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What is Trichotillomania

Trichotillomania is a very upsetting and embarrassing condition to endure. The urge of pulling one's hair out is strong that one just cannot help, but continue doing so. The trauma it brings ad nauseam, exceeds the chagrin that one endures.
PsycholoGenie Staff
Have you come across someone from your peer group, or someone who stays in your neighborhood fidgeting with their hair a tad too much? Have you witnessed some, who pluck out their own hair strands while they indulge in a conversation? If your answer to these questions is yes, and you wonder why people do what you observe them do, then your quandary is solved here. This is an obsessive compulsive disorder called Trichotillomania.

What is Trichotillomania - Meaning
Trichotillomania, in psychological nomenclature, is a type of obsessive compulsive disorder, where the individual gratifies his urge by pulling out his or her own hair. A French physician by the name of Francois Hallopeau, defined this disorder for the very first time in 1889. Nevertheless, the condition described by him fails to do justice to the same. The term mania implies a serious mental illness. In cases of trichotillomania, it is no madness, it is just an urge to comply to the habit of hair pulling. A broader classification would classify the condition under anxiety disorder. The sufferer may pull out hair strands either one by one from the root or may extract a bunch full in concert. Sufferers pluck out hair from the scalp, eyelashes, eyebrows, nostrils and the pubic area. The onset of this disorder is earmarked during childhood and adolescent transition phase where the child is on the threshold of developing habits that lay a foundation for his life. If the child latches on to this disorder, it is probable that the habit might sink with age. However, this is carried forward, well into their adulthood and continues to be a part of their genetic make up. The rare impulse control disorder impinges maximum number of women as its victims, although it is prevalent in men, as well.

What Causes Trichotillomania
This condition primarily originates during childhood, spreads its roots extensively during adolescence and engulfs one permanently when one steps into adulthood. Genetic factors and/or a biological dysfunction of neurotransmitters in the brain may be held as the causes of Trichotillomania. It has been observed in several cases that individuals having trichotillomania are accompanied with other impulse disorders, such as skin-picking, scratching and nail-biting to name a few. Another major cause believed to be intensifying the condition is stress. Stress is believed to play havoc not just with your follicles but also with your system in entirety. An individual suffering from the disorder, when faced with a stressful situation and anxiety levels peaking, is bound to pull hair with greater velocity, even handfuls of it. Sufferers are often believed to have developed a low self-esteem and plummeting confidence levels when in contact with the society. They feel mortified in public when they want to stop themselves from plucking hair but fail to do so. Due to this condition, they enter the zone of becoming follically challenged. They lose hair from body parts from where they are plucked out. They may have bald patches on the head, scanty eyebrows or eyelashes.

What is the Treatment for Trichotillomania
Trichotillomania is a behavior disorder that can be cured by employing certain psychological variables. Antidepressants such as Celaexa, Paxil, Zoloft and Prozac in majority of the sufferers makes a lot of difference. The medication aids them and relieves much of the constant urge that they experience. Administering behavioral therapies such as Habit Reversal Training and Stimulus Control also helps. Habit Reversal training is a therapy brought into existence by Dr. Nathan Azrin in 1973. This therapy involves four steps.
  1. The first step involves making the sufferer understand and aware about his hair pulling activity. He needs to realize this consciously that he is pulling his hair strands and needs to curb the activity. It is observed that they indulge in plucking when they are engrossed in doing something, such as reading or watching television. They are asked to pay attention and sincerely curb the act of pulling their hair-strands. They are instructed to keep record of their hair pulling episodes, how often they occur and how strong the urge is.
  2. The second step is to learn a technique called progressive muscle relaxation. This helps one in concentrating on oneself and relieving stress. Relaxing and regulating one's breathing pattern is the aim of this step.
  3. The third step is to learn diaphragmatic breathing. This type of breathing involves certain techniques of inhaling and exhaling, that are very similar to that practiced in yoga or meditation. It helps one to relax and focus on oneself. It also helps in increasing other sensations in the body, thereby distracting the individual from the urge of pulling hair.
  4. The fourth is called competence response where the person has to clench the fist and bend the arm from the elbow, place at the back at a 90 degree angle. This needs to be done two to three times in a week.
Finally, the patient is asked to practice the steps in order to complete the habit reversal therapy.

Curing trichotillomania is possible by following another therapy called Stimulus Control. Stimulus Control is a type of behavioral treatment that helps sufferers to understand, identify, avoid and eliminate the conditions such as an environment or a particular activity, schedule or situation that leads to a constant hair pulling episode. As mentioned earlier, pulling your own hair is a habit that is formed over time and continues well into adulthood. The aim of this technique is to understand and consciously curb the urge. It involves rearranging one's schedule, helping one to change the environment that triggers hair plucking.

Treating trichotillomania could be handled by using a technique called Habit Reversal therapy. In this technique, one is supposed to remind oneself that hair pulling is dangerous, by saying things like "you are doing something wrong! Hands off!" "This is dangerous and what follows is irrevocable", repeating these statements to oneself often or writing them on a piece of paper and sticking them on a place you frequent the most, also helps in the coping process.

One needs to handle trichotillomania in a matured manner. It is a delicate yet serious condition to endure and may require a considerable amount of time, energy and practice to get rid of it. However, one should never forget that there is light at the end of the tunnel and trichotillomania can be treated.