We are already toward the end of September. Isn’t that crazy? Talking about September, it is Suicide Prevention month. If you have not read the other posts about Suicide Prevention, please do so (KEEP HOPE ALIVE, WHAT SUICIDES LEAVES BEHIND, LIFE AFTER SUICIDE, PERMANANT SOLUTION TO A TEMPORARY PROBLEM, FLASHBACK SUICIDE ATTEMPT, SUICIDE THOUGHTS VS SUICIDE IDEATION). The more we learn, the better we can help. But right now, we’re taking another mini pause on Suicide Prevention month. I usually try to bring awareness of mental illnesses. I’m going to bring up a mental illness I have been waiting to “discuss” for quite some time. It’s Trichotillomania (pronounced trik-o-till-o-MAY-nee-uh).

Trichotillomania, known as “hair-pulling disorder” as well, is a mental disorder that was originally considered a form of OCD. Now it is classified under Obsessive-Compulsive. It involves recurrent, irresistible urges to pull hair from the scalp, eyebrows, eyelids, and other areas of the body, despite repeated attempts to stop or decrease hair pulling. Hair pulling from the face can result in complete or partial removal of the eyebrows and eyelashes, while hair pulling from the scalp can result in varying degrees of patches of hair loss. The hair pulling and subsequent hair loss results in distress for the person, and can interfere with social and occupational functioning.

A 2013 study reports that it is estimated between 0.6% and 4.0% of the overall population has trichotillomania. That is 304,000,000 million people! In the United Stated, 1% will have experienced trichotillomania in their lifetime. This means that approximately 2.5 million Americans may be affected by this condition at some point in their lives. Studies show that the age of onset for trichotillomania is variable, with a mean age of onset between 9 and 13 years of age, and a peak prevalence at 12-13 years. Although trichotillomania seems to be more common in children than adults, severity of presentation appears to be higher in adolescence and prognosis becoming poorer as onset age approaches adulthood.  A 2007 article in the American Journal of psychiatry reports that females tend to outnumber males by 3 to 1 among adults, with the Diagnostic and Statistical Manual (DSM-5) citing an overall female predominance of 10 to 1. Currently there are no studies reporting differences in the prevalence of trichotillomania between different racial groups.

What is the cause to it? There is no certain cause of trichotillomania, but the current way of looking at trichotillomania is as a medical illness.  One theory on a biological level is that there is some disruption in the system involving one of the chemical messengers between the nerve cells in parts of the brain.  There may be also a combination of factors such as a genetic predisposition and an aggravating stress or circumstance; as with many other illnesses.  Further, trichotillomania could be a symptom caused by different factors in different individuals just as a cough can be produced by a multitude of different medical problems.  Finding the cause(s) will take more research.

16VIRUS-HAIRPULLING-superJumboThere are a lot of symptoms of trichotillomania. The primary feature of trichotillomania is recurrent pulling of one’s own hair. Hair pulling can occur in any region of the body in which hair grows; the most common sites include the scalp, eyebrows, and eyelids. Less common areas include facial, pubic, and peri-rectal regions. Other symptoms can include noticeable hair loss, playing with pulled hair, or rubbing it across the face or skin, biting, chewing, or eating pulled hair, and etc.

Treatment of trichotillomania can be complicated, and most treatment options require time and practice. Individuals often try several strategies to cope with their urges before they find something that works. Try not to get discouraged if symptoms come and go. Habit reversal is one of them. This is often the primary treatment of trichotillomania. Individuals learn how to recognize situations where they are likely to pull hair and substitute other behaviors instead. Many people use journaling, alerts, and other strategies to increase awareness of triggers. Instead of pulling hair, a person might substitute behaviors such as; clenching fists or snapping an elastic band on the wrist. Cognitive therapy is another type. This type of therapy can help people explore distorted beliefs related to hair pulling. Self-awareness training is an additional option. Individuals learn to become more aware of their hair pulling patterns by tracking when they pull and detailing emotions and other important information. Relaxation training helps people learn to focus on and calm their central nervous systems in response to stress triggers. Deep breathing training is learning the proper way to engage in deep breathing helps increase relaxation and focus. Process-oriented therapy is talk therapy can be effective in helping people explore their triggers and emotions beneath the pulling. Sometimes necessary: While there are no medications specific to the treatment of trichotillomania, SSRIs and SNRIs can be used to treat some of the accompanying symptoms of anxiety. Family therapy is obviously for children and adolescents, family therapy helps parents learn to better respond to and manage symptoms. Group therapy is also helpful, because trichotillomania can feel isolating. Groups help people connect with others enduring a similar struggle and provide support for one another. Some individuals with trichotillomania learn to manage symptoms and triggers with outpatient treatment, while others require more intensive treatment. It’s important to seek help as soon as possible and continue treatment on an ongoing basis.

I hope the following information was useful. If you don’t have the disorder, I hope it brought a better perspective of the disorder. I also hope it shows you to be compassionate to others. If you have it, please don’t be shy to comment below. The more we share our stories, the more it decreases the stigma on mental illnesses. You always have a friend in me and remember to adult one day at a time.


Suicide Prevention Hotline: 1-800-273-8255

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