Do you pull and tear your hair? You may be suffering from trichotillomania

What it is, who it affects and how is trichotillomania treated, the psychological disorder that causes compulsive trichotillomania and body hair.

Among the mental disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) are trichotillomania, which is the compulsive behavior of pulling out hair and body hair. The name of the disease, coined by the French physician François-Henri Halobo at the end of the nineteenth century to describe the behavior of one of his patients, was derived from the union of three Greek terms, threx (hair), tello (rupture) and mania (mania). As defined by the official MSD handbooks for medical professionals, patients with trichotillomania often pull “hair from the scalp, eyebrows, and/or eyelids,” but this can affect any hair on the body, as well as areas where it has been torn. changes over time. Here’s what we know about this disorder.

What is plucking hair plucking

Trichotillomania is a body-focused repetitive behavior disorder (BFRB) and in the DMS-5 it is included in the OCD and Related Disorders chapter, although it is not considered by experts to be an actual form of the OCD disorder, let alone a form of self-harm. . It’s a condition that is comparable in some ways to nail biting, but there’s still a lot to understand. As noted, the disorder is characterized by regular and chronic pulling of hair and body hair, a behavior that may be partially spontaneous (completely unconscious, the case of MSD manuals) or fully conscious. Trichotillomania can be accompanied by rituals and techniques to enhance the work, bringing pleasure and satisfaction to the patient who performs it.

What affects hair pulling?

The disorder can affect all age groups — from children to adults — but it usually begins “just before or after puberty,” experts say. As for adults, 80-90% of cases are women.

Causes of trichotillomania

The trigger for trichotillomania is not currently known, but experts believe that a combination of genetic and environmental factors may be involved. The “SLITRK1 Mutations in Trichotillomania” study published in Nature by scientists at Duke University found that a small percentage of patients had mutations in the SLITKR1 gene, which relates to connections between neurons.

Consequences of trichotillomania

Some patients may swallow their puffy hair, putting them at risk of forming triple bezoars, which are clumps of hair/hair in the digestive tract. In rare cases, such formations can have serious consequences and require surgery to remove them. The biggest impact is on the psychological level. While patients are satisfied and relieved from the stress of the procedure – hair pulling is often preceded by anxiety and stress – on the other hand, they experience embarrassment, both because of the gesture itself (and they can only control) its consequences. Trichotillomania can actually lead to significant hair and hair loss, altering its appearance. Trichotillomania can cause generalized baldness, causing anxiety, shyness, and symptoms of depression.

Patient with trichotillomania. Credit: Wikipedia

How to treat trichotillomania

MSD brochures indicate that among the potentially effective medications for the disorder are the selective serotonin reuptake inhibitors or clomipramine, N-acetylcysteine, and olanzapine. Some are more appropriate when the patient suffers from anxiety/depressive disorders. On the other hand, CBT is the preferred psychotherapy, with an approach defined as “habit reversal training”. Simply put, patients are taught to monitor and control their compulsive behavior, even using alternate hand gestures.

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