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It is officially classified as an impulse control disorder,
along the lines of pyromania, kleptomania, and pathologic
gambling.
What are the Symptoms of
Trichotillomania?
- Recurrent pulling out of one�s hair resulting in noticeable
hair loss.
- An increasing sense of tension immediately before pulling out
the hair or when resisting the behavior
- Pleasure, gratification, or relief when pulling out the
hair.
- The disturbance is not accounted for by another mental disorder
and is not due to a general medical condition (i.e., dermatological
condition).
- The disturbance causes significant distress or impairment in
social, occupational, or other important areas of functioning.
How and When Does it
Start?
People often start compulsive hair-pulling around the ages of
12-13; although it is not uncommon for it to start at a much
younger or older age. Frequently, a stressful event can be
associated with the onset, such as: change of schools, abuse,
family conflict, or the death of a parent. The symptoms also may be
triggered by pubertal hormonal changes.
Does Trichotillomania Lead To
Other Problems?
During adolescence, which is an especially crucial time for
developing self-esteem, body image, comfort with sexuality, and
relationships with peers of both sexes, teens may endure ridicule
from family, friends, or classmates, in addition to feeling shame
over their inability to control the habit. Therefore, even a small
bald patch can cause devastating problems with development that can
last life-long. Although many people with trichotillomania get
married and carry on with their lives in a normal fashion; there
are those who have avoided intimate relationships for fear of
having their shameful secret exposed.
What Is the Cause?
There is no certain cause of trichotillomania, but the current
way of looking at trichotillomania is as a medical illness. One
theory on a biological level is that there is some disruption in
the system involving one of the chemical messengers between the
nerve cells in parts of the brain. There may be also a combination
of factors such as a genetic predisposition and an aggravating
stress or circumstance; as with many other illnesses. Further,
trichotillomania could be a symptom caused by different factors in
different individuals just as a cough can be produced by a
multitude of different medical problems. Finding the cause(s) will
take more research.
What Is The Relation To Other
Illnesses?
For many people with trichotillomania, there are symptoms of
obsessive-compulsive disorder (OCD) such as compulsive counting,
checking, or washing as well. There are so many similarities
between hair pulling and other compulsive symptoms that some
consider it a subtype or variant of OCD. This idea is supported by
the tendency for the two problems to run in the same families and
the fact that OCD medications can be helpful in treating
trichotillomania.
Depression also frequently occurs in individuals with this
illness. There may be a direct neuro-biochemical relationship
and/or be secondary to the chronic demoralization and low self
esteem hair-pulling can bring.
Other associated behaviors may include nail biting, thumb
sucking, head banging, or compulsive scratching. Frequently, hair
pullers also find they compulsively pick at their skin, which may
also cause physical and emotional scarring.
What Treatments Are
Available?
The two methods of treatment that have been scientifically
researched and found to be effective are behavioral therapy and
medications.
- Therapy: In behavioral therapy, people learn a structured
method of keeping track of the symptoms and associated behaviors,
increasing awareness of pulling, substituting incompatible
behaviors and several other techniques aimed at reversing the
�habit� of pulling.
- Medications: Although medications clearly help some people
temporarily, symptoms are likely to return when the medication is
stopped unless behavioral therapy is incorporated into treatment.
Medications may help to reduce the depression and any
obsessive-compulsive symptoms the person may be experiencing.
Commonly used medications
are:
- fluoxetine (Prozac)
- fluvoxamine (Luvox)
- sertraline (Zoloft)
- paroxetine (Paxil)
- clomipramine (Anafranil)
- valproate (Depakote)
- lithium carbonate (Lithobid, Eskalith)
FOR MORE INFORMATION:
Contact your local Mental Health Association, community mental
health center,
or for additional resources, please call 1-800-969-NMHA.
National Mental Health
Association
2001 N. Beauregard Street, 12th Floor
Alexandria, VA 22311
Phone 703/684-7722
Fax 703/684-5968
Mental
Health Resource Center 800/969-NMHA
TTY Line 800/433-5959
Obsessive Compulsive
Foundation
337 Notch Hill Road
North Branford, CT 06471
Phone: 203-401-2070
Trichotillomania Learning Center,
Inc.
303 Potrero #51
Santa Cruz, CA 95060
Phone: 831-457-1004
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