Trichotillomania, OCD, and Co-Occurring Anxiety Disorders

Trichotillomania is an overactive behavioral response to negative stimuli. This disorder results in a series of unwanted, though brief, behavioral responses to stressors in the patient’s environment. It usually begins in early adolescence and continues into adulthood. Although relatively uncommon in the United States and other Western countries, it is increasing documented in patients from Asia, Europe and other countries.


Trichotillomania seems to be a fairly widespread disorder, with very high rates of co-Occurring co-occurring anxiety disorders in its patient population. Some people with trichotillomania are under pressure at work, worried about being fired or embarrassed by their hair pulling behavior. Many patients with trichotillomania report that pulling out hair greatly enhances their fear and anxiety of various social situations and scenarios. These behaviors are embarrassing for the sufferer, causing significant psychological distress. Research suggests trichotillomania may be genetic (runs in the family) and linked to abnormal brain function.

Trichotillomania shares many symptoms with other anxiety disorders such as obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), specific phobias and many types of stuttering. The severity of the symptoms of trichotillomania ranges widely, from mild cases to full blown OCD and PTSD. Trichotillomania can begin in childhood or adolescence and continue into adulthood. It can occur in male children as well as female and older adults.

Trichotillomania can begin during childhood, frequently without anxiety disorders, and often goes unnoticed or untreated, especially in childhood. Many psychologists believe trichotillomania began as an extreme response to negative stimuli such as fear, anger, or frustration and developed into a habit over time. People develop the habit of pulling out hair on an ongoing basis in an attempt to reduce or eliminate these feelings.

When it comes to treating trichotillomania, there is not much that can be done medically. However, there are several treatments which many people find effective. Psychotherapy is by far the most successful form of behavioral therapy and can be used with great success. Behavioral therapy is also very effective, but this requires a great deal of effort on the part of the patient in order to receive results. There is currently no known medication that can be used to treat trichotillomania; however, there are several forms of alternative therapies which may prove useful.

The most widely used form of therapy is behavioral replacement. This basically means training the sufferer to monitor their hair pulling symptoms and substitute them with more healthy habits and behaviors. An example of a behavioral replacement therapy is replacing the habit of hair pulling with that of reading, writing, eating, or even watching television. Another therapy that is frequently used to treat trichotillomania is known as the use of antidepressants. Research has suggested that using antidepressants may help to reduce the appearance of first-degree co-occurring depression, which is a condition that almost everyone develops if they have trichotillomania and co-occurrences of trichotillomania.

Trichotillomania is a condition which can be treated through cognitive behavioral therapy, which is the most commonly used form of therapy. Cognitive behavioral therapy is also known as “behavioral substitution” and is very effective for many individuals. If you suffer from trichotillomania and co-occurrences of trichotillomania and anxiety disorders, you may wish to consider consulting with your family physician. In the past, doctors have been very reluctant to prescribe medication to individuals suffering from trichotillomania and other forms of obsessive-compulsive disorders. Currently, however, there is a great movement in the medical community towards the use of medication-based treatments, such as those provided through “complementary and alternative medicine”.

Comorbidity – The second diagnostic category is comorbidity, which means that another mental health disorder is present. In the case of trichotillomania and co-occurrence of trichotillomania and anxiety disorders, the presence of these conditions is usually indicative of a higher potential for eventual recurrence. In other words, the individual may not have trichotillomania or co-occurring anxiety problems but have a problem with another psychological disorder such as depression, OCD (Obsessive Compulsive Disorder), or bipolar disorder. While comorbidity can be a difficult issue to deal with, if the co-occurrence is significant, it can be an important indicator of the true cause of the condition. Therefore, treatment protocols should be tailored to address both issues if they are to have any chance of being effectively implemented.

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