Do you feel that trichotillomania is more of a symptom for you, or more of its own condition entirely?
I have long since thought that, at least for me, my trich is inherently correlated with my Autism, and not exactly its own condition.
I was diagnosed with trich before anything else in life- at age 10, started pulling at 9. All of the medical treatment I got centered around trich and getting me to stop pulling. Nothing really delved into what caused me to develop trich, even when it was considered to be “stress-related” or “maladaptive coping”. Everything wanted to stop the pulling, not examine/change the circumstances that caused the compulsion to begin with.
Even once I was diagnosed with generalized anxiety and depression, little of that changed.
I was diagnosed with Autism at 16, and again, nothing changed.
My trich never really improved whatsoever until I was 18 and went to occupational therapy after having had been in an IOP program. My OT said- your nervous system is disregulated and, while mindfulness helps, it is deeper than that. You pull when over/understimulated to help self-regulate your body. Coupled with stress/anxiety, even worse. Basically, just like we see in birds with feather plucking, or overgrooming in mammals.
My psychotherapist then opined that my emotionally neglectful upbringing caused me to lack the ability to self-soothe as my parents never modeled it to me, which in many people leads to self injury, compulsive issues, and/or risk taking behavior. Being Autistic often leads to trauma for people in many different ways, thus adding to the pile.
So, in my opinion, the combination of the Autistic traits of sensory seeking, sensory issues with hair, nervous system regulation, self-injury, and heightened sensitivity to stress/anxiety- and my lack of modeled self-soothing coupled with childhood trauma- led to my body’s urge to pull my hair for relief.
To me, trich is just a developed symptom/consequence of being Autistic, more than it is its own unique condition to me. Understanding my life in this way, holding more awareness of myself, and changing what I can to jive better with my brain/body has made the severity of my trich decrease dramatically. Now I only really have (severe) issues with it in times of heightened stress or physical pain.
I am curious to see if people feel similarly or not.