QUESTION:

Hi,

I am a 16 year old student in high school and my best friend who is 15 has a hair pulling disorder that is called tricotillomania.

Ever since she was 11 years old she has been pulling her hair out during her sleep. Her parents have tried everything. They had her on all kinds of meds and seeing doctors. I think that she has had enough of it and does not know how to stop. She took her self off the meds. and now smokes weed and has tried drugs. I wish that I could help her can you tell me what I could do to help? I know that is in her head and that she is going to have to do it her self but there most be something that I could do to help.

ANSWER:

Pulling out the hair is generally either or both:

a) BPD dysphoria - where the individual pulls out hair because the pain of the hair pulling stops the horrible sensation of dysphoria (anxiety, rage, depression and despair). It’s a form of self-mutilation.

b) obsessive compulsive disorder - this is an anxiety relieving behavior like twirling the hair, counting white cars, or checking the front door repeatedly to "make sure" it’s locked. There are often many anxiety disorders associated with tricotillomania, including the generalized anxiety disorder, obsessive compulsive disorder, and panic disorder.

The screening test I use for my patients will likely be of help. She’s using medications now - just doesn’t consider marijuana and "drugs" to be medications. I hope this is of help. It’s a tough problem that destroys self-esteem and one’s appearance.