Trichotillomania is listed by the Genetic and Rare Diseases Information Centre (GARD), as well as the National Organization for Rare Disorders (NORD) as a rare disease. In the US a condition is considered rare if it affects less than 200,000 Americans, and are often referred to as orphan diseases. But is this really true? Are there only 200,000 or fewer sufferers – or are there far more, who either go undiagnosed or do not report the condition at all, even in anonymous studies? Trichotillomania has deep roots in self-consciousness, guilt, and shame, and it is widely underreported due to these factors.
Trichotillomania is one of the least understood and lesser known psychological conditions affecting people today. Classified as a Body-Focused Repetitive Behavior (BFRB), it is a condition in which a person habitually and repetitively pulls out their body hair, either from the scalp, face, pubic area, or anywhere else that there is hair. It can often go undiagnosed for a long time, because people with the condition generally are extremely private about the behaviour and will deny there is a problem even when the hair loss becomes apparent. If you are concerned about yourself or someone close to you, knowing about who is most vulnerable to the condition as well as the symptoms can help you decide if further action and treatment are needed.
Trichotillomania affects all people at all ages. There is evidence of onset varying from childhood to late adulthood and for varying reasons, from genetic predisposition to comorbid mental health conditions such as Obessive Compulsive Disorder (OCD) and Anxiety Disorder. One thing that is certain about this condition, along with all the other Body-Focussed Repetitive Behaviours (BFRBs) such as Dermatillomania and Trichophagia, is that it has a harmful impact on the body, which is a cause of tremendous shame and embarrassment for the sufferer.
When inflicted with a debilitating condition such as trichotillomania, we yearn to understand why we are struggling with the behaviour, what causes it, and whether it can be prevented. It is also important to establish the cause of a condition when trying to find a cure or treatment that works. One of the major debates regarding the cause of trichotillomania is whether it is genetic.
They say that beauty is only skin deep, but in a world where aesthetics determines value and stature in life, the desire for physical perfection is rigorously sought. Media and marketing campaigns perpetuate the perception that human beings should define themselves by their physical appearance and that our propensity for success is dependent on our ability to project outward beauty. In this vain it is not unusual for people to modify aspects of their physical appearance in pursuit of such perfection. There is another saying that “beauty is in the eye of the beholder”, and yet people generally try to conform to the societal projection of how beauty is defined, regardless of its applicability to what is natural or what is in line with cultural preference.
If you are a hair puller and are feeling concerned that your behaviour is more than just a bad habit, you have no doubt searched for answers on the web and come across the term trichotillomania. It can be scary to read up on a condition and find yourself relating to all the signs and symptoms of a clinical disorder. The key is that if you suspect you have a clinical diagnosis of any sort, is to seek professional help for a formal diagnosis. The unfortunate reality though is that there is still very limited awareness about trichotillomania and all other body-focussed repetitive behaviours (BFRBs), and so these conditions often go undiagnosed. In a similar vain, even if you are certain you have trichotillomania your local health professional may not be qualified or experienced enough to help you manage or treat the disorder.
Trichotillomania, or hair pulling disorder has previously been classified as an impulse control disorder. However, the most recent edition of the DSM5 now categorizes disorders such as hair pulling disorder and skin picking disorder as body-focussed repetitive behaviours (BFRBs), under the classification “Obsessive-Compulsive and Related Disorders”.. This new classification suggests that hair pulling disorder falls under the same spectrum, but is different to obsessive compulsive disorder (OCD). The question then is whether OCD and trichotillomania co-occur and if so how common it is. One study that examined the comorbidity and family genetics of childhood trichotillomania, found that the subjects had substantial psychopathology and that a history of obsessive compulsive symptoms was common.
Trichotillomania, or hair pulling disorder, involves the obsessive compulsion to pull out ones hair. The focus area of hair pulling varies and can be anywhere on the body where there is hair. Pulling at the hair on the scalp is most common and often automatic. For some people hair pulling is just a bad habit which does not affect them negatively in any way. In this case the hair pulling is not considered a disorder. According to the DSM5, trichotillomania is most commonly characterized by:
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