Until I heard a lecture on Obsessive-Compulsive Disorder (OCD) and a portion of that talk covering related disorders I had never heard of trichotillomania. I had never realized that there were related forms of OCD. Trichotillomania is not technically categorized as an OCD, but rather is medically classified as an Impulse Control Disorder. The following is a quick synopsis of trichotillomania.
Trichotillomania is simply a compulsion to pull out one’s hair, eyebrows, eyelashes and even pubic hair out causing bald patches to form. The unclothed or visable areas where the hair-pulling has occurred can be noticeable by family members and friends if they are around them on a regular basis. The person struggling with trichotillomania will usually not perform the act in front of others in order to keep it secret. Even though their hair loss can be embarrassing and shameful due to the value placed on beauty in our culture, the emotional pain is still not enough to deter this disorder from continuing. It must be treated.
It is estimated that 5% of the U.S. population is afflicted with trichotillomania. This means that if the U.S. population is around 300 million then about 15 million people suffer to some degree with trichotillomania.
Women and girls are the primary sufferers of Trichotillomania.
What is going on in the mind of someone struggling with trichotillomania? Why would someone want to pull their hair out or hurt themselves emotionally, physically, and socially? Untreated trichotillomania does tend to cause people to distance themselves from the person struggling with trichotillomania in loosely attached relationships as well as cause the person with trichotillomania to isolate themselves upon the negative perception of themselves.
We will address the “why” question later, but the interest here is the “what” question. For whatever reason, a person struggling with trichotillomania is experiencing a tremendous feeling of tension internally and has the need for a feeling of release. The hair-pulling for some reason provides a sense of relief or release from this intense pent up tension.
The key to treatment is obviously trying to unearth the cause of the precedent tension.
Those suffering from trichotillomania tend to:
1) Pull out one hair at a time.
2) Eat their hair (called trichophagia) which can cause “trichobezoar” or the blocking of an intestine; sort of
like what a hairball would do.
3) Go months at a time in abstaining, but eventually return in secret.
4) Inspect their hair root, twirl their hair, pull the hair between their teeth, and chew on the hair, but not
*There is no known medicinal treatment nor are there any tests to diagnose trichotillomania.
While there is no known exact cause for every sufferer of trichotillomania, evidence for most disorders points to a combination of genetic and environmental factors. Recent research does, however, seem to link a mutation in the gene SLITRK1 with trichotillomania as well as to Tourette syndrome. It is believed that a shortage of serotonin and dopamine, neurochemicals in the brain, may make one susceptible to trichotillomania.
People who suffer from trichotillomania tend to also suffer from depression and anxiety.
According to webmd.com, the risk of developing trichotillomania is higher in people who have relatives that struggle with depression and anxiety, suggesting that the disorder may be inherited.
Similarly to the treatment of other anxiety disorders, the goal is to expose the person struggling with trichotillomania to their fear without having them engage in in the impulsive disorder. The key is to discover the “trigger” or “cue” that is causing the internal tension or stress buildup.
Children tend to completely from trichotillomania. Adults, however, tend to struggle over their entire lifetime (chronic) as it is harder to treat.
Some helpful web sites to check out for the treatment of this disorder are as follows:
A helpful book is the following:
Keuthen, Nancy J., Dan J. Stein, and Gary A. Christenson. Help for Hair Pullers: Understanding and Coping with Trichotillomania. Oakland, CA: New Harbinger Publications, 2001.