Trichotillomania: Treatment, Causes & Definition

Instructor: David White
Among the more uncommon impulse control disorders, trichotillomania can have a devastating affect on self-esteem and emotional well-being. Through this lesson you will learn how to define the disorder and gain insight into its causes and possible treatments.

What is Trichotillomania?

In the fields of psychology and mental health treatment, there are a number of obsessive or impulse control disorders that can seem absolutely unimaginable to even the most experienced professional. Eating things like paint or dirt, setting fires to relieve anxiety, or stealing useless or insignificant objects to produce a sense of pleasure are all pathologies that, though rare, can seriously impair a person's life. Among these, however, there are some illnesses that not only cause emotional distress, but also affect someone's physical appearance, like trichotillomania.

Trichotillomania is an impulse disorder that causes a person to pull out their own hair, often leading to bald spots that are a source of guilt or shame. Because it falls into the category of impulse control disorder, trichotillomania can be described as a compulsive behavior, which means that the individual can't control themselves or stop themselves from doing it.

Trichotillomania often results in bald spots on certain parts of the body.
trichotillomania

Because of the social stigma around the physical effects of trichotillomania, the disorder often goes unreported and untreated. Moreover, as a compulsive or anxiety-related disorder, people with trichotillomania might not actually realize that they're doing it until it is pointed out to them. For example, consider the kinds of self-soothing things that most people do, like cracking their knuckles or stroking their facial hair. Often times, trichotillomania works the same way - the person does it unconsciously.

Causes

Trichotillomania falls under the broader categories of obsessive compulsive disorders and anxiety disorders. Among the reasons that it is associated with these two over-arching categories is that it is most often preceded by a prolonged period of stress or tension for which the act of hair-pulling becomes a coping mechanism.

In many cases, trichotillomania will start off as an insignificant way to relieve stress. For example, if someone has experienced a particularly stressful or traumatic experience, they may begin to slowly and unconsciously pull out their hair in order to feel a sense of relief and control. Because this can be the fastest and easiest way to soothe the anxiety, this behavior has the potential to become addictive, and can eventually affect the brain's pleasure center.

Over time the effects can become a source of shame, preventing the person from engaging in social activity.
trichotillo

In some cases, the disorder may include the pulling and eating of a person's own hair, which is known as trichophagia. Although this is less common than trichotillomania itself, it can greatly exacerbate social stigma and may even pose certain health risks.

In general, under-reporting and stigma has led trichotillomania to be a misunderstood disorder until very recently. Even now, clinicians and psychologists remain divided over the causes; some suggest that it is neurological in origin, while others suspect that it is an addictive habit that develops over time.

Treatments

As previously noted, trichotillomania is an under-reported disorder, which means that it often goes untreated. It is important to remember, however, that there are many reasons why a person's hair could be falling out, which means that many things need to be ruled out before an appropriate diagnosis can be made.

Once a person has been diagnosed, there are a number of different treatment options that can help in overcoming the disorder. Because it is often related to depression, anxiety, or trauma, the logical place to start is addressing the issues that undergird those emotions. This is most often done with a combination of medications and cognitive behavior therapy, which is a kind of talk-therapy that helps a person identify stressors and develop healthy coping skills.

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