What Are the Causes of Trichotillomania?

Trichotillomania is a mental health disorder that is evidenced by hair pulling with noticeable hair loss. This hair loss can be on the head or it can include eyebrows, eyelashes or body hair. It is considered an impulse control disorder that may be a type of anxiety or obsessive compulsive problem. There are various explanations for a cause, but there is no clear answer as to why some individuals develop this condition.

Explanation From Psychoanalysis

• Psychoanalysts believe that trichotrillomania is a method for dealing with unconscious internal conflicts. These may be traumatic incidents or childhood abuse. It may be sexual abuse or neglect. This theory suggests that trichotrillomania is a complex defense mechanism.

Explanation From Biologists

• Biologists see this condition as a genetic issue. They believe that it is inherited. Their evidence is that people with this illness often have close relatives who have been diagnosed with some type of obsessive compulsive disorder. A mutation of the gene SLITRK1 has also been found to be related to trichotillomania.

Explanation From Behaviorists

• Behaviorists believe that trichotillomania is a learned behavior. They suggest that a child saw a parent or some important person in their life use this behavior and imitated it. Or that the individual was stressed at one time and hair pulling relieved that stress and then became a habit. Whatever the teacher, behaviorists are convinced that it was an effective tool in creating this disorder.

Explanation From Neurochemistry

• Some studies of mood and anxiety disorders (including obsessive compulsive disorders) suggest that trichotillomania may be caused by neurotransmitter problems in the brain. They suggest that the issue may be with the substances serotonin and dopamine.

Treatment and Hope

• Trichotillomania is a distressing problem that has unclear causes. However there are treatments that have been effective. Medications such as anafranil that have been prescribed for obsessive compulsive disorder have had some efficacy with this illness. Some antidepressants in the selective serotonin reuptake inhibitors class (paxil, prozac) have shown promise. Behavioral therapy that teaches alternative relaxation techniques can be helpful. While it is a difficult problem, there is hope.