Trichotillomania Blog

Embrace Vulnerability

Trichotillomania is a hard thing. The multiple layers of thoughts, feelings, and behaviors can be difficult to wade through, so sometimes it’s easier to ignore it. Hide it. Hope that nobody else notices. 

However, pretending is exhausting and only reinforces shame. One Trichstop forum member described her experience as shiny and successful on the outside, “But under the surface, I felt I had no sense of self-worth or value, I felt incredibly lonely, and I was just frustrated with myself.” Rachel courageously shared her story in her post, serving as an example of the power of vulnerability that helped her recovery.

Volunteer to help with research

The TLC foundation recently posted a request for research participants aged 18 and older to participate in research studies on trichotillomania. 

The Department of Psychology at American University is currently examining symptoms, personality traits, and the triggers that lead to hair pulling. If you are an adult (at least 18 years of age) and suffer from hair pulling disorder, learn more and participate by clicking this link.  

For additional research opportunities, check out the TLC Foundation's Volunteer for Research page. 

Give Yourself a Gift for Mental Health Awareness Month

Many headlines talk about mental health awareness month with tips, tricks, gimmicks, and celebrations of recovery. These are all wonderful, but I invite you to consider giving yourself the gift of acceptance.

Problems consume

Our brains are hardwired to focus on the negative, which translates into undue attention paid to whatever problem we encounter. This problem could be health, life, or mental health related, the brain is not picky, but the problem tends to become the focus of our thoughts and feelings until it feels like our whole world experience centers on the issue. People who struggle with trichotillomania tend to focus on the problem of hair pulling, and when they are not focused on the problem, they are focused on hiding the problem or fearing that others will notice the problem causing more difficulties of embarrassment and shame for them. The problem then consumes the person’s life, and all one can see is the problem which often leads to the problem becoming central to one’s identity. You feel most that which becomes your point of focus.

Image by <a href="https://pixabay.com/users/stevepb-282134/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=1079838">Steve Buissinne</a> from <a href="https://pixabay.com/?utm_source=link-attribution&amp;utm_medium=referral&amp;utm_campaign=image&amp;utm_content=1079838">Pixabay</a>

Update: N-acetylcysteine (NAC)

A previous blog post talked about the potential benefits of N-acetylcysteine (NAC) for trichotillomania, citing a Minnesota study that showed over half of the participants showed reduced hair pulling when using it. A more recent review of the research discussed NAC and its effectiveness for various mental health disorders.

More details about how it works

NAC is an amino acid historically used as a mucolytic and for treatment of acetaminophen overdose. A mucolytic dissolves thick mucus in the respiratory system. It essentially dissolves the chemical bonds that holds the thick secretions together. A common version of a mucolytic is Mucinex which is made with guaifenesin. However, NAC’s mucolytic properties are not the focus of this blog post, but it does provide an indication of how long NAC has been used in medicine.

Sold as a nutritional supplement over the counter, NAC is often marketed as an antioxidant that can improve brain functioning. Without going in-depth about neuroscience, NAC

The Role of Thoughts and Beliefs in Trich

No matter which way you look at it trich is a complex disorder. While scientists produce evidence that it is a disorder of compulsion and impulse control, others suggest it is closer to a tic disorder. Since information about the mechanisms that cause trich are important for developing successful treatment strategies, researchers continue to look into genetic, neurological, behavioral, and environmental factors that influence hair pulling behaviors. Thus far, the most effective treatments tend to be psychotherapy with an emphasis on habit reversal and cognitive behavioral therapies. Research lends insight about the role of thoughts and beliefs on hair pulling behaviors which may help therapists and client navigate recovery, and this article will summarize a study conducted in 2015 that identified belief categories.  

Wanting Treatment? How to pay for it.

Many sources of mental health treatment are not free and depending upon one’s financial situation; cost can be the one thing that prevents people from getting the help they need. In the U.S., some programs offer free mental health services, but they often focus on substance abuse or certain populations. Rarely do those services offer expertise in treating body-focused repetitive behaviors. This article will talk about paying for mental health treatment and offer some recommendations.

How do you know if it works?

Treatments for trichotillomania yield mixed results, but does that mean they work or they don’t? A recent study sought to answer that very question.

Research About Research

Multiple studies continue to measure the effectiveness of treatments ranging from pharmaceuticals to therapy. Sometimes the press releases will announce something works, while others report “mixed results.” Let’s take a few moments to demystify the ambiguity of “treatment response.”

In simple terms, treatment response is a measurement used by clinicians and researchers to determine if an intervention works. There are statistics involved, and some of them get pretty complicated. The challenge with results and treatment responses is that an intervention can work yet not yield enough of a treatment response to be called effective. Also, there are many definitions of effective, not to mention the difference in the types of people for which an intervention is effective.

Your Therapist Could be Wrong

A recent PsychCentral article zipped through my inbox almost into the trash until I reminded myself about the many clients I worked with as a therapist who accepted the word of previous therapists as if it were the truth. In my practice, I often worked with “hard” clients or the ones who had been through multiple therapists in the office and then passed on because the other therapists labeled them as “severe.”

My clinical training focused on people who struggle with more than one thing at a time, in counseling terms known as co-occurring disorders. Unfortunately, there are many therapists not trained to work with people as a whole person. As a result, I was fortunate enough to meet with clients with a long pedigree of therapists and medications with symptoms that did not fit neatly into one diagnosis that could be treated with that diagnosis’s treatment manual. Folks with long histories of trauma, substance abuse, dysfunctional families, discordant relationships and overall feeling hopeless because therapists kept referring them elsewhere because their cases were too hard.

A trich-y Case

A report published in the Anatolian Journal of Psychiatry in October 2018, presented a case of trichotillomania that manifested during posttraumatic stress disorder suggesting a possible genetic link between the two.

The patient came to the attention of researchers when he presented to an emergency psychiatric clinic for anxiety, depression, irritability, aggression, and pulling out his hair from various parts of his body. At 20 years old, this young man never showed signs of previous trichotillomania or mental illness. However, his best friend died in a car accident the previous year and viewing his friend's damaged body contributed to the development of PTSD. His anxiety, nightmares, emotional stress and hair pulling all started after viewing his deceased friend.

Are BFRBs more like tic disorders or OCD?

The quest for solid, evidence-based treatment for body-focused repetitive behaviors (BFRBs) continues. Within that quest is the search for the neurological mechanisms of BFRBs like trichotillomania because if a neurological process can be identified, then a chemical or behavioral intervention can also be identified to fix it.

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Online Test for Trichotillomania

Find Out The Severity of Your Hair Pulling With This Free Online Test