Psychiatry & Psychology

Pulling Your Hair Out – Complexities of Trichotillomania

December 02, 2008 | By Sabrina Behrens, MA | Share, Save, and Bookmark | 2 Comments

Psychiatry and Psychology Category Many of us have felt overwhelming anxiety or worry that has made us want to “pull our hair out.” There is a real psychological disorder where sufferers actually yank out their hair as a result of unwanted emotions or feelings called trichotillomania. Individuals have an irresistible urge to pull out hair from his or her own body or occasionally from the body of others.

Trichotillomania is seen to have a neurobiological basis. Because it is triggered by a variety of stressful or traumatic life events, simple one-fit-all treatment modalities such as use of anti-depressant medications (e.g. SSRIs) will not completely cure the trichotillomania. There is no magic pill or quick fix for trichotillomania management. It is a complex disorder and requires equally complex therapy.

Hair A recent study published in Behaviour Research and Therapy examined possible phenomenological differences between the automatic and focused styles of pulling in youths with trichotillomania. It looked at differences in severity, phenomenology, co-morbid psychiatric symptoms, and functional impact in individuals with varying levels of hair pulling styles. Youths between the ages of 10 and 17 years were asked to participate in the study via an Internet-based survey. 186 individuals with chronic hair pulling behavior were classified as “high-focused” or “low-focused” and either “high-automatic” or “low-automatic” when pulling out their hair. These classifications were based upon scores obtained on the Milwaukee Inventory for Styles of Trichotillomania-Child Version (MIST-C).

Results demonstrated large differences in pulling styles. “High-focused” pullers reported more severe trichotillomania and greater symptoms of anxiety and depression than “low-focused” pullers, and “high-automatic” pullers reported greater symptoms of depression than “low-automatic” pullers.

This study is the first of its kind to highlight the different trichotillomania presentations and the wide range of symptom severity. Health professionals need to be aware of the constellation of possible symptoms, and treat trichotillomania on a case-by-case basis, using a extensive assortment of treatment options.

Reference

C FLESSNER (2008). Styles of pulling in youths with trichotillomania: Exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms? Behaviour Research and Therapy, 46 (9), 1055-1061 DOI: 10.1016/j.brat.2008.06.006

Tags: anxiety, behavior, body, children, depression, hair, neurobiological basis, phenomenology, psychiatric disorder, research, severity, stress, study, survey, therapy, treatment, Trichotillomania, youth

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vanita
December 13, 2008 | Permalink

i suffer from this irresistible urge to pull out hair from my body. help

M
January 12, 2009 | Permalink

I have dealt with this for over 20 years, I started pulling my hair out when I was in 2nd grade. It has been very difficult for me throughout my life, having to hide it from the “outside” world, but explaining it to my loved ones. They have been understanding and supportive, but as an adult it has become more difficult for me to explain to people. I put off getting a haircut for over a year and am going in today to get it done – I find it hard to explain to a complete stranger who is cutting my hair my situation, but they generally are very understanding. It seems to come and go in phases – as a child I would pull close to the start of the school year (August) and for about a period of 3-5 months would continue. It would grow back, with no urges, and then at the same time would start all over again. Now, it is pretty much year round, but I know it is directly related to stress levels and emotional tension. I haven’t found a way to stop, but I hope this year I can at least start dealing with it instead of hiding it.