Trichotillomania and Excoriation Disorder - Demystifying the DSM-5
Trichotillomania (Hair-Pulling Disorder)
This isn’t just plucking your eyebrows. We’re typically talking hours of time a week spent pulling out hair or resisting the urge to pull out hair.
The criteria are:
- The character keeps pulling out their own hair. This has to result in hair loss.
- The character needs to have tried to stop or reduce how much they pull out their hair.
- The hair pulling causes the character stress (being ashamed, feeling like they’re out of control, etc.) or makes some part of their life more difficult.
- The hair pulling / hair loss isn’t caused by a medical condition.
- The hair pulling isn’t because of another mental disorder.
There are a couple things to consider when writing a character with trichotillomania.
The criteria specifies “hair loss”, but if your character is, for example, pulling out random hairs from all over their arms, it may not be immediately noticeable.
The hair can be from any part of the body – scalp, eyelashes, eyebrows, body hair, armpit/pubic hair, etc.
Characters with this typically only pull hair in private.
The character might also have a specific way they pull out their hair – they may only want to pull out a certain type of hair, or feel compelled to examine at each hair after it’s pulled, or even eat them after pulling it.
Excoriation (Skin-picking) disorder
This isn’t just popping zits. We’re typically talking hours of time a week spent picking at their skin, or fighting off the urge to do so. This disorder often causes scarring and infection.
- The character needs to keep picking at their skin, to the point where they get skin lesions.
- The character needs to have tried to stop or reduce how much they pick their skin.
- The skin picking causes the character stress or makes some part of their life more difficult.
- The skin picking isn’t caused by a medical condition.
- The skin picking isn’t because of another mental disorder.