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Obsessive and compulsive behavior
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Hair pulling and bulimia
Originally Published: November 04, 1994
~ Last Updated / Reviewed on: February 25, 2009
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Alice,
Ever since I was in junior high, I have been pulling out my hair. I can remember not being able to pull my hair into a ponytail because the hair at the nape of my neck wouldn't reach. I still have this awful and shameful habit. I don't see it so much as just a habit, like the way one might bite one's nails, it's more like an obsession. I'll just sit and stare into space and pull clumps of hair out of my head. I remember having seen a program on T.V. which dealt with this habit as a medical problem that is curable with medication. Unlike the men and women represented on this program, I am not stripping myself bald — yet. I tend to consider it a form of self-punishment, perhaps. Just to give you some background information, I have a tendency towards bulimia (cycles of bulimia occur when my depression is at its worst) and am in general not a happy camper. What can you tell me about this? Signed,
Dear Me, The classification that you are asking about sounds like it could be trichotillomania. Trichotillomania is a condition characterized by a failure to resist impulses to pull out one's hair, and was first described more than a century ago. People with trichotillomania describe experiencing either mounting tension before pulling out their hair or gratification or relief after pulling out their hair. It is a chronic condition, primarily affecting young females, with onset usually occurring in early childhood or adolescence. It is estimated that approximately 1 to 2 percent of college students have past or current experience with trichotillomania. It's not clear if more men or women in college have trichotillomania, but we know that more women seek treatment for it. This could be because more women are affected, or it could be because women are more likely to seek treatment than men. So you are certainly not the only person to have these experiences. As well, it is common for trichotillomania to be coupled with other illnesses, such as eating disorders and other psychiatric conditions. There is often a greater lifetime prevalence of anxiety and affective and addictive disorders than has been noted in the general population. It is associated with low self-esteem, high anxiety, and poor body image. The behavior itself is an impulse disorder not elsewhere classified. Treatment standards have not been established, but behavioral therapy is often recommended, as well as hypnosis and various forms of medication, including antidepressants. Nuances necessary to classifying a psychiatric problem cannot be noted over the Internet. This is not to suggest that you do or don't have trichotillomania, but simply to give you some information so that when and if you see a health care provider, you will be informed. If you are at Columbia, you can make an appointment with a therapist at Counseling and Psychological Services (x4-2878). Be honest and open with him/her about your hair pulling, periods of bulimia, and depression, even if you feel embarrassed or ashamed. These could be linked, and someone cannot help you unless you give them all of the information, including your feelings about what is going on with you. You may find you'll feel better from professional assistance, some work on your part, and perhaps even medication.
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