Hair pulling

Have you ever been gripped by an irresistible bad habit – like children who suck their thumbs or those who can’t stop biting their nails?

Many of us have some quirky habit we can’t seem to shake. Something we do when we’re absentmindedly watching TV or when we’re nervous or deep in thought.

For some, a bad habit is really not so simple. Between one and three percent of people experience a compulsion to obsessively pull out their hair, which leaves them with bald patches, stress and feelings of distress.

Trichotillomania is a long and complicated-sounding word to describe an impulse control disorder sometimes also referred to as hair pulling disorder.

Similar to other impulse control conditions such as OCD, kleptomania, pyromania or pathological gambling, trichotillomania involves a recurrent and overwhelming urge to pull out one’s hair. Usually it is the hair on the scalp that is most affected, but other hair such as eyelashes, eyebrows or beard can also be subject to pulling with this condition.

Typically, individuals with this and other conditions like it feel an increasing sense of tension and anxiety immediately before pulling out their hair or when they are really trying to resist the habit. This anxiety dissipates somewhat while the hair is being pulled and then gradually builds up again afterward.

Far from enjoying the experience, those with trichotillomania tend to feel significant distress about their behaviour and also experience difficulties in social, work and other areas of life as a result. Many with this condition avoid intimate relationships and try to hide their hair pulling behaviour.

Although symptoms can begin at any age, trichotillomania usually begins near puberty. It is not understood exactly what causes this condition, but it is believed that both biological and environmental factors play a role.

Sometimes hair pulling can be triggered by a stressful event such as a change of schools, abuse, family conflict or trauma. In other cases, hormonal changes associated with puberty may trigger symptoms.

There is also thought to be a genetic component to trichotillomania as it seems to occur more commonly in those with a family history of anxiety or other psychiatric conditions.

Those experiencing trichotillomania also commonly experience other psychiatric conditions such as obsessive compulsive disorder, anxiety disorders or depression. Other impulse control problems are also common among those who pull out their hair.

Fortunately, there are some effective treatments available that can help those experiencing trichotillomania. Usually, a combination of cognitive behaviour therapy and medication offer the most relief.

In therapy, individuals learn to track their symptoms, increase their awareness of when hair pulling occurs and learn techniques to reverse the habit. These can involve getting the individual to engage in behaviour that is incompatible with hair pulling at times when the pulling is more likely to occur.

Medications that are helpful in treating anxiety and obsessive compulsive disorder also seem to help those with trichotillomania – and combining these with the skills learned in a structured course of therapy can help to manage the condition.

If you or a loved one experience an overwhelming urge to pull out your hair – speak with your doctor about it and get referred to a mental health professional. You don’t need to let this continue to disrupt your life.


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