Hair Pulling: Signs & Symptoms
Trichotillomania is currently categorized in the Diagnostic and Statistical Manual (DSM-IV) as an "impulse control disorder not elsewhere classified." However, there is much debate over how best to categorize trichotillomania and its related behaviors. Even within a single individual with trichotillomania there is usually a great variety of methods and reasons for pulling.
Trichotillomania at times resembles Obsessive-Compulsive Disorder in the feelings of compulsion and repetitive behavior, but the two disorders have different symptoms and require different treatments. Trichotillomania may also resemble a tic disorder, as the action of pulling feels automatic and is preceded by an uncomfortable sensation that must be relieved.
Trichotillomania is most commonly characterized by:
- Inability to resist urges to pull out one's hair
- For some, mounting tension before one pulls
- For some, gratification and relaxation when pulling
- For some, a feeling of relief after pulling
- Noticeable hair loss
- Increased distress and/or interference with daily life
Resources
- Professional Training Institute »
- Article: Trichotillomania and its treatment in adults: a guide for clinicians
- Article: Trichotillomania and its treatment in children and adolescents: a guide for clinicians
What does trichotillomania look like?
Most people with TTM pull enough hair that they have bald spots on their heads, which they go to great lengths to cover with hairstyles, scarves, wigs, or makeup. Others may be missing eyelashes, eyebrows, pubic, underarm, beard, chest, leg or other body hair, which they may camouflage with makeup, clothing, or other means.
Warning Signs
People frequently pull while reading, writing, working on the computer, talking on the phone, watching TV, or falling asleep. Some people are conscious of what they are doing and others are not. Most people pull in private, but some will pull mindlessly in public while doing one of the above activities.
Warning signs include
- Wearing hats, kerchiefs, or wigs
- Wearing lots of eye makeup and/or glasses
- Excessive fiddling with one's hair
- Preoccupation, anxiety, depression, career or academic decline
- Avoidance of windy and wet situations including swimming
- Changes in social behavior patterns