Friday, May 3, 2024

Trichotillomania hair-pulling disorder Diagnosis and treatment

pulling hair

I was twirling a few strands as I chose what to type just now, which is normal for me. A person may sometimes pull their hair out in response to a stressful situation, or it may be done without really thinking about it. For others, their BFRBs wax and wane, with periods of no picking, pulling, or biting. For some, they are able to regulate and stop their behaviors completely. Among adults, hair-pulling disorder is more common in females. Doctors typically prescribe selective serotonin reuptake inhibitors (SSRIs) or clomipramine, a tricyclic antidepressant, for treating trichotillomania.

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Trichotillomania

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How do you help yourself when you have a difficult problem such as hair pulling?

Nearly one-third of adults with trichotillomania report a low or very low quality of life. Those who have symptoms may feel embarrassed or afraid to talk to their doctor about what they are experiencing. Symptoms may affect a person for just a few months, while it may affect another person off and on for many years. The doctor will also rule out any other causes of hair loss and may send you to a dermatologist (skin doctor).

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Signs and symptoms of trichotillomania

pulling hair

What about those people who are seeing excellent therapists, but the therapists themselves have no experience treating hair pulling? These are the questions that we have struggled with for many years. Over the years we have been especially concerned about the needs of children with hair pulling who cannot access professional care. For this reason, we wrote a self-help book that is geared to young people but is also helpful to adults and therapists. The book is called The Hair Pulling "Habit" and You, and is based on the ComB (Comprehensive Behavioral) Model pioneered by Dr. Charles Mansueto.

Further, trichotillomania could be a symptom caused by different factors in different individuals just as a cough can be produced by a multitude of different medical problems. In CBT, people practice mindfulness and challenge limiting beliefs. They also learn to identify the factors that lead to hair-pulling as well as the repercussions of the behavior. Additional complications include social isolation from hiding to pull out hair and financial effects from being unable to continue with normal daily activities like going to work. Some people pull their hair out somewhat automatically, without thinking about it. Treatment may also involve keeping track of hairpulling in a journal and identifying your triggers, which might occur when watching TV or lying in bed.

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However, the older a person gets — especially from adolescence onward — the greater the odds that treating the condition becomes difficult. But its impacts on a person’s life, especially their mental health, are often severe. Because of this, early diagnosis and treatment are very important.

How Trichotillomania Hair-Pulling Is Treated

Another option that research suggests may have benefit is olanzapine (Zyprexa). This drug is used to treat certain serious mental health conditions that affect the mind. Make sure to tell your care team if you experience obsessive thoughts, compulsions, anxiety, or fear. Your mental health professional can help you figure out if you have OCD or an anxiety disorder and include helping you feel better in your treatment plan.

Secondly, they are situations where it is easy to access your head or face because your posture often includes bent elbows and hands close to your face and head. The bathroom and bedroom create special challenges due to the high degree of privacy, which allows for uninterrupted periods of pulling time, as well as easy access to mirrors and tweezers. Anyone who feels distressed about their hair-pulling or feels that they are unable to control the behavior on their own could benefit from seeking treatment. Therapy, combined with self-help strategies and social support, can greatly reduce pulling behaviors, help manage shame, and improve quality of life.

pulling hair

They may try to camouflage the hair loss by wearing wigs or scarves. Some pull out hair from widely scattered areas to disguise the loss. People may avoid situations in which others may see the hair loss. They typically do not pull hair out in front of others, except for family members. People may also be distressed by their loss of control, and they repeatedly try to stop or reduce pulling their hair out but they cannot.

Trich is currently classified in the DSM as an obsessive-compulsive or related disorder, which is itself closely related to anxiety. ADHD is a mental health condition that affects focus, attention, activity, and concentration. While ADHD is not an impulse control disorder like trichotillomania, it can cause problems with impulse control. For this reason, scientists think ADHD and trichotillomania might have some connection with each other, but scientists are still learning about these links. Trichotillomania is also linked to anxiety, but scientists don't fully understand the relationship. For example, some people with trichotillomania might feel anxious or depressed because they are embarrassed about pulling.

Shame and other negative feelings prevent many people from seeking treatment specifically for TTM. Because the disorder is not widely known or understood, many who struggle with it are not aware that it's a mental health condition for which they can seek treatment. The behavior is compulsive and may even occur without conscious notice; it often results in significant hair loss that can lead to alopecia or bald spots. To warrant a TTM diagnosis, the hair loss must not be attributable to other medical conditions. Currently, no medications are specifically approved for the treatment of trichotillomania. However, some patients have benefited from antidepressants—especially if comorbid anxiety or depression are present—or other psychiatric medications, including atypical antipsychotics.

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