1. Trichotillomania:
OCD/Anxiety Disorder
By: Amanda Stangel

2. Overview (OCD)
OCD (ObsessiveCompulsive Disorder)
• an anxiety disorder in which people have unwanted and repeated
thoughts, feelings, ideas, sensations (obsessions), or behaviors that
make them feel driven to do something (compulsions).
• Often the person carries out the behaviors to get rid of the obsessive
thoughts, but this only provides temporary relief.
• Not performing the obsessive rituals can cause great anxiety.
• It can destroy a person's capacity to function at work, at school, or even
to lead a comfortable existence in the home.

3. Overview (Trichotillomania)
TTM (Trichotillomania)
• Recurrent, irresistible urges to pull out hair from your scalp, eyebrows or other
areas of your body, despite trying to stop. (Skin picking)
• Hair pulling from the scalp often leaves patchy bald spots.
• People with trichotillomania may go to great lengths to disguise the loss of
hair.
• May be mild and generally manageable, or the compulsive urge to pull hair is
overwhelming.
• Long-term (chronic) disorder. Without treatment, symptoms can vary in
severity over time.
• It has been estimated that 0.5-3 percent of people will experience the condition
at some point during life.

4. Types
• Focused
• Pulling hair intentionally to relieve tension
or distress
• pulling hair out to get relief from the
overwhelming urge to pull hair.
• elaborate rituals for pulling hair, such as
finding just the right hair or biting pulled
hairs.
• Automatic
• Pulling without realizing they're doing it
• such as when bored, reading, or watching
TV.

5. Signs and Symptoms
• Repeatedly pulling your hair out.
• Increasing sense of tension before pulling, or when you try to resist
pulling.
• A sense of pleasure or relief after the hair is pulled.
• Shortened hair, thinned, or bald areas on areas of your body.
• Preference for specific types of hair.
• Biting, chewing, or eating pulled-out hair.
• Playing with pulled-out hair or rubbing it across your lips or face.

6. Causes
• The cause of trichotillomania is unclear;
• like many complex disorders, trichotillomania probably results from a combination of
genetic and environmental factors.
• abnormalities in the natural brain chemicals of serotonin and dopamine may play a role
in trichotillomania.

7. Medical Issues
• Skin and hair damage:Constant hair pulling
can cause abrasions and other damage,
including infections, to the skin on your scalp
or the specific area where hair is pulled, and
can affect hair growth.
• Hormonal changes of menstruation can
worsen symptoms in women.
• Hairballs: Eating your hair may lead to a large,
matted hair ball (trichobezoar) in your
digestive tract. Over a period of years, the hair
ball can cause weight loss, vomiting, intestinal
obstruction and even death.
• (16 year old girl with trichotillomania since the
age of 3, presented acutely with coffee-ground
vomiting and abdominal pain.

8. Psychosocial/Psychological
Issues
• Emotional Distress: Many people with trichotillomania report feeling
shame, humiliation and embarrassment and experience low self-esteem,
depression and anxiety because of their condition.

9. Vocational Issues
• Problems with social and job functioning: Embarrassment because of hair
loss may lead to avoidance of social activities and occupational
opportunities.
• People with trichotillomania may wear wigs, style their hair to disguise bald patches or
wear false eyelashes. Some people may avoid intimacy for fear that their condition will
be discovered.

10. Treatment
• Therapy:
• BehavioralTherapy
• Cognitive BehavioralTherapy
• Medications:
• may help to reduce the depression and any obsessive-compulsive symptoms the person may be
experiencing.
• Fluoxetine (Prozac)
• Fluvoxamine (Luvox)
• Sertraline (Zoloft)
• Paroxetine (Paxil)
• Clomipramine (Anafranil)
• Valproate (Depakote)
• Lithium Carbonate (Lithobid, Eskalith)

11. References
• http://www.mayoclinic.org/diseases-
conditions/trichotillomania/basics/definition/con-20030043
• http://www.mentalhealthamerica.net/conditions/trichotillomania-hair-
pulling
• https://www.psychologytoday.com/conditions/obsessive-compulsive-
disorder
• http://rarediseases.org/rare-diseases/trichotillomania/