Compulsive Hair Cutting Depression (A comprehensive overview)

This article talks about compulsive hair-cutting depression, its causes and ways to overcome compulsive hair-cutting depression. In this article, you will also find answers to some frequently asked questions about this condition.

What is Compulsive Hair-cutting Depression?

In order to understand what compulsive hair-cutting depression is, we need to first understand compulsive hair-cutting disorder, and depression, individually.

Compulsive Hair-cutting Disorder

Compulsive Hair-cutting Disorder is a (seemingly) extremely rare condition wherein, individuals having this disorder face an obsessive-compulsive urge of shaving or cutting their hair. They often cut or shave their hair in secret, and are in denial of their habit. This disorder is called Trichotemnomania.

The origin of the term Trichotemnomania is from the Greek language; ‘thrix’ means hair, ‘temnein’ means to cut, and ‘mania’ means madness. Compulsive Hair-cutting Disorder (Trichotemnomania) is different from Hair Pulling Disorder (Trichotillomania). It is common for people to get confused between the two.

It can also be misdiagnosed as Alopecia Areata which is an auto-immune disease that leads to patchy hair loss. These misdiagnoses happen because there are hardly any known cases of Compulsive Hair-cutting Disorder (Trichotemnomania).

Compulsive Hair-cutting Disorder (Trichotemnomania) is a type of Body Focused Repetitive Behaviour (BFRB) Disorder.

Body Focused Repetitive Behaviour Disorders are considered to be in the Obsessive-compulsive Spectrum. In DSM-5 (Diagnostic and Statistical Manual of Mental Disorders), Body Focused Repetitive Behaviours are classified under Obsessive- Compulsive and Related Disorders. However, there is no distinct in-detail mention of Trichotemnomania as a condition of its own, in DSM-5.

Body Focused Repetitive Behaviours are compulsive behaviours that individuals ritually perform on themselves. Even though BFRBs are related to OCD, they are two separate conditions. Body Focused Repetitive Behaviours involve excessive grooming, and extreme or severe cases can lead to excessive tissue damage.

Compulsive Hair-cutting Disorder (Trichotemnomania) could be considered self harm/ self injury/ self mutilation if the individuals injure themselves intentionally, and/ or if it leaves scars or causes tissue damage.

Some serious symptoms of  BFRB can include:

• Bleeding
• Bruising
• Scabbing
• Absence of hair in certain areas
• Infections or other illnesses caused by over grooming
• Development of calluses on the affected tissue
• Inability of the affected tissue to heal properly

BFRBs are not impulse control disorders, either. When it comes to over grooming, individuals having BFRB disorders lack impulse control and do not have a choice of stopping themselves from engaging in these behaviours.

The underlying causes of Body Focused Repetitive Behaviours are not known. Several studies show that some people may have an inherited predisposition developing these behaviours.

So what causes Compulsive Hair-cutting Disorder (Trichotemnomania)?

A study was conducted to review adolescents who had been diagnosed with Compulsive Hair-cutting Disorder (Trichotemnomania). In all three cases, there were signs of a patchy scalp due to a sudden hair loss caused by shaving or cutting their hair. Each of these individuals denied to have cut or shaved their hair, and had comorbid OCD (Obsessive Compulsive Disorder).

According to DSM- 5, compulsions are repetitive behaviours or mental acts directed at preventing or reducing distress. Hence, Compulsive Hair-cutting Disorder (Trichotemnomania) may be caused due to the presence of stressors that the individual is unable to cope with. The compulsions are usually involuntary and done unconsciously.

How can Compulsive Hair-cutting Disorder be treated?

One can undergo effective treatments to help oneself manage and stop these behaviours gradually over time. The most common treatments for Body Focused Repetitive Behaviours include a specific type of Cognitive Behavioural Therapy (CBT) called Habit Reversal Training (HRT), Dialectical Behavioral Therapy (DBT), prescription medication, acceptance and commitment therapy and habit reversal training.

Depression : A Mental Health Disorder

Depression is often used as a synonym for sadness, but depression and sadness are not the same. Sadness is just a type of healthy emotion. It is the feeling of sorrow or unhappiness when things do not go your way.

On the other hand, Clinical Depression is a mental illness caused by an imbalance of chemicals in the brain. It is accompanied by a lot of persistent symptoms, and not any random thoughts you can get rid of.

According to DSM-5, Clinical Depression, also known as Major Depressive Disorder, comes under the classification of a Mood Disorder. It is a very common mental illness and can significantly interfere with one’s ability to work, manage personal and professional relationships, carry out daily tasks, etc.

Individuals suffering from Clinical Depression show different behavioural symptoms. (At no cost should these symptoms be used for self-diagnosis. They can be referred to for a better understanding of the disorder.) Some of the symptoms are listed below:

• Low  mood
• Loss of interest or pleasure in things you’d normally enjoy
• Increase or decrease in sleepIncrease or decrease in appetite
• Changes in sleeping patterns
• Feelings of hopelessness
• Feelings of worthlessness
• Excessive guilt
• Poor concentration skills
• Restlessness or slowness
• Fatigue
• Recurrent thoughts of death or suicide

According to the American Psychological Association (APA), for an individual to be diagnosed with Clinical Depression, he/ she/ they must be experiencing 5 or more of these symptoms daily, for 2 consecutive weeks, and at least one of the symptoms should be either depressed mood or loss of interest or pleasure.

Clinical depression also has physical effects such as smaller frontal lobes and hippocampal volumes, and abnormal transmission or depletion of neurotransmitters such as Serotonin, Norepinephrine, and Dopamine.

What causes Clinical Depression?

Till date, there is no explanation as to what exactly sets off the chemical imbalance responsible for Depression in a person. However there are various genetic, environmental and physiological factors that can make individuals susceptible to Depression. Some of them are mentioned below:

• Stressful life changing events such as losing a job, death of a loved one, an accident, could be one of triggers of Depression. It is not the event itself, rather, it is the individual’s inability to deal and cope with the stressors that come along with the big change that makes them vulnerable to Depression.
• When people feel powerless against the negative events of their life, they may start to feel hopeless and worthless. If these feelings are not dealt with in a healthy way, it might cause Depression.
• Serotonin is a hormone responsible for the regulation of emotions in our body. An imbalance in its levels can negatively affect one’s mood.
• Depression can also be hereditary. Having a family history of Depression or Bipolar Disorder increases a person’s risk factors of being susceptible to Clinical Depression.
• An over- activity in endocrine glands which release hormones can lead to an increase secretion of the stress hormone (Cortisol) which is present in individuals diagnosed with Clinical Depression.
• Belonging to a dysfunctional family where children go through physical, sexual, or emotional abuse, could increase their chances of suffering from depression.
• Losing a parent or caregiver at a young age could also be a cause of depression.
• Having no social support is another cause of depression. Being isolated and disconnected from people around you can lead to intense feelings of worthlessness or loneliness that could worsen depression.

How can Clinical Depression be treated?

There is no cure for Clinical Depression. However, with professional help, one will be able to manage and deal with their symptoms and stop them from interfering with one’s life.

Therapy

Various forms of therapy are used to treat depression. One of those is Psychotherapy, also called Talk therapy. It is a very commonly used method to treat Depression. For mild to moderate cases of depression, having a counselor or trained mental health professional is essential.

In the counseling space, the therapist ensures that it is a safe space for you to talk openly about your thoughts and feelings without being judged for them. This gives you an objective insight into your problems, helps you learn about your old coping patterns, and work out healthier mechanisms of coping with your troubles.

Other forms of therapy include Cognitive Behaviour Therapy (CBT), Interpersonal Therapy, and Psychodynamic Therapy.

Suicide Prevention Helplines

Your state or country will have its own registry of Suicide Prevention Helpline numbers. In case of emergency, while experiencing suicidal thoughts, one must seek immediate help on these numbers.

Medications

Depending on the severity of the symptoms, Antidepressants are prescribed by a psychiatrist in order to treat these symptoms. Any change in the intake or dosage of the antidepressants, without the consultation of your doctor, will adversely affect you. Hence, it is important for one to seek professional advice before starting or stopping the intake of antidepressants or making any changes in their doses.

Electroconvulsive Therapy

In severe clinical cases, Electroconvulsive Therapy (also called Shock Therapy) is used to treat the symptoms of depression.

Preventing Depression

• Having a healthy physical and mental lifestyle is key in preventing an illness.
• Exercising and having movement in your day helps in the release of Endorphins which are feel good hormones.
• One must ensure that they get enough sleep and maintain a proper sleep cycle.
• Having a healthy diet, keeping the daily requirement of nutrients in check, and knowing how your body reacts to different foods, is important too.
• Take time to acknowledge your emotions and feelings, and talk about it in a safe space. Continuously bottling-up your emotions or not addressing them will hamper your mental health.
• Have people around you who will support you emotionally when you are feeling low.
• Avoiding substance abuse is also important in preventing depression.

The link between Compulsive Hair-cutting Disorder (Trichotemnomania) and Clinical Depression – Can a person have both together?

This is where Compulsive Hair-cutting Depression comes into play. According to The TLC Foundation for BFRBs many people with BFRB Disorders like Compulsive Hair-cutting Disorder, also have other coexisting disorders. Clinical Depression is one of them.

When there are co-morbid conditions in patients, therapy can become complex. However, the various treatment methods must be followed so that one is able to manage their symptoms before it gets fatal. 

For individuals suffering from depression, it is difficult to admit that they need help and might choose to not talk about their situation. If you notice these symptoms of BFRBs or Depression in your loved ones, you can help them with starting therapy.

BetterHelp: A Better Alternative

Those who are seeking therapy online may also be interested in BetterHelp. BetterHelp offers plenty of formats of therapy, ranging from live chats, live audio sessions and live video sessions. In addition, unlimited messaging through texting, audio messages and even video messages are available here.

BetterHelp also offers couples therapy and therapy for teenagers in its platform. Furthermore, group sessions can also be found in this platform, covering more than twenty different topics related to mental health and mental illness. The pricing of BetterHelp is also pretty cost-effective, especially considering the fact that the platform offers financial aid to most users.

Conclusion

In this article we read about Compulsive Hair-cutting Disorder and Depression, their causes, symptoms, treatment methods and ways to prevent them, and how they co-exists as Compulsive Hair-cutting Depression.

Frequently Asked Questions: Compulsive Hair-cutting Depression

References:

https://www.tandfonline.com/doi/full/10.1080/24750573.2017.1420377?af=R&

https://www.bfrb.org/learn-about-bfrbs/treatment/self-help/335-resources-for-suicide-prevention#:~:text=We%20know%20through%20research%20that,experiencing%20will%20not%20get%20better