What is Trichotillomania?
It is officially classified as an impulse control disorder, along
the lines of pyromania, kleptomania, and pathologic gambling.
What are the Symptoms of Trichotillomania?
Recurrent pulling out of ones hair resulting in noticeable hair
loss.
An increasing sense of tension immediately before pulling out the
hair or when resisting the behavior.
Pleasure, gratification, or relief when pulling out the hair.
The disturbance is not accounted for by another mental disorder and
is not due to a general medical condition (i.e., dermatological
condition).
The disturbance causes significant distress or impairment in
social, occupational, or other important areas of
functioning.
How and When Does it Start?
People often start compulsive hair-pulling around the ages of
12-13; although it is not uncommon for it to start at a much
younger or older age. Frequently, a stressful event can be
associated with the onset, such as: change of schools, abuse,
family conflict, or the death of a parent. The symptoms also may be
triggered by pubertal hormonal changes.
Does Trichotillomania Lead To Other Problems?
During adolescence, which is an especially crucial time for
developing self-esteem, body image, comfort with sexuality, and
relationships with peers of both sexes, teens may endure ridicule
from family, friends, or classmates, in addition to feeling shame
over their inability to control the habit. Therefore, even a small
bald patch can cause devastating problems with development that can
last life-long. Although many people with trichotillomania get
married and carry on with their lives in a normal fashion; there
are those who have avoided intimate relationships for fear of
having their shameful secret exposed.
What Is the Cause?
There is no certain cause of trichotillomania, but the current way
of looking at trichotillomania is as a medical illness. One theory
on a biological level is that there is some disruption in the
system involving one of the chemical messengers between the nerve
cells in parts of the brain. There may be also a combination of
factors such as a genetic predisposition and an aggravating stress
or circumstance; as with many other illnesses. Further,
trichotillomania could be a symptom caused by different factors in
different individuals just as a cough can be produced by a
multitude of different medical problems. Finding the cause(s) will
take more research.
What Is The Relation To Other Illnesses?
For many people with trichotillomania, there are symptoms of
obsessive-compulsive disorder (OCD) such as compulsive counting,
checking, or washing as well. There are so many similarities
between hair pulling and other compulsive symptoms that some
consider it a subtype or variant of OCD. This idea is supported by
the tendency for the two problems to run in the same families and
the fact that OCD medications can be helpful in treating
trichotillomania.
Depression also frequently occurs in individuals with this illness.
There may be a direct neuro-biochemical relationship and/or be
secondary to the chronic demoralization and low self esteem
hair-pulling can bring.
Other associated behaviors may include nail biting, thumb sucking,
head banging, or compulsive scratching. Frequently, hair pullers
also find they compulsively pick at their skin, which may also
cause physical and emotional scarring.
What Treatments Are Available?
The two methods of treatment that have been scientifically
researched and found to be effective are behavioral therapy and
medications.
Therapy:
In behavioral therapy, people learn a structured method of keeping
track of the symptoms and associated behaviors, increasing
awareness of pulling, substituting incompatible behaviors and
several other techniques aimed at reversing the habit of
pulling.
Medications:
Although medications clearly help some people temporarily, symptoms
are likely to return when the medication is stopped unless
behavioral therapy is incorporated into treatment. Medications may
help to reduce the depression and any obsessive-compulsive symptoms
the person may be experiencing.
Commonly used medications are:
fluoxetine (Prozac)
fluvoxamine (Luvox)
sertraline (Zoloft)
paroxetine (Paxil)
clomipramine (Anafranil)
valproate (Depakote)
lithium carbonate (Lithobid, Eskalith)
http://www.nmha.org/infoctr/factsheets/92.cfm