Hair pulling is a relatively common disorder in the general population. This agonizing disorder is more common in females and is often associated with an obsessive compulsive personality. Current estimates indicate that at least 2 million adult Americans over the age of 20 have this disorder. There are countless more individuals who have not been diagnosed or are too shy to visit a physician. Despite being aware about this disorder for decades, the treatment for hair pulling or Trichotillomania has not been very satisfactory. Over the years, countless treatments have come and gone. Today, pharmacological drug therapy and behavior alterations are the mainstay of treatment but have limited success.
Recently a paper published in the Archives of General Psychiatry offers new hope for patients who suffer from Trichotillomania. In a small trial involving 50 individuals, it was observed that those who took the health supplement, N acetyl cysteine, had marked improvement of symptoms after only 12 weeks. N acetyl cysteine used in the study was obtained in a pill form from health food stores like GNC and Vitamin Shoppe.
If these studies do hold up, then this may herald a potentially new treatment for this disturbing disorder.
Why people pull hair remains a puzzle and there are countless theories. The bottom line is that chronic hair pulling is a diversion from a stressful situation, which eventually turns into addictive psychological relief. The majority of individuals not only pull hair from the scalp but also from other parts of the body. At least 20 percent of individuals even eat their hair and a very few minority pull other people’s hair. While hair-pulling sounds painful, most trichotillomanics claim that it provides a calming feeling and relief from the acute anxiety.
Showing posts with label hair pulling. Show all posts
Showing posts with label hair pulling. Show all posts
Thursday, July 23, 2009
Sunday, April 26, 2009
Treatment for hair pulling (trichotillomania) part 2
What about medications?
The use of medications to treat Trichotillomania is empirical. Because so little is known about the disorder, no one really knows what the best medications are, when to start the pill and for how long the treatment should be continued. The most common class of medications used to treat Trichotillomania are the anti depressants. There are no clinical trials on effectiveness of these drugs, but anecdotal reports do indicate that some patients do improve over time. Some patients need to take the anti depressants for 3-9 months to see an improvement. Because of side effects, compliance with these drugs is poor. Many patients stop taking the drug after 2-4 months. The most common complications of these drugs include weight gain, loss of libido, fatigue, and dry mouth. The side effects do stop when the drug is discontinued. Most experts recommend drug therapy with CBT for the best results.
The unfortunate thing is that not all individuals respond to drugs or CBT therapy. Many individuals do relapse even when the treatment is initially successful. Because the disorder can create havoc in one’s life it is recommended that one see a health care worker for help. Even though present day treatments are not ideal, in some individuals, drugs or CBT can help one make a dramatic recovery.
Alternative medicine
Because conventional medicine has not been successful in treatment of many mental disorders, including trichotillomania, many patients have been turning to alternative health care. There are reports that some individuals do benefit from hypnotherapy. When this treatment is combined with drugs or CBT, the frequency of relapse is much less. Alone, hypnotherapy works in less than 5% of individuals. The treatment is prolonged and requires patience and commitment.
Another technique that has been reported to help individuals with Trichotillomania is biofeedback. In this therapy, one is taught how to control or change certain physical responses. For example, when one encounters a certain stress, headache or a frustrating situation, biofeedback can help reduce tension and erases the urge to pull hair. The technique can also help decrease anxiety and helps control negative behaviors like pulling hair. However, on its own biofeedback often fails to work. For the best results, it must be combined with drug therapy or CBT.
The use of medications to treat Trichotillomania is empirical. Because so little is known about the disorder, no one really knows what the best medications are, when to start the pill and for how long the treatment should be continued. The most common class of medications used to treat Trichotillomania are the anti depressants. There are no clinical trials on effectiveness of these drugs, but anecdotal reports do indicate that some patients do improve over time. Some patients need to take the anti depressants for 3-9 months to see an improvement. Because of side effects, compliance with these drugs is poor. Many patients stop taking the drug after 2-4 months. The most common complications of these drugs include weight gain, loss of libido, fatigue, and dry mouth. The side effects do stop when the drug is discontinued. Most experts recommend drug therapy with CBT for the best results.
The unfortunate thing is that not all individuals respond to drugs or CBT therapy. Many individuals do relapse even when the treatment is initially successful. Because the disorder can create havoc in one’s life it is recommended that one see a health care worker for help. Even though present day treatments are not ideal, in some individuals, drugs or CBT can help one make a dramatic recovery.
Alternative medicine
Because conventional medicine has not been successful in treatment of many mental disorders, including trichotillomania, many patients have been turning to alternative health care. There are reports that some individuals do benefit from hypnotherapy. When this treatment is combined with drugs or CBT, the frequency of relapse is much less. Alone, hypnotherapy works in less than 5% of individuals. The treatment is prolonged and requires patience and commitment.
Another technique that has been reported to help individuals with Trichotillomania is biofeedback. In this therapy, one is taught how to control or change certain physical responses. For example, when one encounters a certain stress, headache or a frustrating situation, biofeedback can help reduce tension and erases the urge to pull hair. The technique can also help decrease anxiety and helps control negative behaviors like pulling hair. However, on its own biofeedback often fails to work. For the best results, it must be combined with drug therapy or CBT.
Treatment for hair pulling (trichotillomania)
Trichotillomania is a dreadful disorder and very little is known about it. For one thing, the disorder is associated with a lot of torment and internal turmoil. The most important aspect of this disorder is that the individual is not to be blamed for it. why Trichotillomania happens is not well understood and like most medical disorders bad luck or bad genes seem to part of the problem.
One reason why there is little known about Trichotillomania is because many individuals who have this disorder do not go and see their health care worker. Over the years, fear, embarrassment and lack of family support has driven these individuals into the closet. Medical professionals rarely come across individuals with Trichotillomania and most health care professionals have no idea how to treat it. Nevertheless, if one does seek help, there are some treatments that can improve the disorder. Two basic treatments are currently available for hair pulling.
Psychotherapy or cognitive behavior therapy (CBT) is an effective treatment for Trichotillomania. It is a slow process but helps one understand the disorder and brings awareness to the problem. Over time, some individuals learn not to pull their hair. The therapy centers around control of emotions, stress and trigger factors. The triggers and negative behaviors are then substituted for positive things. For example, if one used to pull hair, then now one will go for a swim, read a book or cook a meal. CBT requires commitment and patience. It is not a one shot deal because recovery can take 3-8 months. Frequently CBT also entails family involvement to help members understand the disorder and what they can do to help the affected individual. Over time, CBT can help diminish urges to pull hair and relieves strong impulses causing disruptive behavior.
Does CBT always work? No. CBT does work when treatment is sought out early. In normal people who have capacity to understand and comprehend, the results are good. Individuals who have other problems like drug abuse, alcoholism or personality disorders, CBT does not work well. From anecdotal reports, about 30-50 percent of individuals do benefit from this therapy.
One reason why there is little known about Trichotillomania is because many individuals who have this disorder do not go and see their health care worker. Over the years, fear, embarrassment and lack of family support has driven these individuals into the closet. Medical professionals rarely come across individuals with Trichotillomania and most health care professionals have no idea how to treat it. Nevertheless, if one does seek help, there are some treatments that can improve the disorder. Two basic treatments are currently available for hair pulling.
Psychotherapy or cognitive behavior therapy (CBT) is an effective treatment for Trichotillomania. It is a slow process but helps one understand the disorder and brings awareness to the problem. Over time, some individuals learn not to pull their hair. The therapy centers around control of emotions, stress and trigger factors. The triggers and negative behaviors are then substituted for positive things. For example, if one used to pull hair, then now one will go for a swim, read a book or cook a meal. CBT requires commitment and patience. It is not a one shot deal because recovery can take 3-8 months. Frequently CBT also entails family involvement to help members understand the disorder and what they can do to help the affected individual. Over time, CBT can help diminish urges to pull hair and relieves strong impulses causing disruptive behavior.
Does CBT always work? No. CBT does work when treatment is sought out early. In normal people who have capacity to understand and comprehend, the results are good. Individuals who have other problems like drug abuse, alcoholism or personality disorders, CBT does not work well. From anecdotal reports, about 30-50 percent of individuals do benefit from this therapy.
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