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woman holding hair

It’s a not so well known mental health condition with a hard to pronounce name that has too many syllables, but for those who have it – it’s a great source of distress and suffering. Trichotillomania (also referred to as Trich), is a mental disorder characterized by the compulsive urge to pull out body hair. While most sufferers pull from their scalp some pull their eye brows, eye lashes, pubic region or facial hair. Like other mental health conditions, the exact causes for Trich are not known or well understood.

It is currently classified as a Body Focused Repetitive Behavior (BFRB) and often co-occurs with other mental health conditions – most consistently depression and anxiety. It has similarities to OCD in that there are strong behavioral urges and great difficulty resisting those urges, and resulting in repetitive and compulsive behaviors. Contrary to what most people think the act of pulling rarely has anything to do with pent up anxiety or anger, in fact any people pull without realizing that they are doing it, often reporting that they feel like they are in a trance.

In other cases people are very deliberate about it, dedicating hours a day to the task. The act of pulling is a complex sequence of behaviors leading up to and following the actual pull. Many have rituals that they carry out with the hair they pull such as dragging it across their lips, tying it around their fingers, or chewing on the root of the hair. Some even swallow the hair which can lead to serious health complications. Woman struggle with this condition almost as 9x as often as men do and it can effect a person at any age.

Suffers often report struggling with depression, embarrassment, shame and frustration. Most will say they have tried everything they can think of to stop pulling, but report they simply can’t resist the urge.

The impact of this condition spans several ares of one’s life. Because many hide their condition from others, they go to great lengths to avoid certain situations such as swimming or being out on windy days when the bald spots can been seen more easily). Some socially isolate themselves due to shame and embarrassment. Time spent in front of the mirror pulling is time lost at work or with family and friends. Health concerns can result from skin infections or skin irritation. The treatment for Trichotillomania is called Habit Reversal Training (HRT) and it has three components.

The first includes helping a person become more aware of the situation and circumstances of when they pull and identifying vulnerable times, places or emotional states.

Secondly HRT outlines blocking behaviors that will create barriers and obstacles to pulling, for example wearing gloves so that fingers cant grasp the hair or wearing glasses to block access to the eyebrows.

The final component of Habit Reversal Training involves creating competing behaviors for the most vulnerable times to pulling. These are motor actions that occupy the hands and are incompatible to the act of pulling such as playing with fidget toys, pulling on a string, popping bubble wrap or playing with a beaded bracelet. This little known condition with the long name can have a big impact on someone’s quality of life. Treatment is available and recovery is possible.

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