Review on The Trichotillomania

Introduction

Everyone experiences it; everyone also has different ways of dealing with it. Some people cope by drinking, smoking, overeating, meanwhile, others have a unique way of dealing with stress. For example, others eat their own hair which is called trichotillomania. Trichotillomania is defined as an irresistible urge to pull out one’s hair and was classified as disturbance of impulse control by Asahikawa Medical College. They have recorded a case of trichotillomania that was referred to the psychiatric ward of Asahikawa City Hospital.

Body

It was a teenaged girl that displays compulsive hair pulling behavior that refuses to go to school due to her being embarrassed by hair loss in the scalp. The girl's family; her parents, and older sister has been living with her parental grandmother prior to her consultation in the hospital. It was then her mother shows irritation even with slightest things and continually scolding her over small matters. At the age of 15-years-old, she began to manifest the compulsive hair-pulling behavior. That patient was said to undergo supportive psychotherapy for 8months as initial treatment; however, the initial treatment did not alleviate the symptoms, a prescribed medicine 'clomipramine’ at 30 mg/day was given to her.

After taking this medication for 2 weeks that’s where her symptoms began to abate. Furthermore, it was said that after 4 months of medication the patient returned to school and took parts on part-time jobs. Healthofchildren.com said that In America, the total number of people who pull their own hair may be as high as 11 million.

The frequency of trichotillomania was estimated to 2 percent of the general population; it was said that among college that they surveyed, more than 10 percent of it said that they pull their own hair at some point though only 1 percent meet the criteria of having trichotillomania. According to the Office of Rare Diseases of National Institute of Health, it states that trichotillomania is considered a rare disease meaning that less than 200,000 people in the United States are affected by this disorder. It was also stated that Adult women are diagnosed twice as often with than men. It is dominated by a female who among are preadolescents to young adult with 70 to 93 percent.

According to Mayo Clinic, the cause of trichotillomania is still unclear like any other disorders it can be probably the results of genetic and environmental factors through the health of children agrees on it they expanded the possible causes of trichotillomania they believed that causes trichotillomania can be the explained by psychoanalytical, behavioral, or biological theories. Under the psychoanalytical theory, the significance of trichotillomania occurs in an attempt on resolving a childhood trauma, which may be common is sexual abuse. According to this, an unconscious unresolved past conflict might trigger hair pulling.

Whereas, the behavioral theory states that stressful events, such as moving to another place or a passing of a loved one, or a family conflict preexist of the onset of hair pulling and that hair pulling begins its course in an attempt to relieve tension caused by the stressful events. The behavior continues further and becomes habitual; the individual then is not aware of its initial trigger. And biological theory believes that trichotillomania starts due to neurochemical imbalance, such as serotonin imbalance. Altered dopamine levels might also play a role in developing trichotillomania. Genetic factors might not or might play a role in developing trichotillomania, although a few studies report that an increased percentage of a relative with the various psychiatric disorder.

Trichotillomania symptoms doesn’t differ from both gender; the common symptoms of it are repetitively pulling its own hair out that usually ranges from scalp to other parts of the body, presence of bald spot where hair has been pulled out, having a feeling of relief, satisfaction, and pleasure after pulling the hair, a sense of tension before once hair is pulled or when trying to resist pulling once hair and the presence of other common behaviours, like inspecting the hair root, pulling hair between teeth, chewing on hair, or eating hair. Trichotillomania is diagnosed for adult women and men but also adolescents or children with mean age of preexisting symptoms ranges 9 and 13 and a notable peak of 12-13 years old.

The said patients who have trichotillomania is not capable of undergoing treatment until it’s his or her hair pulling disorder continued for two years. The said traditional treatment for trichotillomania involves psychological or behavioral therapy or even medication. Behavioral modification helps to increase the individuals’ awareness of hair pulling especially the children; it might be simply acknowledging the problem and instituting a plan of desensitization of behavior. Another type of behavioral therapy was said to be successfully used in treating trichotillomania; Habit reversal training treatment acquires the patient to have increased awareness of her or his action and must learn to alter the behavior.

Correcting the brain’s biochemical imbalance by medication is a common component of treatment. Drug trials for children and adolescents are limited that behavioral therapy is conducted first, prior to exposure to medication. It was said that behavioral therapy is more successful in helping persons with trichotillomania that with drug therapy because in drug therapy they are more open to having relapses when discontinued.

The said drug is called clomipramine in which have believed as the most successful in treating trichotillomania. They stated that low-dose clomipramine treatment or the drug treatment resulted in an improvement in trichotillomania symptoms. Where they observed that efficacy of clomipramine, an agent known to be effective against obsessive-compulsive disorders, suggests that trichotillomania and obsessive-compulsive disorder may be common features in neurochemistry.

Conclusion

To conclude this essay, trichotillomania is an impulse control disorder that might be the effect of a sudden change of environment or genetics. Individuals with this disorder have low self-esteem and think poorly of themselves, And isolates themselves from the world even their loved ones’ due to the embarrassment of hair loss. Furthermore, these individuals might be suffering from mental illness other than trichotillomania itself.