The Covid pandemic caught the world off guard. Seemingly overnight, the pandemic changed every aspect of daily life, from how we worked, how we played, and even how we cared for ourselves. The resulting lockdowns, shutdowns, masking, and distancing restrictions meant that people were suddenly faced with having to find new ways to access everything from basic needs, to work, social connections, and even healthcare. It has been a time of isolation unlike anything we’ve experienced in generations and, honestly, most people were not prepared for what was to come. It comes as no surprise that as the pandemic has worn on, mental health issues have escalated along with the demand for mental health care.
When it comes to Trichotillomania (TTM), not all hair pulling is the same. While hair pulling is the dominant feature of TTM, research has revealed that the presentation of TTM is quite heterogenous. Research has found that there are distinct sub-types of TTM. These sub-types were identified as:
- Subtype 1: Sensory-sensitive Pullers
- Subtype 2: Low Awareness Pullers
- Subtype 3: Impulsive/Perfectionist Pullers
Each of these subtypes has a unique set of clinical profile and constellation of symptoms that can be used to shape treatment approaches.
When it comes to mental health disorders, one thing is true: while there are specific diagnostic criteria used to make a diagnosis, how those behaviors and traits are manifested can vary quite a bit. Rarely is a diagnosis a “one-size-fits-all.” Trichotillomania, or hair pulling, is no exception. Hair pulling behavior does not look the same from person to person. There are individual differences and variations in pulling behaviors. In fact, research has looked at how people engage in hair pulling and, it turns out that there is not a single type of hair pulling, but rather distinct subtypes of hair-pulling:
Subtype 1: Sensory-sensitive Pullers
This subtype is characterized by highly focused pulling behavior. The pulling tends to be very intentional. Urges to pull tend to be infrequent, and not particularly intense. The frequency of pulling tends to be lower than in other subtypes.
Body focused repetitive behaviors (BFRBs) often first appear in childhood or early adolescence. It is not clear exactly why some children develop a BFRB while others do not. What we do know is that many mental health disorders can be influenced or shaped by both genetics and by environmental factors, including family dynamics. For children, that usually means interactions with their parents.
While hair pulling is more than just something one might consider a “bad habit”, it does have qualities that are in line with habits and habit formation. It’s not a coincidence that Habit Reversal Training (HRT) is the standard treatment for hair pulling. But have you ever wondered just how habits and hair pulling are connected? What are habits and how do they even start? In this new TrichStop webinar, Dr. Vladimir Miletic takes a closer look at the psychology of habit formation and how introducing competing responses can help reduce hair pulling.
Decisions…we all make them. Sometimes we’re fully aware of the decisions we make. We think them through and choose our actions. Other times, though, we seem to be running on autopilot, and we just seem to end up where we are. Sometimes that works out just fine. Other times, we’re left wondering, “Why did I do that?” “What was I thinking?” Even when we’re not fully aware of our decisions, we make them a million times a day.
What do decisions have to do with hair pulling? Quite a lot actually.
If you or a loved one lives with a body-focused repetitive behaviors (BFRBs) like hair pulling, you’ve probably had the experience of someone asking why you do it and can’t you just stop? It’s frustrating for sure and there isn’t always a good answer. Hair pulling is complex and there are layers of reasons why it happens.
When you think of Trichotillomania (TTM), you usually think of hair pulling, right? Most people do. Have you ever wondered what happens to the hair that’s pulled out? For many people with TTM, they simply discard the hair. It might surprise you though that some people who compulsively pull their hair don’t merely pull it out and discard it. There is a significant percentage of people with TTM that go further. Some people ingest the hair that they pull. This persistent, compulsive ingesting of hair is called trichophagia.
Trichophagia primarily affects females and is most often associated with TTM. However, it can also be associated with other mental health conditions such as anxiety or depression, obsessive-compulsive disorders, pica (the ingestion of non-food substances), and eating disorders.
Trichotillomania (TTM) is a disorder frequently diagnosed in late childhood or adolescence. It is estimated that the lifetime prevalence of TTM for adolescents is about 1-3% so it is not an uncommon phenomenon. TTM is also associated with other mental health issues such as anxiety, depression, diminished self-esteem, and impaired social and academic functioning. It is generally accepted that the early intervention can help to manage the effects of TTM.
Nail biting or even picking at a scab just a bit too much is something most of us have done. We’ve done it and been able to stop. For some people though, the urge to pull or pick continues and can even become too much to resist. Why does that happen?
Habitual nail biting, hair pulling, and skin picking are collectively referred to as body-focused repetitive behaviors (BFRBs). These recurrent, destructive behaviors directed toward the body are thought to be triggered by some unpleasant emotional state. They’re not uncommon and many people engage in these behaviors from time to time (e.g., nail biting) but do so at subclinical levels that create little or no distress. For others, however, their emotions somehow get misdirected, and the result is destructive body-focused behaviors like chronic, repetitive skin-picking and hair-pulling.
Trichotillomania (TTM) is a chronic disorder characterized by repetitive hair pulling that results in significant hair loss, emotional distress, and impaired functioning across settings. Because it shares some characteristics with other disorders such as obsessive-compulsive disorder (OCD) and Tourette’s Syndrome, TTM is currently classified as an Obsessive Compulsive-related disorder. However, TTM is not OCD nor is OCD the same as TTM, although they can co-occur. There are distinct differences that create a dilemma for many in the TTM and research community. How significant are these differences and what implications might they have for treatment, if any? There remains quite a debate as to whether TTM and other body-focused repetitive behaviors are correctly classified or should be in a separate category.
Online Test for Trichotillomania
Find Out The Severity of Your Hair Pulling With This Free Online Test