Probably everyone knows it, that he sometimes pulls his hair or wraps it around his finger. Women also like to pluck out annoying facial hair from time to time. This is usually not uncommon, but there are also people who pull out their hair compulsively every day and sometimes even for hours, until the head has bald patches or even bleeds. This is called trichotillomania.
What characterizes trichotillomania?
The word trichotillomania is made up of the following three Greek terms: “tricho” means hair, “tillo” means plucking, and “mania” stands for the libidinous or even addictive behavior. Trichotillomania, the mental clinical picture, is therefore a compulsive plucking of hair, for example the hair on the head, but also the eyelashes or eyebrows. But also all other hairs like the beard or the pubic hair can be preferred areas. This disorder, which usually appears in childhood, belongs to the complex impulse control disorders and can last for several months or even years. The disorder is characterized by the inability of the affected person to resist the urge, impulse, or temptation to perform that action.
Causes
The exact causes of trichotillomania have not yet been clearly identified. The triggers must therefore be determined individually for those affected. It is believed that a hereditary disposition combined with certain triggers in the brain leads to an imbalance of neurotransmitters, triggering the compulsive action. Other reasons are thought to include traumatic events, such as the death of a close relative, problems in the family, divorce, abuse, stress, stressful events in childhood, or events that lower self-esteem. According to studies, more than two-thirds of those affected have experienced at least one traumatic event in their lives. In some cases, post-traumatic stress disorder has been diagnosed. Recognizing one’s own triggers can be helpful in finding ways and means to deal with these difficult situations.
Symptoms, complaints, and signs
Trichotillomania is primarily noticeable by the compulsive pulling out of the hair on the head. In some cases, hair is also pulled out from other areas of the body. As a result, bald patches form on the affected body regions. The affected persons usually do not feel any pain or these are simply ignored. The actions are often not even consciously experienced, although the urge to pull out the hair is usually strongly felt. Trichotillomania can basically occur at any age. However, it often sets in during puberty.
Diagnosis and course of the disease
The disorder is easily recognized by the bald patches that appear after tearing. In most cases, the mental illness lasts only a few months. In some cases, however, it lasts for several years. It is almost always accompanied by inner restlessness, pressure or a feeling of tension. The process of pulling out the hair usually leads to the desired relaxation in the short term. However, the sensations of anger, shame, and fear that often follow again increase the inner tension, which again leads to the compulsive impulse. A vicious circle develops, which is difficult to break. The experience of not being able to control oneself leads to feelings of frustration and inferiority. In some cases, this leads to concomitant disorders, such as anxiety disorders or depression. Many sufferers do not want the compulsive acts to be discovered. Therefore, in some cases, social isolation occurs.
Complications
Because trichotillomania is a purely psychological disorder, the condition leads to a number of different psychological and physical complaints. In most cases, sufferers pull out their own hair. This involves pulling out hair from various parts of the body, although sufferers usually do not feel any pain or other unpleasant sensations when pulling it out. Trichotillomania mainly occurs during puberty. Many sufferers are therefore bullied or teased, which can only further exacerbate the symptoms. Due to the torn out hair, the patients often no longer feel beautiful and therefore suffer from inferiority complexes or reduced self-confidence.Furthermore, suicidal thoughts may also develop. Patients with trichotillomania also suffer from anxiety disorders or severe depression. Social contacts can also usually not be maintained in the disease. The treatment of trichotillomania is always carried out with a psychologist. In severe cases, the treatment can also take place in a closed clinic. There are no particular complications. However, the treatment may take a long time and may not be successful in every case. However, the life expectancy of the affected person is not affected by trichotillomania.
When should you go to the doctor?
With trichotillomania, the sufferer always needs to see a doctor. In this disease, self-healing cannot occur and the symptoms will continue to worsen if treatment is not initiated. Therefore, in the case of trichotillomania, a doctor should be contacted at the first signs and symptoms. Early diagnosis and subsequent treatment can limit further complications. A doctor should be consulted if the affected person compulsively pulls the hair from his head. These complaints can occur especially in stressful or strenuous situations and have a negative impact on the quality of life of the affected person. In most cases, those affected by trichotillomania no longer even notice the pulling out themselves, so outsiders should point out the complaints to the patient. A psychologist should be consulted for trichotillomania. In many cases, friends or family must persuade the sufferer to seek treatment. The further course cannot be predicted in general. However, the life expectancy of the affected person is not reduced or otherwise limited by this disease.
Treatment and therapy
Trichotillomania can be treated. Here, psychotherapeutic treatment plays an important role, especially in a severe course. Behavioral therapy helps the affected person to recognize the behaviors and symptoms and especially the triggers and to subsequently change the behavior. During therapy, the affected person is supposed to learn to gradually cope better with the disease and its consequences. This takes time, however, until the ingrained patterns of behavior are discarded and replaced by new ones. Supplementary drug therapy can also help to suppress the compulsive impulse and counteract the accompanying symptoms, such as depression or anxiety, which often occur along the way. Many patients respond positively to antidepressants. Only the use of medications is not recommended, because when they are discontinued, the urge to pull out the hair often arises again. Therefore, it is recommended to use behavioral therapy at the same time. Relaxation techniques such as autogenic training or progressive muscle relaxation are recommended to reduce stress. Support from caregivers is also helpful. Which measures are successful for the person affected must always be decided on an individual basis. Medical treatment is not always necessary. Even in difficult cases, a favorable prognosis can be established.
Prevention
As prevention, it has been found helpful to make a plan to stop oneself from the compulsive urge. This means, when the urge to pull out hair is noticed, replacing the urge with positive thoughts or using relaxation opportunities during these moments. It is recommended to take a few minutes for oneself in these situations to clear the mind in this way. Stress should be reduced. However, this does not only apply in these situations, but in general it is important to eliminate all stress triggers as much as possible in order to establish a mental balance.
Aftercare
Affected persons have in most cases only limited measures of an aftercare at their disposal in case of trichotillomania, because it is a rare disease. If the condition has been present since birth, it usually cannot be completely cured. Therefore, affected individuals should have genetic testing and counseling if they wish to have children in order to prevent the disease from being passed on to their offspring. There can be no cure on its own.Most patients depend on taking various medications and also on using various ointments and creams. The doctor’s instructions should always be followed, and attention should also be paid to regular intake and use, and likewise to the prescribed dosage. In case of ambiguity or severe side effects, those affected by trichotillomania should consult a doctor. Likewise, in the case of trichotillomania, contact with other patients of the disease can be very useful, as this leads to an exchange of information on how to cope with everyday life more easily. Possibly, there is a reduced life expectancy of the affected person due to this disease.
What you can do yourself
Self-help measures should take place in an identified trichotillomania exclusively accompanying. Since treatment proves to be comparatively difficult and no universally valid therapies exist to date, all measures should be coordinated. Only in this way can the problem be comprehensively remedied. In many cases, inner turmoil and restlessness trigger the pulling out of hair. Relaxation techniques such as autogenic training can eliminate the cause of the hair pulling impulse. In addition, the reaction of the environment plays a significant role. Parents and relatives should avoid reproaches at all costs. Otherwise, the problem will intensify. Children accumulate aggression, for example, and have no room for retreat. Instead, successes, i.e. the failure to pluck out, should be sufficiently appreciated and rewarded. Since the head is the subject of the sick child and his environment anyway, it should be given positive attention. Head massages provide pleasant stimuli. The use of hair ornaments, caps and scarves promises a creative approach to the disease. Trichotillomania presents an issue especially at hairdresser appointments. Parents should inform the latter about the disorder in advance. Sometimes there are ways to use certain hairstyles to make the torn out areas not visible.