Nicole King
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Trichotillomania: Impulse Control Disorder

An impulse control disorder in which patients pull their hair out.

You’ve probably never heard of Trichotillomania and if you have you probably know someone or are someone with this disorder. People refer to this as a BFRB, or a body focused repetitive behavior, and it is a compulsive disorder where people pluck or rip out their body hair. This doesn’t mean that it is OCD, but it does share the traits of repetitive behaviour, compulsions, and can be prevalent in OCD patients. In other words, you can have TTM and not have OCD, or you can have OCD that involves TTM.

It is currently in the DSM-IV as an impulse control disorder, which means it is in the same category as addiction to drugs and alcohol, gambling addictions, skin picking disorders, eating disorders, paraphilias, suffering, and explosive attacks of rage. Impulse control disorders can be caused by a wide array of things but are believed to be linked to serotonin levels in the brain. Serotonin re-uptake inhibitors have been known to alleviate some patients symptoms with some of these disorders. There’s also research showing that certain seizure disorders have been known to be prevalent in patients with impulse control disorders.

Predominantly female, this condition is very rare in men, though there are certainly men who struggle with this as well. Sufferers of this condition are often so ashamed they never actually come forward with anything about it, so any research data on how many people actually suffer from this disorder is believed to be inaccurate. Though, according to the National Institutes of Health, it is believed to be about four percent of the population that suffers from this disorder.

Some people will only pluck out single pieces of hair while others will actually pull out several pieces of hair at once. Others don’t even actually pull out any hair, and just twist it around their teeth, tongue, or fingers. Some patients actually eat the hair which can be very dangerous resulting in the surgical removal of hair from the intestines. Baldness is one of the most prevalent consequences of this disorder causing more shame to the patient. They will go out of their way to hide it, wearing hats, beauty products for hiding baldness, or even avoiding going to any kind of social functions. Patients do this to relieve some kind of stress, depression, or anxiety, often feeling the need or a certain sensation overwhelm them that is relieved upon the plucking or pulling of the hair.

CBT is currently the leading treatment but doesn’t seem to work for everyone. Delving further into CBT, therapists may use HRT, or Habit Reversal Training, to help the person suffering TTM. HRT is a specific type of therapy used for people with tics and other repetitive behaviors and is a five-step therapeutic process. The five components to this therapy include awareness training, competing response training, contingency management, relaxation training, and generalization training. This type of therapy has not met all requirements for being a complete therapy for all TTM sufferers though, so you may have to go through different types of therapy to find what works for you.

If you or someone you know is suffering from this disorder, there is hope. It is treatable once you find the right therapist for you, and they can find the right treatment for you. There is always hope with mental disorders, so never give up and never be too ashamed to talk to someone about it. The things you are going through are nothing they haven’t heard of before, and it is certainly nothing they can’t help you get through. This isn’t a hopeless situation and you are not alone in dealing with your impulse control problems. I urge you to find a therapist today. Thank you.

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