Trichotillomania - What To Do When You're a Puller

Trichotillomania (or Trich for short) is an impulse control disorder characterized by the pulling out of hair from the scalp, eyelashes, pubic area, underarms, beard, chest, legs, or other parts of the body, resulting in noticeable bald patches.  Hair pulling varies in it's severity, it's treatment, and the location of the body that the hair is pulled from.

At the current time, not much is known about Trichotillomania.  There are, however, studies that seem to point to trichotillomania having more to do with genetics rather than simply the environment, however, environmental factors can also play a role in trichotillomania and it's onset.

Trichotillomania resembles Obsessive-Compulsive Disorder in some ways, such as the feelings of compulsion and repetitive behavior, but  is entirely different as they have different diagnoses and treatments.

Trichotillomania is commonly characterized by these factors:

• The inability to resist urges to pull out one's hair.
• Noticeable hair loss.
• Gratification and relaxation when pulling hair.
• Mounting tension before pulling the hair.
• A feeling of relief after pulling.
• Increased distress or interference with daily life.

Sadly, due the fact that Trichotillomania is not widely understood, there are few treatments readily available and fewer psychologists and therapists that are familiar with the condition. However, studies have shown that Cognitive-Behavioral Therapy (CBT) has proven to be effective. Types of Behavioral Therapy may include Habit Reversal Training , which increases the person's awareness of when they pull, and what they may have been thinking of, doing, where they were, and more. They may keep records of when the pulling occurs, and in addition, learn a different response to put in place of the hair pulling (such as clenching the fists). Another type of Behavioral Therapy is Stimulus Control Procedures , which may include the person wearing impediments on their fingers such as bandaids, gloves, or fingertip protectors.

Medication is another option, although there is not a medication that is a cure-all for trichotillomania as of yet.  It has been found that combining medication with therapy helps as well.

In addition to medication and cognitive-behavioral therapy, there are also alternative methods that have been claimed to work, but have not been backed up by scientific evidence.  Some examples are:

• Yoga
• Dietary changes
• Prayer
• Hypnosis
• Meditation
• Herbal Remedies

Trichotillomania can begin at any age, therefore, anybody can develop it at any time.  The majority of hair pullers do begin at childhood or early adolescence, however, some it only lasts a brief while, while in others, it grows into a full-fledged disorder.

There is also a subset of younger children in the ages of infancy and preschool that also pull hair.  It is very rare that it continues on to become trichotillomania disorder, however.

Yes, trichotillomania can cause other issues.  Most of the time, when a person has trichotillomania, they also become depressed, and can also develop anxiety, mostly involving social situations.

It can also cause some strife in families.  Many parents of children who have trichotillomania, or spouses of one with trich, think it is their fault, therefore an uneasy stigma can form in the household.  For parents or loved ones of trichotillomania are often encouraged to go to group counseling to speak with other parents or loved ones who have the same issues.

As far as health concerns, the damage is normally purely cosmetic.  However, some with trichotillomania often play with, and eat the hair.  When hair is ingested, it can cause hairballs in the stomach and intestines that normally do not pass.  These are called trichobezoars, and can be dangerous and potentially fatal if not given medical attention.

I am currently a student pursuing a degree in Psychology.  My biggest goal in life is to be able to help people in some way.  That is why I picked this profession.  In addition to my career goals, I have also suffered from Trichotillomania.  It is not as severe now as it has been in the past, but I had to deal with it on my own, because at the time that I was diagnosed, there was nobody that specialized in my disorder.  After I get my doctorate, I am going to make a point to specialize in this field, and let others know that they are not alone.