About Trich

Animal Behaviors

The grooming behaviors which animals carry out may be related to Trichotillomania. When dogs lick themselves, cats lick their hair, or birds pick their feathers, those are all grooming behaviors, which may have some relationship to trich. Not too many studies have been done on this topic, so nothing is for sure, but it seems that somewhere there is a connection.

LEARN ALL ABOUT HAIR HERE!!!

What does Trichotillomania Mean? (trick-o-till-o-main-ee-uh)
Trichotillomania (also known as “Trich” or “TTM”) is a repetitive hair pulling disorder. People who have Trich pull hair out from all over their body, some realize they do it, some don’t. As much as 4% of the world population may have some sort of variation of it.
The name “Trichotillomania” comes from 3 Greek words. “Trich,” meaning hair, “till,” meaning pull and “mania,” frenzy or urge. Don’t worry, it doesn’t mean crazy or insane!

To get an official diagnosis of Trich you have to be compatible with the following:
A. Repetitively pull out your hair to result in noticeable hair loss
B. Feel tension before, during, or when trying to resist pulling
C. Sense of gratification, pleasure, or relief while pulling hair out
D. Your hair pulling isn’t classified as any other disorder

There is debate to whether or not these criteria should be official, because studies have shown that if you take out criteria B&C, the prevalence (% of the population with Trich) goes higher. In one group study by Dr. Gary Christensen, if all the criteria were applied, 0.6% of the group qualified, but when criteria B&C were taken out, the percent rose to 2.5.
Periodically, a board of doctors meets, discusses, and votes on the correct diagnostic criteria for medical conditions that should be published to a book called the DSM (Diagnostic Statistic Manual.) The criteria above were published for Trichotillomania in 1994, and in 2010 there will be a new book of medical criteria published. Trich specialists are trying to prove that the current criteria may not be 100% correct, and hope to see more accurate criteria and changes in the next edition.

The Onset of Trich
The average age for which people start to pull is around pre-teen years or 13 years old. People may start pulling at any age, from 4 months to 70 years old. There are various reasons or triggers that may make pulling more likely to start (not necessarily cause pulling) including:

Effects of Pulling:

Trichotillomania causes both physical and emotional damage to pullers.

Physically, it causes baldness to spots the hair has been pulled. To try to cover up emptiness or baldness, pullers may use wigs, hats, glasses or other covering items. Infection or scars can also happen if pulling damages skin near hair area from digging for an ingrown hair for example. If the puller uses the hair as floss, it can cause dental erosion. Trichobezoars, or hair balls are one of the most serious effects, and can lead to death if not surgically removed. Not often, but sometimes, damage can be done to the hair follicle, which is what makes the hair grow. Carpel Tunnel Syndrome can be caused from repetitive use of the same muscles and joints to pull hair out, and can damage joints.

Emotional effects are just as awful as physical ones, and may even be worse. Each puller is different, for some people it effects their life a lot, for others not to quite an extreme extent. For almost all people, pulling causes embarrassment, anger, depression, or anxiety. Time, thoughts and energy all are given to pulling, and causes strain in many lives.

Places to Pull

Any hair on the body is vulnerable to hair pullers, though many people find they pull certain areas of hair rather than or more than others. The most common areas of pulling (listed in most common order) are: scalp, eyelashes, eyebrows, pubic hair, and other. Other could be arms, legs, chest, etc...

Boys vs. Girls!

Interestingly, studies so far show that pulling in females is much more common than pulling in men. There have been many studies on the ratio, and they all range from 70-93% being female pullers.

A theory is that men may be able to cover up their pulling more easily, therefore not talk about it because no one notices. For example, if a man pulled his beard hair, he could just shave it off, or if he pulled his scalp hair, an extra short hair cut wouldn’t look “unnatural.”

Another relatively new finding is that the pulling ratio between males and females starts out rather equally in children!

Pulling Behaviors
Method:
Most of the time, hairs are pulled one by one with the thumb and index finger. Some people pull while looking in the mirror, or they may use a “pulling tool,” for example, tweezers. While the majority of pullers pull from themselves, some people pull from other items, including dolls, toys, rugs, dogs, cats, pets, or even other people.
Types:
There are two types of pulling which are theorized:
Automatic and Focused
Click the link to find out more!
Time:
People can spend anywhere from a couple minutes to hours pulling their hair. A study by Dr. Mansueto in 1990 showed that 47% of a group who had Trichotillomania pulled for more than an hour a day.
Situations
The situation that the puller is in plays an enormous role in the pulling. For many people, certain environments trigger pulling episodes. Many times, pulling may occur when stressed, worried, bored, tense, etc.. Trigger situations could include:
-Being in a classroom (school)   -In the car  -In bed, very popular  -In the bathroom  -Reading  -Watching TV  -Many more!
In most cases, pulling is a very private thing, not done in the presence of close friends or family. Most pullers pull alone.
Beliefs:
Many people pull out certain hairs for certain reasons. For many, if the hair seems “out of place,” thick, stubby, or a certain texture, the puller feels that they need to pull it out. Shape, color, and texture may all play roles in which hairs are pulled. Another incentive to pull is the root of the hair, which you will read about later. Some people pull a hair believing it is bad or bothersome. People will joke with themselves and say “only this one hair, then I’ll stop,” but of course it never turns out that way.
Post Pulling:
After pulling has occurred, most people do something with the hair rather than just discarding it. The behavior could involve rolling the pulled hair between fingers, “examining” or looking at the hair, rubbing the root along the face, etc... Some people save the hairs, or even eat the hairs. Eating the hair can cause serious internal damage, and hair being swallowed leads to trichobezoars. Learn More
The Root:
The root is a huge incentive for many hair pullers. Select pullers may be “fascinated” by the root. Some people like the root for particular reasons, if the root is white, big, wet, or has a bit of blood, they may seem special to the puller. A study showed that 48-77% of pullers engage in some oral (facial) behavior with the hair after pulling it. People will run the root along their lips, cheek, or face. Some people even bite the root, or stick it between their teeth like dental floss.

The BRAIN!

Serotonin:

Inside of your brain, there are neurotransmitters, which are chemicals involved with the communication between your brain and your body actions. Serotonin is one of the many neurotransmitters in the brain, but specifically serotonin relates to grooming behaviors. Surprisingly, studies have shown that taking medication to speed up the serotonin communication process may reduce pulling.

Dopamine:

A portion of your brain is called the Basal Ganglia. This section filters the movement decisions you body “suggests,” such as scratching an itch. After filtering, it sends the decisions on to the part of the brain that commands the body to perform an action. Specialists think that for people w/ TTM, this “filtering” system may not work quite as well. (Pulling takes movement and deciding movements.) Possibly, for some people, dopamine inhibitors may help to reduce pulling.

Home Stress
-Parent separation
-Move of residence

Injury

-To scalp or other area that causes attention to area and surrounding hair

School
-Tests
-Other stresses

Other
-Belief that if you have an eyelash on your cheek, you should blow it off and make a wish
-Many other numerous triggers are possible