“Pulling your hair out” is a clichéd phrase we often use to underscore our frustration over something, but for millions of people, the phrase is no trite hyperbole. Up to 4 percent of the overall population suffer from trichotillomania, a chronic disorder that involves recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other areas of your body, despite trying to stop. It can be difficult to treat.
You may be suffering from trichotillomania if have any of the following symptoms:
· Repeatedly pulling your hair out, typically from your scalp, eyebrows or eyelashes, but can be from other body areas, and sites may vary over time
· An increasing sense of tension before pulling, or when you try to resist pulling
· A sense of pleasure or relief after the hair is pulled
· Shortened hair or thinned or bald areas on the scalp or other areas of your body, including sparse or missing eyelashes or eyebrows
· Preference for specific types of hair, rituals that accompany hair pulling or patterns of hair pulling
· Biting, chewing or eating pulled-out hair
· Playing with pulled-out hair or rubbing it across your lips or face
Most people who have trichotillomania also will pick their skin, bite their nails or chew their lips. Sometimes pulling hairs from pets or dolls or from materials, such as clothes or blankets, may be a sign. Most people with trichotillomania pull hair in private and generally try to hide the disorder from others.
Sufferers of trichotillomania are placed in one of two categories, “focused” or “automatic.” The former describes people who pull their hair intentionally to relieve tension or distress. Some people may develop elaborate rituals for pulling hair, such as finding just the right hair or biting pulled hairs. The latter category describes the people who pull their hair without even realizing they are doing it, such as when they are reading or watching TV.
If you think you may be suffering from trichotillomania, see a doctor, who will first try to eliminate other possible causes of hair pulling or hair loss through testing. A diagnosis of trichotillomania will mean that you meet the criteria in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. This manual is used by mental health providers to diagnose mental conditions and by insurance companies to reimburse for treatment. The criteria currently are:
· You repeatedly pull out your hair, resulting in noticeable hair loss.
· You repeatedly try to stop pulling out your hair or try to do it less often.
· Pulling out your hair causes you significant distress or problems at work, school or in social situations.
· Your hair loss isn't due to another medical or skin condition or the symptom of another mental disorder.
Once diagnosed, the treatment will likely be psychotherapy, primarily habit reversal training. This type of therapy helps you learn how to recognize situations where you are likely to pull hair and how to substitute other behaviors instead.
There are currently no medications approved by the FDA for the treatment of trichotillomania, but your doctor may be able to prescribe some meds that will address your symptoms.