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By Nancy Keuthen, Dan Stein & Gary Christenson
New Harbinger Publications, US (2001)
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Trichotillomania (TTM) is
a compulsive urge to pluck out hair, resulting in alopecia. It is
also referred to as 'compulsive hair-pulling'. Although TTM is not
an Obsessive-Compulsive Disorder (OCD), it is a disorder that involves
irresistible urges and can co-occur with OCD. It can also co-occur
with BDD.
Epidemiological studies now show
that Trichotillomania is more common than previously thought, females
having a fourfold higher incidence than males. Onset may occur in
early childhood but is more often in adolescence and early adulthood.

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Symptoms:
A person with TTM sometimes experiences a build up of tension before
hair-pulling that is then relieved by this behaviour. Even if there
is no tension prior to plucking, the person may find plucking pleasurable.
This makes the behaviour difficult to stop.
The most common places that
people with TTM pull hair from are the scalp, eyelashes and eyebrows.
They may also pull hair from the face, arms, legs, abdomen and pubic
area. Fingers are commonly used to pull hair but some people may
use tweezers. A person with TTM may also pull hair from other people
(e.g. family members) or pets.
Hair sucking or chewing (sometimes
resulting in hair ingestion) may also occur in people with TTM and
this may lead to intestinal problems requiring surgery. Many also
chew their nails, cheek and tongue.

People with TTM are very secretive
about their disorder and avoid seeking treatment. They may pull
hair from places that may not be noticed to avoid drawing attention
to their problem (for example, a woman with long hair might pluck
from the crown and then brush the hair over to hide a bald patch).
People with TTM will usually have
tried stopping the behaviour themselves by a variety of ways including
taping their fingers together, or wearing hats and gloves. TTM
usually begins in childhood or adolescence and there is no consistent
evidence to suggest that it may be more common in males or females.
Evidence suggests that several biological factors (e.g. brain
structure, viral infection) may be responsible for the onset of
TTM. People with TTM often feel depressed, ashamed and have low
self-esteem. Occupational, domestic and social functioning may
also be affected. TTM can, however, be treated and controlled.
TTM Treatments:
TTM research is not extensive at present and the efficacy of various
treatment methods has not been compared systematically. Nevertheless,
several methods may be used to treat TTM, with two or more of
them often being used in combination. Behavioural treatments often
employ 'habit reversal training'. This basically involves breaking
down each part of the hair pulling behaviour and attempting to
change it. As well as changing behaviour, cognitive-behavioural
therapy (CBT) involves subjecting the person's thoughts and feelings
about hair pulling to analysis and change (e.g. that pulling makes
the person feel better). In an attempt to stop hair-pulling further,
the person may have a hairpiece glued to the crown of their head
to prevent any more hair being plucked from the area. Over time,
it is hoped that this might break the pulling habit. Hypnosis
may benefit some people with TTM, and drug treatment will often
be employed. Successful treatment of TTM seems to be most likely
with a combination of CBT and medication.
Whilst Trichotillomania has been
recognised for over 100 years it has, until recently, been hidden,
the rapid place in which this illness is gaining public discussion
will encourage sufferers to seek treatment. The result will be
help for the sufferer and greater understanding by clinicians
of the dynamics and neurobiology of Trichotillomania. It is via
this understanding that the aetiology may be explained and more
effective treatments emerge.
If you think that you might have
TTM, the first point of contact for help should be your GP. Your
GP may have little or no knowledge of TTM and so you will need
to describe it to them. You may find it helpful to print out this
webpage and take
it along with you. Many people with TTM avoid seeking help because
they feel ashamed or embarrassed. As difficult as it may be to
seek help, your GP is there to help you and everything you tell
your GP is confidential. To help overcome the negative emotions
involved in TTM, such as depression and low self-esteem, becoming
involved in a trichotillomania support group is recommended.
Source: OCD Action
2002
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Your road to
recovery could be helped by following some basic lifestyle
guides.
Relaxation, physical exercise, regular sleep patterns
and eating a balanced diet are all important factors in
not only a healthy lifestyle but also in ensuring you
have a better chance of recovering from OCD. |
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OCD
Action.
Aberdeen Centre,
22-24 Highbury Grove,
London,
N5 2EA.
Telephone:
(0) 207 226 4000
Fax:
(0) 207 288 0828.
Email Us |
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By Dan Stein, Gary Christenson & Eric Hollander
American Psychiatric Publishing, US (1999)
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