Trichotillomania:OCD/Anxiety Disorder

By: Amanda Stangel

Overview (OCD)

OCD (Obsessive Compulsive Disorder)• an anxiety disorder in which people have unwanted and

repeated thoughts, feelings, ideas, sensations (obsessions), or behaviors that make them feel driven to do something (compulsions).• Often the person carries out the behaviors to get rid of the

obsessive thoughts, but this only provides temporary relief.• Not performing the obsessive rituals can cause great anxiety.• It can destroy a person's capacity to function at work, at

school, or even to lead a comfortable existence in the home.

Overview (Trichotillomania)TTM (Trichotillomania)• Recurrent, irresistible urges to pull out hair from your scalp, eyebrows

or other areas of your body, despite trying to stop. (Skin picking)• Hair pulling from the scalp often leaves patchy bald spots.• People with trichotillomania may go to great lengths to disguise the

loss of hair.• May be mild and generally manageable, or the compulsive urge to

pull hair is overwhelming.• Long-term (chronic) disorder. Without treatment, symptoms can vary

in severity over time.• It has been estimated that 0.5-3 percent of people will experience the

condition at some point during life.

Types• Focused• Pulling hair intentionally to relieve

tension or distress• pulling hair out to get relief from the

overwhelming urge to pull hair.• elaborate rituals for pulling hair,

such as finding just the right hair or biting pulled hairs.

• Automatic• Pulling without realizing they're

doing it• such as when bored, reading, or

watching TV.

Signs and Symptoms• Repeatedly pulling your hair out.• 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, thinned, or bald areas on areas of your body.• Preference for specific types of hair.• Biting, chewing, or eating pulled-out hair.• Playing with pulled-out hair or rubbing it across your lips or

face.

Causes• The cause of trichotillomania is unclear;• like many complex disorders, trichotillomania probably results from a

combination of genetic and environmental factors.• abnormalities in the natural brain chemicals of serotonin and

dopamine may play a role in trichotillomania.

Medical Issues• Skin and hair damage: Constant hair

pulling can cause abrasions and other damage, including infections, to the skin on your scalp or the specific area where hair is pulled, and can affect hair growth.

• Hormonal changes of menstruation can worsen symptoms in women.

• Hairballs: Eating your hair may lead to a large, matted hair ball (trichobezoar) in your digestive tract. Over a period of years, the hair ball can cause weight loss, vomiting, intestinal obstruction and even death.• (16 year old girl with trichotillomania since the

age of 3, presented acutely with coffee-ground vomiting and abdominal pain.

Psychosocial/Psychological Issues

• Emotional Distress: Many people with trichotillomania report feeling shame, humiliation and embarrassment and experience low self-esteem, depression and anxiety because of their condition.

Vocational Issues• Problems with social and job

functioning: Embarrassment because of hair loss may lead to avoidance of social activities and occupational opportunities.• People with trichotillomania may wear wigs, style their hair to disguise

bald patches or wear false eyelashes. Some people may avoid intimacy for fear that their condition will be discovered.

Treatment• Therapy:• Behavioral Therapy• Cognitive Behavioral Therapy

• Medications:• may help to reduce the depression and any obsessive-compulsive symptoms the

person may be experiencing.• Fluoxetine (Prozac)        • Fluvoxamine (Luvox)          • Sertraline (Zoloft)• Paroxetine (Paxil)      • Clomipramine (Anafranil)    • Valproate (Depakote)• Lithium Carbonate (Lithobid, Eskalith)

References

• http://www.mayoclinic.org/diseases-conditions/trichotillomania/basics/definition/con-20030043• http://www.mentalhealthamerica.net/conditions/trichotilloman

ia-hair-pulling• https://

www.psychologytoday.com/conditions/obsessive-compulsive-disorder• http://rarediseases.org/rare-diseases/trichotillomania/