Trichotillomania Symptoms
Trichotillomania (trik-o-till-o-MAYN-ee-uh) is an impulse control disorder that causes you to have recurrent and irresistible urges to pull your hair. This can cause obvious bald or thin spots that can be embarrassing and distressing. It is commonly a co-occurring disorder with other conditions such as anxiety and depression or other disorders such as Tourette Syndrome and Compulsive Skin Picking.
Anxiety
Trichotillomania is a type of impulse control disorder that causes people to pull out their hair. It may be from their scalp, eyelashes, eyebrows or even the pubic hair. It’s a habit that is difficult to stop and it often happens over and over again. It’s not clear what triggers the urge to pull, but it seems to be related to anxiety in many cases. People who have anxiety tend to feel a lot of tension and distress, which can cause them to start pulling their hair.
The good news is that trichotillomania can be treated with therapy techniques and medication. The treatment usually involves an interprofessional team that includes a primary care clinician, a psychiatrist and a licensed clinical psychologist. Treatment options include cognitive behavioral therapy, habit reversal training and other types of therapies. The prognosis is generally better if the condition is diagnosed and treated early in life, before it gets out of hand.
People who have trichotillomania often don’t know they’re doing it and can’t stop themselves from pulling their hair. The symptoms can affect a person’s work and social life. They might avoid social situations or friends and even turn down job offers for fear of being embarrassed by the way they look. This can lead to feelings of isolation and depression.
Symptoms of trichotillomania can also be confused with other disorders, such as a depressive disorder, obsessive-compulsive disorder or attention deficit hyperactivity disorder. For example, some people who have trichotillomania also pick their skin compulsively and chew their nails or bite their lips. Others have Tourette syndrome or other tics. These conditions are sometimes referred to as the Obsessive Compulsive Spectrum. For a long time, researchers believed that Body Dysmorphic Disorder, Compulsive Skin Picking and Trichotillomania were all part of this spectrum. However, they are now considered to be separate conditions.
The exact cause of trichotillomania is unclear, but it’s likely that there are both genetic and environmental factors involved. It may run in families, and it’s more common in people who have another close family member with the same condition. It can develop at any age, but it’s most common in childhood and young adulthood. It can also be triggered by extreme stress or trauma.
Depression
The symptoms of depression associated with trichotillomania are a serious concern, and should never be ignored. The condition can have a devastating impact on the life of a person, from their physical health to their social and work lives. Depression can lead to a lack of energy and feelings of hopelessness, and may make it difficult to cope with the urges to pull out hair. It can also cause a person to lose their appetite, which can then affect their overall health.
People with trichotillomania are often embarrassed by the bald patches and other effects of the condition, and can feel shameful about seeking help. They may try to hide their hair loss by using hats and scarves or attempting to use makeup, nail polish and false eyelashes and eyebrows. They can also be more prone to other compulsive behaviors, such as onychophagia (nail biting) and skin picking disorder.
Trichotillomania usually begins in the early teens, between ages 10-13. It can last throughout a person’s lifetime, though it can fluctuate in severity over time. People with trichotillomania can be diagnosed by a psychiatrist or psychologist who is familiar with the disorder, and they can receive specialized treatment.
Many people who have trichotillomania also have depression, which can sometimes be hard to diagnose. They can sometimes confuse the symptoms of depression with those of trichotillomania, and they may try to self-diagnose, believing they are simply feeling sad or stressed. The onset of trichotillomania can occur at the same time as other symptoms of depression, and it is often triggered by stress.
A psychiatrist or psychologist who is familiar with trichotillomania can diagnose the condition and prescribe medications, such as clomipramine (Anafranil), fluoxetine (Prozac) or olanzapine (Zyprexa). Some people with trichotillomania have found relief from alternative therapies, including acupuncture, hypnosis and yoga. Others have benefitted from support groups, both online and in-person. There are many different ways to treat trichotillomania, and the most effective therapy is a combination of medication and behavioral techniques such as Habit Reversal Training. This therapy teaches people to identify the situations that trigger their pulling, and they are taught to replace the behavior with a competing response, such as squeezing a ball or using their hands to make a fist.
Emotional Changes
People with trichotillomania often experience depression or anxiety. The comorbidities of these conditions can overshadow the hair pulling symptoms or obscure them completely. Professionals should fully assess the person and address underlying issues to arrive at an accurate diagnosis of trichotillomania. Medical conditions like alopecia can also cause hair loss or contribute to trichotillomania, and these issues should be ruled out before beginning treatment.
The onset of trichotillomania is usually in adolescence, though it can occur at any age. Kids with the condition often feel distress and anxiety, which can lead to compulsive behavior. They may pull their hair, eyebrows, eyelashes or arms to calm themselves. They may even chew their nails or bite their lips. Kids with trichotillomania tend to hide their behavior because they think it’s embarrassing. They might avoid social situations or turn down job offers because of their condition.
Most people with trichotillomania struggle to understand their condition. They know they’re causing themselves damage but find it difficult to stop themselves. Research suggests that the disorder is related to obsessive-compulsive disorder. It shares the same core features as OCD, including intrusive thoughts paired with compulsive behaviors.
Clinical trials of treatments for trichotillomania and skin-picking disorders have largely focused on the core symptoms, but effective approaches are still needed to address associated cognitive impairment and social dysfunction. Studies have found that a number of variables contribute to the development of the two conditions, and subgroups can be identified by factors such as automatic and focused symptoms, perfectionism, and trait impulsivity.
Many types of therapy can help people with trichotillomania, including cognitive behavioral therapy (CBT) and habit reversal training. CBT helps people identify and challenge the irrational beliefs that drive their hair-pulling habits. It can also teach them new, more healthy behaviors to replace the hair-pulling ones, like clenching their fists instead of pulling their hair.
People with trichotillomania should try to seek therapy as soon as possible. It’s important to be honest with your therapist and share what you’re feeling, as hiding the disorder can make it worse. It’s also helpful to open up about trichotillomania with friends and family, as many people who have learned to manage their condition say that speaking about it helped them reduce their symptoms.
Hair Loss
Hair loss is the most obvious symptom of trichotillomania. People with this impulse control disorder may pull their own hair, causing it to thin over time or fall out completely. This can lead to bald spots that are noticeable and distressing. It also can cause other issues like low self-esteem, depression and anxiety. People with this condition may attempt to hide their hair loss by wearing hats, wigs or false eyelashes. They may also try to cover their bald spots by styling their hair in ways that conceal the areas that have been pulled.
The exact cause of trichotillomania isn’t known, but it can result from changes in the way the brain processes emotions and other behaviors. It’s also believed that genetics and environment play a role. Symptoms usually start in childhood or adolescence, but they can continue throughout life.
When people with this condition pull their hair, it can affect the skin and hair follicles. The constant tugging can leave scars on the scalp and permanently affect the hair growth in the affected area. It can also result in hairballs called trichobezoars that can develop in the gastrointestinal tract and cause weight loss, vomiting and intestinal blockage.
It’s important to recognize the symptoms of trichotillomania so that you can seek treatment. You may want to look for a health care professional who has experience with this condition. A professional would examine your scalp, looking for thinning hair or bald patches, as well as other areas, like the eyebrows and arms. They would also determine if you have other disorders that often accompany trichotillomania, such as onychophagia (nail biting) or skin picking disorder.
The main treatment for trichotillomania is a type of cognitive behavioral therapy called habit reversal therapy. The therapist will work with you to figure out if your hair pulling is automatic or focused. The therapist will then help you find another behavior, called a competing response, to replace your hair pulling when you have the urge. For example, you might clench your fists or suck your thumb instead of pulling your hair.
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Cascia Talbert is a Catholic mother of five special needs kids. In 2018 she published the book, "Taking Care of Your Family's Health and Well-Being, Saints to Turn to and the Catholic Faith," available anywhere books are sold. She is also a professional flutist and an Avon Independent Sales Representative. You can learn more about Cascia on the following websites, cjsfunandgames.com and avoncrystallake.com. She lives in the Chicago suburbs with her husband, children and Baby, the playful black kitty.
