Trichotillomania: the strange obsession of pulling out one’s own hair.

A fairly common mania among anxious people.

The trichotillomania is a bizarre disorder characterized by the irresistible urge to pull out one's hair, usually from the scalp, eyebrows and eyelashes..

Although individuals suffering from this pathology are aware of the harm they can do to themselves by acting in this way, they are unable to stop or control this impulse. In addition, it is common that in times of stress these individuals try to pull out their hair as a way to calm down, thus producing a vicious circle that can cause further damage, both physically and psychologically.

What is Trichotillomania?

This condition usually appears around 13 years of age and is officially classified as an impulse control disorder, as is pyromania, pyromania and trichotillomania.like pyromania, kleptomania or pathological gambling. It is also closely linked to Obsessive-Compulsive Disorder, as they share many of the same symptoms and maladaptive psychological mechanisms.

It has a prevalence of 1% of the population and affects both men and women, although the latter more frequently seek treatment.

Symptoms

Trichotillomania is characterized by the presence of the following symptoms:

• Recurrent hair pulling causing a noticeable loss of hair (as can be seen in the photograph).
• An increase in the perception of tension just before pulling out the hair or when resisting this act.
• Pleasure, gratification or release when pulling the hair.
• The disturbance is not explained by another mental disorder or medical condition.
• The disturbance causes significant discomfort or impairment in social, occupational, or other important areas of activity. For example, a loss of self-esteem as a consequence of partial alopecia caused by hair pulling.

Warning signs

The onset of this disorder occurs around the age of 13, although in some cases it may begin earlier.. Often, a stressful event can be associated with this pathology, for example, changing schools, abuse, family conflicts or the death of someone close to you can generate anxiety and nervousness and provoke the debut of this disorder.

Some experts affirm that the symptoms can be provoked, or at least strongly influenced, by the hormonal changes characteristic of puberty.

Most likely causes

Adolescence is a critical stage for the development of self-esteem, body image, self-confidence, or intimate relationships. During this period, people suffering from this pathology may be ridiculed by their own family, friends or classmates. In addition, they may feel a great deal of guilt or shame for not being able to stop this type of behavior. Even a small hairless patch can cause serious emotional problems for the person suffering from this condition.

In many cases, people suffering from trichotillomania manage to lead a normal life: getting married, having children... But in some cases, there are individuals who avoid intimate relationships for fear of exposing their disorder..

There is no specific cause for trichotillomania. Although some researchers think that it is possible that at the Biological level there is a neurochemical mismatch at the brain level, mainly a deficit of serotonin. There may also be a combination of factors such as genetic predisposition and an aggravating stress or circumstance. For example, a traumatic event.

Comorbidity (associated disorders)

It is common for people with trichotillomania to show symptoms of Obsessive Compulsive Disorder (OCD) such as counting or hand washing. In fact, there are many similarities between trichotillomania and OCD, which is why some experts consider it a subtype of OCD. some experts consider it a subtype of Obsessive Compulsive Disorder (OCD)..

Depressive disorder also frequently occurs along with trichotillomania. There may be a direct relationship between the neurotransmitters involved in depression and this condition (and also OCD), as both pathologies are associated with low levels of serotonin. Although there could also be a relationship between depression and low self-esteem caused by trichotillomania, because pulling out one's hair can be demoralizing. On the other hand, pulling out the hair can result in wounds that cause physical and emotional pain..

Treatment

Trichotillomania can be treated in two ways, according to research conducted in this field.

Psychotherapy

On the one hand, cognitive behavioral therapy is shown to be very effective.. On the other hand, and in some severe cases, the administration of drugs is necessary. However, a combination of both treatments is ideal.

With cognitive behavioral therapy patients learn to identify and manage symptoms and employ strategies that help them improve their quality of life.. You can learn more about this type of therapy in our article: "Cognitive behavioral therapy: what is it and what principles is it based on?

2. Pharmacology

Medication can also be effective in treating symptoms, but for long-term results, cognitive behavioral therapy is necessary. Some medications (antidepressants or mood stabilizers) used for the treatment of this pathology are:

• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Clomipramine (Anafranil)
• Valproate (Depakote)
• Lithium (Lithobid, Eskalith)