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Is Trichotillomania An Anxiety Disorder

The Relationship Between Anxiety And Compulsive Hair Pulling


There is a very strong correlation between trichotillomania and anxiety. Even though the relationship between the two is not completely understood on a scientific level, there is no doubt that the two share a close relationship.

Many people use the hair pulling behavior as a coping mechanism for negative feelings like anxiety. They have an exceedingly tough time coping with difficult emotions such as these without performing the self-soothing behavior.

Pulling out hair does not hurt those with trichotillomania. Furthermore, most of those with it are not trying to damage or hurt themselves. Far from it. Instead they are trying to make themselves feel better, less stressed out, and more calm.

The Link Between Trichotillomania And Anxiety

The exact cause of trichotillomania is not known. In fact, the disorder may have no singular genesis, but, rather, a collection of potential triggers, both nebulous and concrete. What is known is that trichotillomania often develops in concert with anxiety disorders and many experts now understand trich as a maladaptive attempt to cope with overwhelming psychological distress. In 2012, Alexandra Heather Foss, an abuse survivor who suffered from crippling anxiety, wrote a stirring personal essay for The New York Times about her own history of hair pulling:

The way I coped with circumstances outside my control was to grab onto something my body, more specifically, my hair. I tried to marginalize my pain and dissatisfaction by uprooting the bad things that were making me anxious with tweezers, my fingers, nail clippers, safety pins, whatever tools were available during the desperate hours of my suffering. I would pull and pick and the destructive vortex of emotion that was threatening inside to sweep me away from life would stall, would recede, and for a while I could be calm, safe, even though that safety came at a painful price.

What Is The Difference Between Trichotillomania And Obsessive

TTM falls under the overall category of obsessive-compulsive disorder, but it has some key differences from OCD itself.

  • Obsessions. OCD involves obsessions, which are thoughts or urges that a person cant control and doesnt want. TTM doesnt involve obsessions.
  • Feeling of reward. When people with TTM pull out their hair, they often feel relief or other positive emotions. OCD doesnt involve positive feelings in that way.

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What Can I Expect If I Have This Condition

TTM isnt usually a danger to your physical health . However, it can be very disruptive and damaging to your mental health and quality of life.

Because people with TTM often feel ashamed or embarrassed of this condition, most avoid treatment. Those who avoid or delay treatment are much more likely to have issues like permanent hair loss, scarring and more severe mental health problems.

How long does TTM last?

The available research, while limited, shows that people with TTM have this condition for an average of about 22 years. In some cases, the condition is a lifelong problem. People also often describe that the condition has phases, becoming more or less severe for periods of time. Overall, early diagnosis and treatment are the best chance for limiting how long this condition lasts and how severely it impacts your life.

Whats the outlook for this condition?

The overall outlook for this condition depends partly on the age of the person who has it. Infants and children with TTM often have the best outlook, with the condition commonly going away on its own.

However, the older a person gets especially from adolescence onward the greater the odds that treating the condition becomes difficult. TTM on its own is rarely a life-threatening problem. But its impacts on a persons life, especially their mental health, are often severe. Because of this, early diagnosis and treatment are very important.

How Do People Overcome It

Is Trichotillomania an Anxiety Disorder? Causes &  Treatment

People with trichotillomania usually need help from medical and behavioral specialists in order to stop. With the right help, most people overcome their hair-pulling urges. When someone is able to stop pulling, hair usually grows back.

Overcoming hair-pulling urges may involve a type of behavioral therapy called habit substitution, taking medicine, or a combination of therapy and medicine.

In therapy, people with trichotillomania learn about urges. They learn how urges fade on their own when people don’t give in to them, and how urges get stronger and happen more often when people do give in. They learn to identify situations, places, or times they usually have an urge to pull.

Therapists teach people with trichotillomania how to plan a replacement habit they can do when they feel a strong urge to pull hair. Replacement habits might be things like squeezing a stress ball, handling textured objects, or drawing. The therapist guides the person on how to use the new habit to resist the urge to pull hair. With practice, a person gets better at resisting the urge to pull. The urge becomes weaker and easier to resist.

Because the urges and habits that lead to hair pulling are so strong, resisting can be difficult at first. People may feel more tension or anxiety as they begin to resist urges to pull. A therapist can coach a person through these difficult parts and offer support and practical advice about how to reverse the powerful urges.

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Whats The Outlook For People With Trichotillomania

Trichotillomania is often underdiagnosed. Those who have symptoms may feel embarrassed or afraid to talk to their doctor about what they are experiencing. Symptoms may affect a person for just a few months, while it may affect another person off and on for many years.

Many people report symptoms happening in cycles where hair pulling urges may happen often for a few months then go away completely for a little while.

If you think that your friend or loved one is experiencing symptoms of trichotillomania, it can be hard to know what to say. Here are some tips:

Trichotillomania Causes In Adults:

Research shows that people who acquire trichotillomania in their adulthood can be a consequence of another mental disorder. This means hair pulling is essentially a side effect of a more prominent disorder.

Its worth looking into it. Because my therapist taught me that I suffer from ADD. Which explained so much LOL. Other disorders that can coincide with trichotillomania are anxiety, depression, OCD, or ADD.

1. Feeling different textured hair

One of the biggest causes for trichotillomania is when you pull hair that feels different from the rest. The strand you pull stands out and seems out of place. The strand can be too thick, too curly, too coarse, or going in the wrong direction. You might even hunt for these strands. And to correct the strand, we pull it out so that its not among the rest.

If you want to learn more about your trichotillomania,read this bookOvercoming Body-Focused Repetitive Behaviors: A Comprehensive Behavioral Treatment. Its such an AMAZING resource and all of you should read it!! It taught me so much about this topic of textured hair and so much more.

Quick interventions: Tell yourself its okay to have imperfect strands, buy moisturizing hair products

2. Having an imbalance of neurons

Quick interventions: Exercise and eat healthy foods, engage in activities or hobbies that make you happy, take medication

3. Lacking awareness
4. Enjoying the physical sensations

Examples of sensations trichotillomania hair pulling can give you:

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Are There Any Complications

Trichotillomania can cause permanent hair loss and scarring. This is more common in people who continue to pull their hair out into adulthood.

Some people with trichotillomania may also eat their hair, a condition known as trichophagia. This may result in hair building up in the digestive tract and can also cause a dangerous obstruction.

Treating Trichotillomania And Anxiety

What is Trichotillomania (Hair-Pulling) Disorder and how is it different from OCD?

If you or a loved one is experiencing Trichotillomania and anxiety, it is time to get professional help. Doing so will increase the likelihood of recovering and prevent the disorder from reoccurring in the future when stressful situations arise.

Our team at California Sunrise Recoverys Mental Health Center is skilled in treating anxiety and its symptoms, even those that are less frequent. We can also help get to the bottom of trichotillomania causes in each patient to avoid being affected by triggers in the future.

Call us today at !

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What Tests Will Be Done To Diagnose It

In some cases, a punch biopsy is necessary to confirm a diagnosis of TTM. This test can also rule out other skin conditions that might be the true cause of hair loss or hair pulling.

In cases where your healthcare provider suspects a blockage from swallowed hair, you might also undergo other diagnostic tests. These include imaging tests like a computerized tomography scan, blood testing for anemia and more.

Recommendations Regarding Existing & New Clinical Strategies

Research conducted over the past 5 years has focused on TTMs prevalence , the functional impact and effectiveness of treatments currently being utilized in clinical practice , TTMs core psychopathology , clinical recommendations from the perspective of expert treatment providers , the potential utility of combined treatment approaches , and the development and empirical evaluation of novel pharmacological approaches that hold promise for clinical care, while simultaneously informing us about TTMs underlying neurobiology. Collectively, this wealth of new information has advanced the field considerably with respect to TTM assessment, has improved our understanding of its phenomenology, and has put us collectively in a better position to evaluate the treatments that are currently available.

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What Causes Trichotillomania And What Triggers It

Scientists are yet to find out what exactly causes trichotillomania. Research has helped to identify certain factors that may play a role:

  • Genes: Genetic transmission can be one of the causes. Someone who has a family member with trichotillomania is more likely to get the condition.
  • Structural changes in the brain: There may be problems in those areas of the brain that are involved in the formation of habits, behavior, and the control of impulses.
  • Functional problems in the brain: Some scientists believe that trichotillomania is a subset of OCD, which is caused by chemical changes in the brain.
  • Childhood trauma: Early research suggests emotionally painful events during childhood to be one of the causes. However, there is a lack of evidence.

How Is Trichotillomania Diagnosed

Habit Reversal Training for Trichotillomania, Excoriation Disorder, and ...

Patients of trichotillomania most often approach their primary physicians for their problems of hair thinning or alopecia. Primary physicians usually rule out all the causes of hair loss before referring such patients suspected of trichotillomania to a psychiatrist or a psychologist. The psychiatrist or psychologist takes a proper medical history of the patient and looks for signs that point toward the diagnosis of trichotillomania. Blood tests may only be done to cancel out diseases that may cause hair loss.

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Things You Can Try Yourself

Here are some tips from people with trich that may help when you feel the urge to pull your hair:

  • squeeze a stress ball or something similar
  • form a ball with your fist and tighten the muscles in that arm
  • use a fidget toy
  • wear a bandana or a tight fitting hat, such as a beanie
  • come up with a saying that you repeat out loud until the urge to pull passes
  • take a soothing bath to ease any stress or anxiety
  • practise deep breathing until the urge to pull goes away
  • exercise

Nimh Trichotillomania Severity Scale

The NIMH scale is a five-item, clinician-administered scale that rates hair-pulling symptoms during the past week. The items assess pulling frequency , urge intensity, urge resistance, subjective distress, and interference with daily activities.

Psychosocial functioning and quality of life were assessed with the following: Sheehan Disability Scale . The Sheehan Disability Scale is a valid and reliable, 3-item, self-report scale that assesses psychosocial functioning in 3 areas of life: work, social or leisure activities, and home/family life. Scores on the scale range from 0 to 30.

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Reduce Anxiety = Reduced Hair Pulling

While anxiety is not the root cause of trichotillomania, its definitely an influence.

Anxiety makes the urge to pull more intense and it fuels a whole bunch of other fires that cause hair pulling.

Reduce your anxiety and youll reduce your hair pulling.

It may not take away the urges completely but it will help you make better choices when the urge is there.

What Is Trichotillomania

What is Trichotillomania (hair pulling disorder) & how do we deal with it?

Trichotillomania is a mental condition that falls under the class of obsessive-compulsive and related disorders. This disorders primary characteristic is the inability to stop pulling hair from all the hairy parts of the body, including the eyelids, eyebrows, and scalp.

If you continuously pull hair from your face, you end up with patches of lost hair. Additionally, the hair-pulling process and the subsequent results can leave you distressed and also may interfere with your occupational and social functioning.

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Tips To Reduce Anxiety

  • Take a time-out. Practice yoga, listen to music, meditate, get a massage, or learn relaxation techniques. Stepping back from the problem helps clear your head.
  • Eat well-balanced meals. Do not skip any meals. Do keep healthful, energy-boosting snacks on hand.
  • Limit alcohol and caffeine, which can aggravate anxiety and trigger panic attacks.
  • Get enough sleep. When stressed, your body needs additional sleep and rest.
  • Exercise daily to help you feel good and maintain your health. Check out the fitness tips below.
  • Take deep breaths. Inhale and exhale slowly.
  • Count to 10 slowly. Repeat, and count to 20 if necessary.
  • Do your best. Instead of aiming for perfection, which isn’t possible, be proud of however close you get.
  • Accept that you cannot control everything. Put your stress in perspective: Is it really as bad as you think?
  • Welcome humour. A good laugh goes a long way.
  • Maintain a positive attitude. Make an effort to replace negative thoughts with positive ones.
  • Get involved. Volunteer or find another way to be active in your community, which creates a support network and gives you a break from everyday stress.
  • Learn what triggers your anxiety. Is it work, family, school, or something else you can identify? Write in a journal when youre feeling stressed or anxious, and look for a pattern.
  • Talk to someone. Tell friends and family youre feeling overwhelmed, and let them know how they can help you. Talk to a physician or therapist for professional help.

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When To Seek Help

If you cant stop pulling your hair and you experience negative repercussions in your social life, school or occupational functioning, or other areas of your life because of it, its important to seek help. Trichotillomania wont go away on its own. It is a mental health disorder that requires treatment.

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