What is Trichotillomania?

By Stephanie Osuba

Trichotillomania is a hair pulling disorder categorized in the Obsessive Compulsive and Related Disorders section in the DSM-5. It is one of the other Body Focused Repetitive Behaviors (BFRBs) – along with excoriation (skin picking) and onychophagia (nail biting) – in which the individual will pull, pick or bite at various parts of the body resulting in damage.  Symptoms include recurring hair pulling, hair loss, and related stress and impairment because of the behavior. The disorder is not considered self-mutilation like cutting or burning because the behavior is not intentional and research suggests that there is no connection between the disorder and unresolved trauma. Often people are ashamed of the behavior and their resulting appearance because of it and try their hardest to stop. Comorbidities include, tic disorders, mood disorders, and anxiety disorders, although, trichotillomania can also occur in the absence of any other psychopathology.  The regular age of onset is between the ages of 11 and 13, however, baby trichotillomania is a rare phenomenon that seems to go away as the child grows older. Research also suggests that the disorder is primarily genetic as it appears in the first relatives of people with trichotillomania than it does in the general population.

Available treatments include cognitive behavioral therapy (CBT) and habit reversal training (HRT) with adjunctive dialectal behavioral therapy (DBT) and acceptance and commitment therapy (ACT). These therapies help the person to be aware of the pattern of the behavior and helps to identify triggers to pulling. It also teaches methods to redirect that urge to pull into a new healthy pattern of behavior in order to reduce or eliminate the urge. While there is no FDA-approved medication specifically for BFRBs, research is being conducted. OCD medication such as selective serotonin reuptake inhibitors (SSRIs) and anafranil can help alleviate symptoms as well.

Sources: Deibler, M. W., Psy. D. (n.d.). Trichotillomania (TTM) and related Body-Focused Repetitive Behaviors (BFRBs). Retrieved from http://www.thecenterforemotionalhealth.com/trichotillomania-and-related-disorders

Zwolinski, R., LMHC. (2013, October 03). Cause And Treatment Of Trichotillomania. Retrieved from https://blogs.psychcentral.com/therapy-soup/2012/04/cause-and-treatment-of-trichotillomania/

If you or someone you know appears to be suffering from trichotillomania, the licensed psychologists, psychiatrists, psychiatric nurse practitioners, and psychotherapists at Arista Counseling & Psychotherapy can assist you. Contact our Paramus, NJ or Manhattan, NY offices respectively, at (201) 368-3700 or (212) 722-1920 to set up an appointment. For more information, visit http://www.counselingpsychotherapynjny.com/.

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