Teens

Trichotillomania is especially prevalent during adolescence when teenagers ensure ridicule from family, friends or classmates over self-esteem, body image, comfort with sexuality and relationships with peers from both sexes. Along with the impulse to pull out the hair, teenagers with trichotillomania often experience intense shame over their inability to control the behavior. Many teenagers suffering from the disorder go on to avoid not only intimate relationships but also marriage in an effort to hide their shameful secret. An especially crucial time for development, adolescence essentially puts teenagers with trichotillomania at great risk for devastating problems that can last a lifetime.

What Causes Trichotillomania?

Although medical professionals are yet to identify an exact cause of trichotillomania, the impulse control disorder appears to be a medical illness related to a number of factors including biological disruptions in chemical messages between nerve cells in the brain. Just like any other illness, trichotillomania may also result from stressful circumstances or genetic predisposition. Finally, trichotillomania may manifest differently in different people just as a cough and many other medical problems do. Although medical professionals have their theories, further research is required to identify the true cause of trichotillomania.

Related Mental Health Problems

Trichotillomania so closely resembles the symptoms of obsessive-compulsive disorder that some medical professionals consider it a variant or sub-type of OCD. For one, counting, checking and washing are the most common symptoms of OCD that many people with trichotillomania also experience. Furthermore, OCD medications seem to be helpful in the treatment of trichotillomania, increasing the likelihood that the two are related. Finally, trichotillomania runs in families just as obsessive-compulsive disorder does. Once again, further research is required to officially link the two anxiety disorders together.

Although depression is common in people suffering from trichotillomania, medical professionals are yet to determine if the relationship is a direct neuro-biochemical one or a secondary one resulting from the low self esteem commonly associated with pulling out the hair. People with trichotillomania also commonly engage in similar behaviors including nail biting, head banging, thumb sucking, compulsive scratching and picking at the skin.

Treatment for Trichotillomania

Behavioral therapy and medication are two proven effective treatment methods for trichotillomania. In therapy, patients with the disorder learn to keep track of their symptoms and behaviors to help increase their awareness of hair pulling. Patients in therapy also learn to reverse the habit of pulling by substituting incompatible behaviors.

Medication proves particularly helpful in people suffering from trichotillomania, although cognitive behavioral therapy is almost always required to reap the full benefits of medication. The problem is that the relief people experience through medication is usually temporary and symptoms usually return after stopping the medication regimen.

Cognitive therapy helps ensure medication continues to provide relief from the symptoms of trichotillomania. Finally, medication may also help to reduce any of the depressive or OCD symptoms people with trichotillomania so often experience.

Let us know, do you or a loved one suffer from trichotillomania? Share your thoughts in the comments below.

Written by Anthony D'Aconti

Anthony D'Aconti is the Founder of Breathe Into the Bag, an anxiety magazine created to help people suffering from generalized anxiety disorder (GAD), OCD, PTSD, panic disorder, phobias, acute stress disorder, agoraphobia and social anxiety disorder. You can also find Anthony D'Aconti on Google+, Facebook, and Twitter

  • SMS

    Thanks for bringing attention to trich!!! I have suffered from it for 14 years and it affects every day life significantly.

    • Anthony D’Aconti

      I can certainly imagine its ability to affect everyday life. I hope that by raising awareness about trichotillomania, you can feel better understood and less anxious. I wish you the best!

  • glorrierose

    I remember doing this in my early to late teens. I had a bald patch, but it was hidden by my very long & thick hair. I remember the satisfaction of pulling out a hair and having the follicle come with it. I apparently outgrew it, because I certainly never received any therapy for it. This was in the 1960s and nobody talked about such things then.

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