Trichotillomania – An Ayurvedic Perspective

Abstract

Trichotillomania (TTM) also known as a hair-pulling disorder is a debilitating psychiatric condition characterized by the recurrent pulling out of one's own hair, leading to hair loss and functional impairment. If untreated, TTM may lead to life-threatening medical problems. In DSM-5-TR, TTM is kept under the category of “Obsessive-compulsive and related disorders.” As there is no established treatment in contemporary medicine for TTM, many patients seek other interventions such as Ayurveda (traditional Indian system of medicine). There is no clarity regarding ayurvedic diagnosis and management of TTM. This has created a major diagnostic and management dilemma in clinical ayurvedic psychiatry practice while approaching a patient of TTM. The aim of the present study is to understand TTM according to Ayurveda and to propose an ayurvedic diagnosis and treatment protocol for it. The present study has explored the similarity between Bhutonmada/Grahonmada (psychiatric condition having idiopathic manifestation) and TTM. Although some references related to hair-pulling behavior are available in ayurvedic texts, they may not represent TTM exactly as an independent disease entity. There is some similarity between Bhutonmada and TTM in terms of etiology, pathology, course and prognosis, and clinical features. Hair-pulling behavior and other self-injurious behaviors can be understood as Bhutonmada with the intention of Himsa. Spiritual or divine therapies, ayurvedic psychotherapy, and virtuous code of conduct, along with ayurvedic medicines, may provide relief to TTM patients. The present study provides new insights for diagnosing and managing the patients of TTM according to Ayurveda.