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What is trichotillomania? -

Trichotillomania (TTM) is a mental health disorder that falls under the classification of obsessive-compulsive disorder (OCD).

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What is trichotillomania? -

People with TTM compulsively pull out or break their own hair.

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Origins -

The word “trichotillomania” comes from the Greek tricho (hair), tillo (pull), and mania (excessive behavior or activity).

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The difference between trichotillomania and OCD -

One of the main differences is that TTM doesn’t involve obsessions, and OCD does. People with OCD struggle to control their obsessive thoughts and urges.

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The difference between trichotillomania and OCD -

Another difference is the feeling of reward. People with TTM feel a sense of relief and/or reward when they pull out their hair. OCD doesn’t involve the same positive feedback.

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Who does it affect? -

While it can affect infants, TTM is more common in children and adolescents. It generally starts between ages 10 and 13.

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Who does it affect? -

In children, it affects both males and females equally. When TTM occurs in adult age, women are mostly affected by it, by as much as a ratio of 9 to 1, when compared to men.

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How common is trichotillomania? -

Trichotillomania is not very common. It is estimated that about 0.5% to 3.4% of adults suffer from it at some point in their lives.

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How does TTM affect the body? -

People with TTM pull out their own hair. They usually do so one strand at a time, and often, from the same spot.

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From where do people pull out their hair? -

People pull out hair from the scalp, but they can also pull out eyelashes, eyebrows, and pubic hair.

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Why do people pull out their hair? -

Children sometimes pull their hair out as a self-soothing behavior and often outgrow it. Adolescents and adults, on the other hand, tend to struggle with the condition, which is often associated with other mental health problems.

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Impact on mental health -

TTM may cause anxiety, as well as embarrassment or shame. In fact, it’s common for people who suffer from this condition to not seek professional help because they feel embarrassed.

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Trichophagia -

There is one form of TTM called trichophagia, also known as Rapunzel syndrome, which can be pretty serious.

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Trichophagia -

People with trichophagia not only pull out their hair, but they eat it, too. This can lead to dangerous blockages in the digestive tract.

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Trichophagia -

Because long hair has a smooth surface, it's hard for the stomach to digest it, and consequently, for it to move through the digestive tract. Over time, this may lead to a large hairball forming in the stomach cavity. In some cases, surgery is required to remove the hairball.

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Damage -

Pulling out the hair will lead to skin and tissue damage. The damage caused by hair pulling can lead to hair loss in the affected areas.

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Diagnosis -

The diagnosis of trichophagia is based on specific criteria. In the US for instance, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) specifies five criteria. Let’s take a look at them.

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Criteria -

The first one is “recurrent pulling out of one’s hair, resulting in hair loss.” The second criteria is ”repeated attempts to decrease or stop hair pulling.”

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Criteria -

The third criteria in DSM-5 is “the hair pulling cannot be better explained by the symptoms of another mental disorder (e.g. attempts to improve a perceived defect or flaw in appearance, such as may be observed in body dysmorphic disorder).”

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Criteria -

The fourth criteria is “the hair pulling or hair loss cannot be attributed to another medical condition (e.g. a dermatological condition).”

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Criteria -

The final criteria used in the diagnosis of TTM is: “the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.”

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What causes trichotillomania? -

The specific causes of TTM aren’t easy to pinpoint. There are, however, a number of factors that may influence the onset of the behavior, including genetics (DNA mutations).

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What causes trichotillomania? -

Changes in brain chemistry or structure may also play a role in the development of trichotillomania, as people with TTM often display these changes.

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What causes trichotillomania? -

In many circumstances, TTM appears to develop as a coping mechanism in response to a stressful period, or it developed out of boredom.

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Other conditions associated with TTM -

People with TTM often suffer from other mental health problems, including OCD, anxiety, and depression. Some may also struggle with substance abuse.

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Treatment -

Treatment for trichotillomania often requires the patient to seek therapy and/or take medications.

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Treatment: medications -

There are a number of medications used in the treatment of TTM, depending on the patient and other associated conditions. These may include antidepressants, antipsychotics, anticonvulsants, and nutraceuticals.

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Treatment: therapy -

Different types of therapy may help patients manage the condition. Habit reversal training, for instance, is one of the most successful approaches to deal with TTM. Nonetheless, other forms of therapy can also be beneficial.

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Outlook -

TTM can be disruptive and have an impact on mental health and quality of life, but it doesn’t usually pose a serious threat to one’s health. Many people live with TTM for many years, but treatment is available and the condition can be managed.

Sources: (Cleveland Clinic) (WebMD) (DSM-5)

See also: Intrusive thoughts—Why we have them, and how to take away their power

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