Trichotillomania, also known as the hair pulling disorder is an uncontrollable mental disorder which involves irresistible urges to pull hair from the scalp, eyebrows and other parts of the body.

The disorder often leads to patchy bald spots which lead to significant distress and interferes with work and social function. This disorder is distressing for the individual involved, and as a result, they may try to hide their hair loss.

Trichotillomania can be manageable for some; however, others have a compulsive urge to pull hair, and this can be overwhelming for some. There are treatment options available to help those with the disorder to stop pulling their hair, but the confusion on what treatment to go for proves challenging as each procedure can have differing effects on each individual.

Trichotillomania is a long-term (chronic) disorder. It requires treatment, and without it, symptoms may worsen. For some people, if not treated, symptoms can come and go for weeks, months or years at a time. Rarely, hair pulling ends within a few years of starting.

Symptoms

Symptoms include:

-Distress that can translate into problems and to work, social situations or education.

-Repeated attempts to minimise symptoms with little results.

-Playing with the pulled-out hair or indeed using it to run across your face (other bodily areas).

-Chewing, biting, nibbling, eating the pulled-out hair.

-Pulling hair out in recognisable patterns (when exposed to stressful situations).

-A noticeable hair loss or shortened hair length resulting in bald patches on the areas of hair.

-A sense of pleasure, satisfaction or relief from pulling the hair.

-The tension that is noticeable before pulling.

-Repeated pulling of the hair, typically from the scalp, eyebrows or eyelashes (this can include other areas of the body).

Accompanying symptoms are often associated with Trichotillomania which includes picking the skin, biting nails or chewing on the lips. Most try to disguise the disorder from the public and do this in private however urges can sometimes be uncontrollable.

Automatic Response and Focused Responses

Some individuals can pull their hair intentionally to relive the tension or distress they are experiencing to combat their urges to pull at the hair, and some have an automatic response and pull their hair without even realising. This can be dependent on the situation that the individual may be facing, and some may do both automatic and focused hair pulling.

Negative and Positive Emotions

Trichotillomania is primarily related to our feelings whether that be a negative or positive emotion.

For many trichotillomania and its hair pulling symptoms may be a way of dealing with uncomfortable feelings of stress, tension, anxiety, boredom, depression, frustration or even loneliness.

For others, trichotillomania often finds the sensation of pulling hair satisfying and offers a sense of relief. Trichotillomania for that reason can be addictive, and many continue with the hair pulling to maintain their positive feelings.

What Shall I Do?

Trichotillomania and its causes are unclear but can be a result of a combination of genetic and environmental factors. If you recognise any of these symptoms, you should visit your doctor as this is not just a bad habit and is a severe mental health disorder which will not improve without the proper treatment.

Do I Have An Increased Risk Of Trichotillomania?

As previously mention Trichotillomania is contributable to both genetic and environmental factors.

-Your family history and genetics play a role in your development and those with close relatives may be at a higher risk of developing trichotillomania.

-The average age of development of trichotillomania is just before or during the early teens and often seen in ages 10-13. It is usually a lifelong problem.

-People who have other neighbouring mental disorders such as anxiety, depression or OCD are at a heightened risk of developing trichotillomania.

-Stress is a significant factor to play and can trigger trichotillomania in stressful situations.

Complications Involved In Trichotillomania

Trichotillomania can have significant adverse impacts on your life causing:

-Emotional distress such as shame, embarrassment and low self-esteem among many other mental health problems.

-Skin and hair damage can be caused by the pulling of hair leading to infections on the affected area which would lead to further complications in regrowth of new hair.

-Hairballs can be a by-product of eating large amounts of your hair (trichobezoar) in your digestive tract causing vomiting, intestinal obstruction and even death.

-Work and Social functioning is affected due to embarrassment and can often mean that people will avoid social situations, job opportunities and confidence in themselves to perform to their best ability at work, socially and even in their sexual lives.

So, what can be done to combat Trichotillomania?

It is important to remember that this disorder is a long-term (chronic) disorder and will require treatment to prevent worsening symptoms.

Diagnosis Of Trichotillomania:

-Identifying any mental or physical health problems associated with hair pulling.

-Eliminating all possible causes through testing through your trusted dr.

-Discussing your hair loss problems and asking as many questions as you can.

-Seeing how much hair loss you have

Treatment options are limited for this disorder; however, there are avenues to explore to manage, reduce or stop the hair pulling entirely.

Therapy Is Available And Can Include:

-CBT (Cognitive behavioural therapy): This can help you examine, identify and unlearn and distort your beliefs that may have caused you environmentally to begin your hair pulling.

-Acceptance and commitment therapy: The therapy teaches you to accept your urges but without acting upon them.

-Habit reversal training: This is the primary treatment used and enables you to recognise situations where you are at most risk of acting on your urges and how to substitute other behaviours instead. This redirects your urges on.

-All three options are advised to be used alongside each other to benefit from the best results possible in minimising your symptoms. Other treatments to combat mental health disorders such as anxiety have also been proven to be beneficial in countering trichotillomania.

If these therapies prove unsuccessful for you, then it is essential that you seek help from your Dr who may advise medications such as antidepressants Anafranil, N-acetylcysteine (amino acid influencing neurotransmitters related to your mood, Zyprexa (antipsychotic).

Conclusion

Many of those who suffer from trichotillomania feel alone in their experience. There are many support groups available for those suffering from trichotillomania that you can meet and share your experiences with. This can be a powerful tool for those suffers. Ultimately, the best recommendation that I can give is to visit your doctor to ask as many questions as you need to and explore all avenues to manage, decrease, or entirely stop your hair pulling. Many cases of this disorder go unreported or simply unrecognised making it difficult to learn its exact frequency in the population.

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