Trichotillomania

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.AddictionThe following page includes discussions of addiction, including substance abuse. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Trichotillomania**, also called **Hair-Pulling Disorder** or sometimes shortened down to **Trich** or **TTM**, is a mental disorder that involves recurrent, irresistible urges to pull out hair from the scalp, eyebrows, or other areas of the body, despite trying to stop. Trichotillomania is also part of a group of behaviors known as body-focused repetitive behaviors.

## Signs & Symptoms

* Repeatedly pulling hair out, typically from the scalp, eyebrows or eyelashes, but sometimes from other body areas, and sites may vary over time.
* An increasing sense of tension before pulling, or when one tries to resist pulling.
* A sense of pleasure or relief after the hair is pulled.
* Noticeable hair loss.
* Preference for specific types of hair, rituals that accompany hair pulling or patterns of hair pulling.
* Biting, chewing or eating pulled out hair.
* Significant distress or problems at work, school or in social situations related to pulling out hair.

Many individuals who have trichotillomania also pick their skin, bite their nails or chew their lips. Sometimes pulling hairs from pets or dolls or from materials, such as clothes or blankets, may be a sign.

### Types of Hair Pulling

Hair pulling usually happens in one of two ways, automatic or focused.

#### Automatic

Some individuals pull their hair without even realizing they're doing it, such as when they're bored, reading or watching TV.

#### Focused

Some individuals pull their hair intentionally to relieve tension or distress. Some individuals may develop elaborate rituals for pulling hair, such as picking just the right hair or biting pulled hairs.

### Diagnosis

The DSM-5 diagnostic criteria includes:

* Recurrent hair pulling, resulting in hair loss.
* Repeated attempts to decrease or stop the behavior.
* Clinically significant distress or impairment in social, occupation, or other areas of functioning.
* Not due to substance abuse or a medical condition.
* Not better accounted for by another psychiatric disorder.

## Causes

It's not entirely clear what causes trich, it could be:

* A way of dealing with stress or anxiety.
* A chemical imbalance in the brain.
* Changes in hormone levels during puberty.

For some individuals, hair pulling can be a type of addiction. The more they pull out their hair, the more they want to keep doing it.

## Treatment

Trich is commonly treated using a type of CBT called habit reversal training.

This aims to help replace a bad habit with something that's not harmful. Treatment usually involves:

* Keeping a diary of hair pulling.
* Working out the triggers for hair pulling and learning how to avoid them.
* Replacing hair pulling with another action, like squeezing a stress ball.
* Loved ones providing emotional support and encouragement.
* Antidepressants are not usually prescribed to treat trich.

## Trichophagia

About 20% of individuals with this condition eat their hair after pulling it, a condition known as trichophagia. This can lead to hairball-like blockages in their digestive tract. These blockages are sometimes dangerous and often cause damage that needs surgery to repair.

## Known Individuals with Trichotillomania

### Aimee Interrupter

Aimee Allen, better known by her stage name Aimee Interrupter, is the lead vocalist of the ska-punk band The Interrupters. In July, 2020, she opened up about her experience with trichotillomania, "I've had trichotillomania my whole life and it's something that I manage [...] I wouldn't say I don't pull my hair out anymore, but it's rare." she said in an interview with *Kerrang!*. She would reference her trichotillomania and other related OCD symptoms in The Interrupters's song *Jailbird*: "The trauma skips like an old C.D that's all scratched up from my OCD [...] I bite my nails until they bleed, pulling out my hair from the root like a weed."

## References

https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20355188

https://www.nhs.uk/mental-health/conditions/trichotillomania/

https://www.ocduk.org/related-disorders/trichotillomania/

https://www.bfrb.org/learn-about-bfrbs/trichotillomania

https://my.clevelandclinic.org/health/diseases/9880-trichotillomania

https://www.kerrang.com/aimee-interrupter-ive-suffered-ive-had-to-fight-for-survival-but-its-all-been-worth-it