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People with both TTM and depression, for example, may be inclined to seek help for their depressive symptoms; this may, in turn, lead to help with hair pulling. In some cases, a “punch biopsy” (where your healthcare provider takes a skin sample for lab analysis) is necessary to confirm a diagnosis of TTM. This test can also rule out other skin conditions that might be the true cause of hair loss or hair pulling. They may pull hair from other areas like the eyebrows, eyelashes, or any other area on their body that has hair. Trichotillomania (often abbreviated as TTM) is a mental health disorder where a person compulsively pulls out or breaks their own hair. This condition falls under the classification of obsessive-compulsive disorder (OCD).
The DSM-5 diagnostic criteria include:
If you have TTM, it’s important to see a healthcare provider (or multiple providers) with specialized training and experience in treating this condition. They can best guide you on what you can do to minimize the impact of this condition on your life. The possible side effects that can happen with medications depend on the medications themselves, as well as your medical history and circumstances. Your healthcare provider can tell you more about possible side effects, including potential trouble signs and how you should react if you see those signs.
Finding treatment
Family members may need professional help in coping with this problem. Trichotillomania comes with many physical and emotional complications, which are usually a result of excessive hair-pulling. Because this condition can cause shame and embarrassment, many people find it tough to discuss it with a doctor.
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The disorder is usually chronic and lifelong, but its severity may ebb and flow with time. There is no proven way to prevent trichotillomania, but getting treatment as soon as symptoms start can be a big help. Learning stress management is also a good idea because stress often triggers hairpulling behavior. Some people with trichotillomania also pull out the hair from their eyebrows.
People with hair-pulling disorder feel an intense urge to pull their hair out and experience growing tension until they do. A person with trichotillomania may also pull their hair out because of stress. Sometimes, people with hair-pulling disorder don’t even realize that they’re pulling their hair.
Trichotillomania (hair-pulling disorder)
Just as you are a unique person, so, too, is your pattern of pulling behavior. We call this a "pulling profile." Although it may be painful to do so, looking at the what, where, when, how, and why of a pulling episode is an essential part of the recovery process. While no treatment has been found to be universally effective, some show great promise and may deliver lasting relief.
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Though your symptoms may vary in severity and fluctuate over time, trichotillomania is chronic. Doctors usually treat the condition with cognitive behavioral therapy (CBT) called habit reversal training. Habit reversal training teaches people to replace hairpulling with another less harmful action.
How is trichotillomania treated?
We have also adapted material from our book for self-help workshops for adults, which we call "Help Yourself." This article outlines the information from those workshops. We hope that it will assist you in your efforts to help yourself manage or recover from trich. Trichotillomania is a condition characterized by a compulsive urge to pull out one’s hair. They might send you to a psychiatrist, psychologist, therapist, or other mental health care professional. Your mental health care provider will also ask questions about your hairpulling, your life, and your overall mental health to help figure out what's going on.
However, treating the underlying negative emotions may help prevent the urge to pull your hair from coming back. You may do both automatic and focused hair pulling, depending on the situation and your mood. Certain positions or activities may trigger pulling out hair, such as resting your head on your hand or brushing your hair. In both adolescents and adults, a trichotillomania diagnosis may be further hampered by the person’s reluctance to disclose their hair-pulling behavior.
Brain imaging studies have found that people with trichotillomania show increased thickness in areas of the frontal cortex related to the development of habitual behaviors. Differences in this brain area have also been observed in individuals with OCD, suggesting a close relationship between the two conditions. Other studies have found evidence of decreased amygdala volume in people with trich, which may be related to difficulties in emotion regulation also observed in this population. In some cases, people engage in “rituals” after pulling, such as rolling the hair between their fingers, touching it to their lips or face, or inspecting the end to look at the root.
Between pouring your morning coffee and jumping in the shower, we’re betting that your usual morning routine doesn’t allow much time for hair styling. Luckily, there are plenty of easy styles out there that will leave your strands looking pulled together in minutes, so you’ll get to work on time. A half-up hairstyle gets shorter layers out of your face but still gives you the breezy feel of keeping it down. Use a few bobby pins to pull back the top portion of your hair into a swirly bun, then spritz it with TRESemme Tres Two Extra Firm Control Hairspray ($5) to keep it in place all day long.
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The connection between trauma and trichotillomania is not fully understood. Other studies suggest that experiencing trauma may increase the severity of hair-pulling, even if the former doesn’t necessarily cause the latter. Anxiety is a common trigger for pulling episodes; for many with trich, pulling can be soothing and may provide temporary relief from feelings of anxiety (though such relief is rarely long-lasting). Trichotillomania and diagnosable anxiety disorders also frequently co-occur.
Your GP may examine areas where the hair is missing to check that nothing else is causing the hair to come out, such as a skin infection. You should also see your GP if you or your child has a habit of eating hair. This can cause hairballs to form in the stomach, leading to serious illness. It's important to remember that this is a very personal, individual journey. Finding space and grace to make good choices for yourself will help you gain clarity on what you want. Choosing a therapeutic provider to support your BFRB journey is a process that takes time.
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