OCD and Compulsive Hair-Pulling (Trichotillomania)

Posted by Phil Cardenas on Oct 01, 2013

Compulsive hair-pulling, or trichotillomania (TTM), is an impulse control disorder that can be triggered by stress or depression. It usually appears in young people ages 9-13, but can be present as early as infancy and can persist throughout adulthood if not treated.

While it lies on the obsessive-compulsive spectrum of disorders and shares some clinical features, TTM is different from Obsessive Compulsive Disorder (OCD) in its symptoms, neural function, and cognitive profile. OCD sufferers are aware of their behavior and find it unpleasant and disturbing, but some trichotillomania patients engage in the hair-pulling unconsciously, and some may even get reinforcement from its stress-and-relief pattern. 

TTM is one of the more difficult disorders to treat since its origins seem to be both biological and behavioral. Some antidepressant medications can have benefits, but too often the doses needed to treat TTM are too high to avoid undesirable side effects or only partially treat the symptoms. Behavioral therapy such as Habit Reversal Training (HRT) and Stimulus Control (SC) offers encouragement, and when combined with drug therapy can have very positive results. 

Because TTM involves irresistible urges to perform unwanted behavior, it shares some similarities to OCD, but the two are not the same. They can, however, exist simultaneously, and treatment for one often has positive effects on the other. Nonetheless, both conditions are complex psychological disorders that should be carefully diagnosed and treated by expert therapists.

You can also learn more about TTM in the Expert Perspectives section of the Beyond OCD web site. Dr. Fred Penzel, a licensed psychologist who has specialized in the treatment of OCD and related disorders since 1982, offers insights into TTM and its treatment.  Read more about what Dr. Penzel has to say about Trichotillomania in his self-help book "The Hair-Pulling Problem: A Complete Guide to Trichotillomania," (Oxford University Press, 2003). Learn more about it at www.trichbook.com.

Beyond OCD is a non-profit organization dedicated to better understanding and treatment of OCD. An important first step for everyone affected by OCD, TTM, or any physical or psychological problem is learning. If you think that you or someone close to you may be suffering with OCD, our website, BeyondOCD.org, offers in-depth resources for understanding what OCD is and is not, information about coping with OCD in yourself or a loved one, as well as specific guides for children, teens, and college students. Our Expert Perspectives section has dozens of articles about the latest knowledge in OCD research and the most effective ways to treat it. Don’t forget to visit our blog, either. It has timely articles about the latest news relating to OCD and other topics of interest. 

The scientific understanding of OCD and related disorders -- and how to treat them -- has increased significantly in just the past few years. New information is published frequently, and more mental health professionals are becoming actively involved in treatment and outreach. 

Beyond OCD wants you to know that OCD and other obsessive-compulsive disorders can be treated and that relief may be closer than you think. If you want to learn more about OCD, its treatment options, and tap into our many other resources, take a few minutes to explore BeyondOCD.org. We’re here to help you get the information you need to get Beyond OCD.


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