Trichotillomania is not just a “bad habit,” it’s a chronic disorder that can significantly impact a person’s emotional wellbeing, their confidence, and if not treated can persist for months or even years.

What is trichotillomania?
Trichotillomania is classified by the overwhelming urge to pull or pluck one’s hair despite attempting to stop. People suffering from trichotillomania may pluck hair from their body, such as the scalp, eyebrows, or eyelashes.  Additionally, trichotillomania may also come with rituals or patterns that can accompany the hair pulling. Some individuals may bite, chew, or play with the hair after it is pulled out. Many individuals may also show other unique behavioral traits, such as picking at their skin, biting their nails or even pulling hair from pets, toys, or other materials. Often attempts made to try to stop are unsuccessful.

Individuals with trichotillomania can fall into a few different categories.

Firstly, there is focused and automatic. Focused describes a person who pulls their hair as a method to relieve tension. For some individuals, the feeling of tension may increase over time as the person tries to resist the urge to pull their hair out, and a feeling of relief can occur after pulling the hair out. In some cases, the pulling of hair can serve as a stress coping mechanism.

Automatic describes a person who pulls their hair without even realizing it. This can occur when the person is bored or engaging in minimally physical activity, such as watching television.

A person can actually have both focused and automatic. Mood is also a factor. While some people may pull their hair as a way to deal with negative emotions, others may actually pull their hair because they find relief in doing so, and continue this behavior to experience these positive feelings.

Trichotillomania is considered a chronic disorder and symptoms can change over time. The symptoms can also come and go. There are a few risk factors that may make a person more likely to develop this condition such as age, family history, other disorders (like OCD), and stress.

Effects of Trichotillomania

Emotions
Many people with trichotillomania may have feelings of shame or embarrassment as well as anxiety, and depression and diminished self-esteem. This can take a tremendous toll on their quality of life and wellbeing, spiraling into a vicious cycle of negative emotions that, at times, can seem suffocating and inescapable. These feelings can also spill over into their social life.

Social complications
Hair loss can be difficult for anyone to deal with. Due to feeling embarrassed a person with trichotillomania might avoid social functions or activities. A person with trichotillomania may opt to wear a wig or hairstyles to hide any bald patches they have on their scalp. Intimacy with others may also be avoided, as some people may have lingering fears about their condition being discovered.

Physical health concerns
As a person may also pick at their skin as well as their hair, a person with trichotillomania may be more likely to cause scarring, infections, and damage that can impact the growth of their hair. If a person is consuming their hair, a large ball of hair can sometimes end up in the digestive tract. Over the span of years, this large matted ball of hair can grow in size and lead to complications, such as weight loss, vomiting, and even death.

Treatment
There are many treatments available in the form of therapies. Treatment options include habit reversal training and cognitive therapy. Additionally, therapists can help with the other disorders associated with trichotillomania such as anxiety or depression.  While there are not any medications that can stop the condition itself, a doctor may prescribe medications that can help, such as anti-depressants. Above all remember that if you have trichotillomania, you are not alone. There are also support groups out there that can be useful in coping and finding people who can relate.