• A mental disorder where the sufferer pulls out their hair, or parts of their hair, has to keep it a certain length, is so nervous they pull it all out... severe sufferers are known to be completely bald having pulled it all out. x
  • It is an impulse control disorder characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair. (Wikipedia)
  • Trichotillomania (TTM), or "trich" as it is commonly known, is an impulse control disorder characterized by the repeated urge to pull out scalp hair, eyelashes, facial hair, nose hair, pubic hair, eyebrows or other body hair. Trichotillomania is classified in the DSM-IV as an impulse control disorder that is not elsewhere classified under another axis or disorder. It is classified in this manner to control diagnoses of TTM. It is an Axis I disorder. The name derives from Greek tricho- (hair), + mania. History Trichotillomania was described clinically for the first time by a French physician, Francois Hallopeau, in 1889. For many there seems to be a strong stress-related component. In low-stress environments, some sufferers exhibit no symptoms (which are known as 'pulling') whatsoever. This 'pulling' often resumes upon leaving this environment. Characteristics Trichotillomania sufferers can live relatively normal lives; however, they may have bald spots on their head, among their eyelashes, pubic hair, or brows. Prolonged pulling may affect hair pigment, resulting in white hair regrowth.[citation needed] Permanent hairloss (traction alopecia) has been reported from extensive pulling. An additional psychological effect can be low self-esteem, often associated with being shunned by peers and the fear of socializing due to appearance and negative attention they may receive. Some "trichsters" (a name for TTM sufferers) wear hats, wigs or style their hair in an effort to avoid such attention. Many clinicians classify TTM as a habit behavior, in the same family as nail biting (onychophagia) or compulsive skin picking (dermatotillomania). These disorders are a cross between mental disorders, such as OCD obsessive compulsive disorder because the sight or feel of a body part causes the sufferer anxiety, and physical disorders such as Stereotypic Movement Disorder because the sufferer performs repetitive movements without being bothered by or completely aware of them. The current classification of trich as an impulse disorder with Pyromania, Pathological gambling and Kleptomania, has been called into question as inadequate and in need of revision. TTM sufferers are no more likely to have significant personality disorders than anyone else.[citation needed]. It was shown, however, that TTM sufferers have decreased cerebellar volume. In addition, people who suffer from TTM have, like people with other OCD-related disorders (e.g. body dysmorphic disorder, impulse control disorder, kleptomania, Tourette's syndrome), a reduced ability to transport serotonin at the presynaptic level. Anxiety, depression, as well as frank OCDs are more frequently encountered in people with TTM.Sufferers may also eat/chew the roots of the hair that they pull, referred to as trichophagia. It is characteristic that they may feel they are the only person with this problem due to low rates of reportage. Patients should be cautioned that treatment of co-morbid conditions such as Attention Deficit Hyperactivity Disorder with stimulants may increase the frequency and intensity of hair-pulling. Prevalence Sixty-five percent of those afflicted are female. Evidence now points to a genetic predisposition. The number of reported trichotillomania sufferers has increased throughout the years, possibly due to a reduced stigma around the condition. Estimates of the number of sufferers range from 1-3% up to 5% of the world's population. This prevelance data is based on the DSM-IV criteria which includes reported increased tension preceding, and relief following, pulling, which has found to be inapplicable to some trich sufferers. Without the presence of this criteria the prevelance is much higher. Related dangers A practice related to TTM is trichophagia, in which hairs are swallowed. In extreme cases, this can lead to the development of a hairball (trichobezoar) in the abdomen, a serious condition in humans (see Rapunzel syndrome). A trichobezoar can lead to intestinal blockage, which may only be relieved via surgery. [11] Treatments Habit Reversal Training Habit Reversal Training or HRT, has been shown to be a successful way to treat TTM. HRT was developed by Dr. Prasandy Azrin and colleagues and first published in 1973 in an article titled Habit Reversal: A Method of Eliminating Nervous Habits and Tics. The treatment focused on getting patients to increase their awareness of their behavior by recording and learning as much as possible about when, where, and how it occurred, and how to know ahead of time when it would occur. They were next trained to focus on, and reduce the tension that preceded the pulling. Finally, they were taught to perform a muscular movement that was inconspicuous, that was the opposite of and incompatible with the behavior they wished to eliminate. Many patients who pull their hair don’t realize that they are doing this; it is a conditioned response[citation needed]. With Habit Reversal Training, doctors train the individual to learn to recognize their impulse to pull and also teach them to redirect this impulse. As a part of the behavioral record-keeping component of HRT, patients are 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. Trichotillomania is a chronic problem, meaning that although one can recover from it, there is currently no cure. It can be stubborn, but with proper treatment and persistence, picking and/or pulling hairs can be greatly reduced and even brought under control (often called "hibernation". Clinicians who are specialized in treating this problem are not always easy to find, but do have the techniques and training to bring about substantial improvement. In the absence of treatment availability, many sufferers world-wide find assistance in dealing with the impact of trich on their lives through online peer-run support groups. Some community-based support groups also exist. Medications Selective serotonin 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. Antidepressants are only one of many treatments being tried at this time, along with reverse behavior treatment, attempting to "unlearn" the behavior or habit. There have been a few small and not well-controlled clinical trials of drug treatment for trichotillomania (ie, using such drugs as anafranil, prozac, and lithium). There have also been anecdotal reports of vitamin therapy, specifically Inositol, being successful. No one medication has been shown to have a particular advantage over any other, and drugs alone have not been shown to be particularly effective for many. One should use care in choosing a therapist who has specific training, experience, and insight into the condition, in order to avoid being misdiagnosed 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. According to F. Penzel, antidepressants can even increase the severity of the TTM. Source = Wikipedia
  • You know I was pulling my hair out trying to figure out this question, I was about to post when I found that others beat me to it.
  • i have that and its a pain in the butt the bald patches on my eyelids are really annoying and make me look like a complete idiot. most of the time for me it really has nothing to do with stress, i often find myself pulling out eyelashes whilst im watching tv completely relaxed.
  • Simply put, an abnormal desire to pull out one's hair.

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