Trichotillomania has been gaining widespread attention as a legitimate mental issue in recent years. Yet still, it remains largely misunderstood by most, and generally unheard of outside of those who suffer with it or endeavour to treat the issue. The Diagnostic and Statistical Manual (DSM) of the American Psychiatric Association (APA) describes the hair pulling of Trichotillomania as being separate from other non-clinical hair pulling behaviour. It’s part of the BFRB (Body-Focused Repetitive Disorder) group of issues, which also includes excoriation (skin picking) and nail-biting. There is no question about the occurrence of the problem, as it’s reported between 2-4% of the American population experience trouble with the issue, a number which may be larger due to the shame of seeking help. But still, despite this, it begs the question… Is this form of impulse disorder not, in fact, the main problem, but the symptom of a much deeper problem?
Trichotillomania links closely with anxiety and depression. Out of a study questioning 894 people who suffer from the condition, 84% associated feeling anxious with its onset. These are significant numbers, suggesting the issue that needs addressing isn’t the hair pulling itself, but the emotions that trigger the behaviour. In much the same way that self-harm is the result of emotional instability, the hair pulling of trichotillomania could be a similar extension of a much deeper lying cause. When framed in this context, the mechanism of hair pulling serves as a coping strategy and a quasi-mindfulness ‘exercise’ to alleviate tension. This is backed up further by participants of the same study claiming the impulse to engage in this behaviour increases in proportion with the levels of anxiety they experience.
This line of thought isn’t meant to discredit the plight of those who experience the effects of trichotillomania, but is merely an enquiry that looks to gain a better understanding of why it occurs. It is possible, of course for there to be more than one contributing factor that causes the onset of this condition. Trichotillomania is quite clearly a compulsive behaviour that fits the mould and type of obsessive compulsiveness – or OCD type tendencies. But as it stands, the condition is still very much in its infancy as a diagnosable mental health issue, and hence isn’t as widely accepted as part of the verbiage of psychologists as other better understood mental health issues.
It’s interesting to note however, even when a case trichotillomania can be attributed to more compulsive tendencies, the possibility of experiencing both anxiety and depression still exists. Due to the nature of the condition, and the unwanted attention the obvious loss of hair attracts in public, it encourages the sufferer to isolate themselves to avoid embarrassment. Over time, the result of this can be the onset – or the increased – anxiety of being ridiculed, accompanied by depressive-like symptoms due to the inability to lead a normal life.
