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?



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. Approximately one to two 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 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.

You are certainly not the only person to have these experiences. As well, trichotillomania commonly coexists with other illnesses, such as eating disorders and other psychiatric conditions. People with trichotillomania often have a greater lifetime prevalence of anxiety and affective and addictive disorders than the general population. The behavior, associated with low self-esteem, high anxiety, and poor body image, 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 accurately noted over the Internet. This information will better inform you, but a health care provider is recommended for diagnosis of trichotillomania. If you are at Columbia, you can make an appointment with a therapist at Counseling and Psychological Services by calling 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 providers will more thoroughly understand your situation to provide the most appropriate treatment. You may find that you'll feel better from professional assistance with some work on your part.


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