Trichotillomania

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Trichotillomania in a young woman
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Trichotillomania in a young woman

Trichotillomania (TTM) is an impulse control disorder characterised by the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair. It is believed to be related to obsessive-compulsive disorder.

Most TTM sufferers live relatively normal lives, except for having bald spots on their head. Many clinicians classify TTM as a mental disorder, though the classification is debatable. Some clinicians classify TTM as a form of obsessive-compulsive disorder. Some classify TTM as a form of self-mutilation, although the psychological mechanism behind TTM differs from the one that causes self-injurious behavior. Others say that TTM is no more a mental disorder than is any other habitual behavior, such as nail biting. Many TTM sufferers have relatively normal work and social lives; and TTM sufferers are not any more likely to have significant personality disorders than anyone else.

There have been recent clinical trials of drug treatment for trichotillomania, for example using anafranil, prozac, and lithium. One should use care in choosing a therapist who has specific experience and insight into the condition, lest one be overdiagnosed or overmedicated. Prozac and other similar drugs, which some professionals prescribe on a one-size-fits-all basis, tend to have limited usefulness in treating TTM, and can often have significant side effects.

A practice related to TTM is trichophagia, in which hairs are sucked and/or eaten. In extreme cases, this can lead to the development of a hairball (trichobezoar) in the abdomen, a serious condition in humans; see Rapunzel syndrome.

Contents

Treatment for Trichotillomania

Trichotillomania is classified as an Obsessive Compulsive Spectrum Disorder. Compulsive Spectrum Disorders are obsessive compulsive qualities that are related and similar to that of Obsessive Compulsive Disorder.

Habit Reversal Training

One form of treatment for Trichotillomania is Habit Reversal Training. Many patients who pull their hair donít realize that they are doing this; it is a conditioned response. With Habit Reversal Training doctors train the individual to learn to recognize their impulse to pull and also teach them to redirect this impulse. Patients feel the urge to pick at their hair are taught to visualize something that will get their mindset off of picking at their hair. Once they are aware of what they are doing then they are able to focus and stop themselves from the urge of picking.

Patients are also often instructed to keep a journal of their hair-pulling episodes. They may be asked to record the date, time, location, and number of hairs pulled, as well what they are thinking or feeling at the time. This can help the patient learn to identify situations where they commonly pull out their hair and develop strategies for avoiding episodes.

Medications

Selective seretonin reuptake inhibitors (SSRIs) are commonly used in the treatment of trichotillomania. Antidepressants have been shown to be effective in treating both Obsessive-Compulsive Disorder and trichotillomania.

Exposure and Response Techniques (ERT)

Stimulus and Control Techniques

Books

  • Penzel (2003) The Hair-Pulling Problem: A Complete Guide to Trichotillomania; Oxford University Press, ISBN 0195149424
  • Keuthen, Stein, Christensen & Christenson (2001) Help for Hair Pullers: Understanding and Coping With Trichotillomania; New Harbinger Publications, ISBN 1572242329
  • Stein (Ed.), Christenson (Ed.) & Hollander (Ed.) (1999) Trichotillomania; American Psychiatric Press, ISBN 0880487593
  • Parker (Ed.) (2004) Trichotillomania - A Medical Dictionary, Bibliography, and Annotated Research Guide to Internet References ; Icon Health Publications, ISBN 0597846642

External links

fr:Trichotillomanie nl:Trichotillomanie

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