Trichotillomania is a type of impulse-control disorder characterized by the repeated urge to pull out one’s hair. People with trichotillomania feel a strong, irresistible urge to pull out their hair from any part of the body – most commonly from the scalp, eyebrows, and eyelashes.
The condition is similar to other body-focused repetitive behaviors (BFRBs), such as skin picking and nail biting. Trichotillomania is thought to be related to anxiety and could be associated with underlying neurological or emotional problems, such as low self-esteem and body image issues.
The disorder causes considerable distress and interferes with daily activities, such as work, school, and relationships. Treatment for trichotillomania usually involves cognitive-behavioral therapy and medications.
Is trichotillomania an anxiety disorder?
Trichotillomania is an impulse control disorder, rather than an anxiety disorder. It is characterized by an overwhelming urge to pull out one’s own hair, resulting in noticeable hair loss. It is also known as “hair-pulling disorder” or “compulsive hair-pulling”.
While some may assume that it is caused by anxiety, that is not necessarily the case. It is unclear exactly why some people develop trichotillomania, but we do know that many people with this disorder experience it as a result of negative emotions, such as stress, guilt, low self-esteem, and depression.
However, research has shown that trichotillomania is not directly caused by anxiety, or any other psychological condition. Rather, it has been linked to imbalances in the brain’s reward circuitry and serotonin levels.
Treatment approaches for trichotillomania typically involve psychotherapy, medications, and lifestyle changes. With proper treatment, symptoms can improve significantly, so it’s important to see a qualified healthcare professional for diagnosis and support.
Why is trichotillomania considered OCD?
Trichotillomania is considered to be an obsessive-compulsive disorder (OCD) due to the repetitive behaviors and intense urges associated with the condition. Those who suffer from trichotillomania feel an irresistible urge to pull out their hair, which is often accompanied by feelings of anxiety or tension.
For example, as a person struggles to resist the urge to pull their hair, the tension may become so strong that they may inadvertently wind up giving in to their impulse. Furthermore, those with trichotillomania tend to engage in ritualistic behaviors.
After pulling out the hair, they may go through the same pattern of behaviors, such as inspecting the extracted hair, separating it according to length or color, or playing with it. These rituals can become so ingrained that they can be hard to break out of.
In addition, many of those affected by trichotillomania also have obsessive thoughts that they cannot control, such as obsessively worrying that their hair is never perfect. They may become obsessed with the idea of achieving perfectly straight and smooth hair, spending hours in the mirror or executing complicated hair-care routines, or they may feel guilty or ashamed after pulling their hair.
Overall, trichotillomania is classified as an OCD because of its combination of obsessive thoughts, ritualistic behaviors, and an intense urge to pull out the hair.
What OCD medication helps with trichotillomania?
The most widely-used medication for trichotillomania is clomipramine, which belongs to a class of drugs called tricyclic antidepressants. Clomipramine has been found to be highly effective in reducing the symptoms of trichotillomania.
Other medications that may help in treating trichotillomania include selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and sertraline, mood stabilizers, such as lithium and anticonvulsants, such as topiramate.
Some people may also find relief from medications that increase serotonin levels in the brain, such as tryptophan, buspirone, and fenfluramine. Other medications used in the treatment of trichotillomania include antipsychotics, such as risperidone and lorazepam.
In addition, psychotherapy and behavior modification techniques have also been found to be effective in treating trichotillomania.
How do you deal with trichotillomania?
Dealing with trichotillomania requires a multi-faceted approach that includes both behavioral and biological strategies.
Behavioral Strategies:
1) Develop a regular hair care routine. This will allow you to focus on something more positive and may provide some structure and distraction.
2) Identify and address triggers for hair pulling. People often pull when they are stressed, anxious, or preoccupied with thoughts and feelings. Make note of these situations, and think of strategies that could help you cope with these feelings.
3) Seek out a qualified behavioral therapist. Cognitive Behavioral Therapy (CBT) can help you better understand why you are engaging in this behavior, and help you develop strategies to reduce the frequency of the episodes.
Biological Strategies:
1) If stress and anxiety are contributing factors, consider taking medications. Anti-depressants, such as SSRIs, can help reduce the urge to pull.
2) Try topical medications. Naltrexone gel has been shown to reduce the urge to pull, when applied directly to the scalp.
3) Use assistants such as gloves, hats, or scarves to cover the areas of scalp that are pulled. This can help make the behavior less feasible and reduce the possibility of injury.
Overall, it is important to remember that trichotillomania is a treatable disorder, and with a combination of behavioral and biological strategies, it is possible to reduce the episodes of hair pulling.
