Trichotillomania and anxiety are a sort of dual effect. It is an obsessive compulsive disorder (OCD), where sufferers have such an irresistible urge to pull out hair or the skin etc from their scalp that they can’t seem to stop. Some people are completely bald. It’s a condition which has been diagnosed in a lot of patients as being a type of OCD (Obsessive Compulsive Disorder) where the victims are obsessed with pulling out hair etc but also have an overwhelming, nagging fear of having bald spots, and that too in excessive amounts. Some people with this condition don’t even have an outward sign of this disorder but may have feelings of anxiety when they think about it.
Treatments for trichotillomania and anxiety fall into two main categories – psychological and pharmaceutical. Treatments of the psychological variety aim to stop hair pulling by trying to teach the sufferer some kind of “coping mechanisms” so that they can better manage the condition. These include antidepressants (such as fluoxetine, sertraline, anafranil) and mood stabilizers (antipsychotics, olanzapine).
Some psychiatrists will prescribe antipsychotic drugs (neuroleptics) to help control the symptoms of trichotillomania and may also prescribe some types of antipsychotic drugs to treat OCD (Obsessive Compulsive Disorder), where the patient is obsessed and unable to stop doing a specific behavior, such as compulsive hair-pulling. Medications that are commonly used in these cases are risperdal (Clomipramine), quetiapine (Paxil), and olanzapine (Sertraline). The patient may also be given SSRIs, such as fluoxetine, or tricyclic antidepressants (TCA), such as citalopram.
However, a major problem with this type of therapy is that the sufferer must still have hair pulling behavior in order to qualify for treatment. In other words, you can’t just take medications and then suddenly stop hair pulling – the trichotillomania or obsessive-compulsive spectrum requires behavioral modification or else the medications won’t have any effect. For many people, this can present a great deal of difficulty.
One way to treat trichotillomania and hair pulling, which some sufferers respond to quite well, is via the use of “behavioral substitution” (BPS). With this type of therapy, instead of medication, the patient learns to replace hair pulling behavior with various alternative behaviors, such as eye contact, hand touch, or other non-hair pulling body movements. Eventually, the patient learns to substitute these behaviors for hair pulling, resulting in dramatic and permanent hair pulling cessation. This type of therapy has been found to be highly effective in many cases. However, it is important to note that it does not teach the patient how to handle stress and stressful situations; it simply provides them an alternative to the harmful behavior.
Another very promising method for trichotillomania and anxiety is the use of neurofeedback. Using neurofeedback, the therapist and patient are able to monitor brain wave activities as the person pulls hair. When the brain waves show a strong presence of alpha, the person may be less likely to pull hair. Similarly, when the brain waves show low levels of alpha, the person may be more likely to withdraw from stressful situations that cause stress.
The goal of this type of therapy is similar to the results seen in medical trials using neurofeedback. Eventually, the patient learns to control brain wave activities and eventually stops pulling out hair. However, there is no guarantee that the trichotillomania and anxiety will completely stop. It may take months or years for the therapy to achieve a certain level of success.
However, there is hope, especially since some forms of behavioral therapy are covered by Medicare and insurance companies. If your insurance company covers the therapy, you may be eligible for a large scale treatment. Trichotillomania and anxiety may also be treatable with medication. You should discuss with your doctor all possible treatments available to you. This is especially important if the disorder is resistant to conventional methods.
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