Trichotillomania

• Trichotillomania usually starts in childhood and pre-adolescent years, between ages 7 and 12, more common among girls. It is not unusual to begin with pulling one’s eyelashes and to later escalate into pulling one’s hair.
• Trichotillomania is classified in the Diagnostic and Statistical Manual of Mental Disorders 5 in the category of obsessive-compulsive and related disorders, along with skin-picking disorder. However, trichotillomania is a separate condition with its own nuances and unique symptomatology, previously classified as an impulse control disorder in DSM-IV-TR.
• The impulse to pull one’s hair happens often enough that it leaves a patch of skin exposed, creating social and emotional repercussions for the person. Kids and teens may be trying to hide the spot by wearing hats, different hairstyles or make up. They may feel embarrassed to share the problem with others and often engage in behaviors that attempt to hide what’s happening to them.
• This in turn could cause additional struggles with low self-esteem and increased feelings of anxiety or depression.
• People, who suffer from the disorder report feeling out of control in their attempts to stop or control the behavior, which is often experienced as soothing. Some kids don’t even realize that they are doing it – they may pull when feeling stressed, bored or simply when watching television at home, thinking or looking in the mirror.
• It is not uncommon for kids, who struggle with the disorder to look for pulling a certain type of hair and then examine it; to bite or sometimes even swallow the hair. The latter is a more rare condition but if severe, when entire hairs are swallowed, it may require surgical intervention.
• Usually, people experience a sense of building pressure or tension with the intense need to pull the hair, which tension then transforms into a sense of relief after the hair has been pulled.
• This feeling of building tension is similar to the experience of people, who struggle with obsessive compulsive disorder prior to engaging in the compulsive behavior. 
• When someone close to the kid or teen notices the behavior, this is usually the time that the family will seek treatment. There is either a concern from a social worker at school, a parent at home, who notices the behavior or maybe the primary care physician makes the referral to a therapist.
• As with many other psychological disorders, the cause of trichotillomania is unknown and it may be the result of all genetic, environmental and individual factors. Certain stressful, familial and traumatic events can certainly play a role in triggering the disorder.
• Although there are many commonalities between people, who struggle with the disorder, it is unique and different for everyone, much like any other psychiatric disorder.
• The good news is that trichotillomania is treatable with the right combination of psychotherapeutic, medical and behavioral interventions.

If you are concerned about someone you know, seek professional help. Call 773-470-3106 and make an appointment today.