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Psychology & Psychiatry
December 2, 2008

Pulling Your Hair Out – Complexities of Trichotillomania

By Sabrina Behrens, MA | 5 Comments | Share | Print | Email | Tweet | Like | 1+

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.

HairA 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

Sabrina Behrens, MA

Mrs. Behrens is a freelance writer and psychotherapist. She holds a BA in English from UCLA and a MA in clinical psychology from Pepperdine University. She spends her free time reading, writing, baking and spending time with her family.

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5 Responses

  1. vanita says:
    December 13, 2008 at 3:12 am

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

    Reply
  2. M says:
    January 12, 2009 at 10:01 am

    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.

    Reply
    • ANOM says:
      March 9, 2012 at 7:09 am

      think about it you pull hair because you feel a tension smokeing weed aliveiates tension. so when you are high you dont have the urge to pull out your hair.

      you can get prescribed weed for this. it has helped me with my problem, almost all my hair is back execpt some spot on the eyebrows (worst for me casue they grow in big thick and bushy)

      anyway ya weed actually helps

      good luck to ya

      Reply
  3. ANOM says:
    March 9, 2012 at 7:08 am

    think about it you pull hair because you feel a tension smokeing weed aliveiates tension. so when you are high you dont have the urge to pull out your hair.

    you can get prescribed weed for this. it has helped me with my problem, almost all my hair is back execpt some spot on the eyebrows (worst for me casue they grow in big thick and bushy)

    anyway ya weed actually helps

    Reply
  4. mike says:
    March 9, 2012 at 7:12 am

    .

    Reply

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