The Differences Between Trichotillomania & Obsessive-Compulsive Discover

Trichotillomania (TTM) and Obsessive-Compulsive Disorder (OCD) are both anxiety-related mental health conditions that involve compulsive behavior, but the key difference lies in the pathology of these compulsions.

What is Trichotillomania?

TTM is a complicated mental health disorder consisting of frequent urges to pluck one’s hair, resulting in considerable hair loss. The disorder is defined as body-focused repetitive behaviours (BFRBs), in which individuals engage in recurrent acts that damage themselves. The defining symptom of TTM is compulsive hair pulling which most commonly happens from the scalp, brows, eyelashes, or other hair-covered parts of the body, with intensity ranging from mild to severe. In severe situations, continual hair tugging can cause visible patches of hair loss or bare areas on the head, resulting in substantial aesthetic modifications.

Hair-pulling can cause emotional distress, shame, and embarrassment because individuals may feel a low sense of self-esteem, affecting the overall quality of their lives. As a result of this behavior, people with TTM tend to develop avoidance behaviours to conceal their hair loss, such as wearing hats, scarves, or wigs or withdrawing from social situations where their hair loss may be noticed. In the long term, the repetition of hair pulling can lead to skin damage, infections, and even trichobezoars if ingested.

What is OCD?

Obsessive Compulsive Disorder (OCD) is characterised by intrusive, unpleasant thoughts or obsessions, which are followed by repetitive behaviours or compulsions aimed at reducing anxiety compulsions or averting a feared result. These compulsions can take many forms, including excessive hand washing, checking, or putting items in a specific way. But unlike TTM, OCD involves a wider spectrum of obsessions and compulsions, and enacting the compulsive behaviour doesn’t result in positive feelings.

Why do People Easily Misunderstand the Two?

If you’re a mental health professional or enrolled in an online clinical counseling masters, then you’ll know TTM is categorised as a type of OCD. Both illnesses entail repeated actions motivated by underlying psychological discomfort, making it difficult to distinguish between them purely based on external symptoms. Cultural stigma and a lack of awareness contribute to misunderstandings about these conditions, hampering appropriate diagnosis and treatment. However, people with TTM pull out their hair and often feel relief or positive emotions from this behavior, whereas OCD behaviors do not typically result in positive feelings. So, the main differences are the presence of obsessions and the emotional response to the behaviours.

How to Differentiate between Trichotillomania and OCD?




Obsession and Compulsion

revolve around specific themes or fears, such as contamination, symmetry, or harm. Compulsions are performed in response to obsessive thoughts to alleviate anxiety or prevent a feared outcome.

is characterized by the recurrent urge to pull out one’s hair.


often ritualistic and aimed at reducing anxiety or preventing a perceived threat. Examples include repetitive hand washing, checking, or counting.

the compulsive behaviour specifically involves hair pulling, which may not be directly linked to obsessive thoughts or ritualistic patterns.

Response to urges

the compulsions are driven by the need to neutralize obsessive thoughts.

compulsion serves as a means of tension relief or emotional regulation, followed by a sense of relief or pleasurable gratification afterwards.

Impacts on daily functioning

time-consuming nature of compulsive rituals or the avoidance of situations that trigger obsessive thoughts.

physical consequences.

Treatment approach

exposure and response prevention (ERP) therapy to gradually expose individuals to feared stimuli and reduce the need to engage in compulsive behaviours.

interventions such as Habit Reversal Training (HRT) focus on increasing awareness of hair-pulling triggers and developing alternative coping strategies.

Solutions & Treatments for Hair-pulling

Consulting with a licensed mental health practitioner to undertake a thorough assessment, including a complete clinical interview and an assessment of symptoms and functional impairment, is what individuals with TTM should do. By actively participating in this process, they are helping the doctors to create an effective treatment plan that’s tailored to their specific needs, while also fostering healing and well-being.

The treatment process will also require a multidisciplinary strategy that includes psychotherapy, medication, and lifestyle changes. Nowadays, research has been able to show that CBT, specifically Habit Reversal Training (HRT), can help to effectively reduce hair-pulling behaviors in Trichotillomania patients. Mindfulness-based practices and stress-reduction strategies can also be used to assist in alleviating the underlying emotional anguish that drives many diseases. Pharmacotherapy, such as Selective Serotonin Reuptake Inhibitors (SSRIs), can also be used in combination with treatment to control symptoms.

At the end of the day, differentiating between Trichotillomania and OCD is critical for proper diagnosis and therapy. While both illnesses are characterized by repeated behaviors and psychological anguish, their underlying causes and symptoms differ greatly. By raising knowledge and understanding of these conditions, individuals may build empathy, eliminate stigma, and allow access to prompt therapies, eventually improving the quality of life for those afflicted. It is crucial to remember that if you are suffering from hair-pulling or obsessive-compulsive symptoms, obtaining expert help is the first step toward healing and recovery.

Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:May 30, 2024

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