The case report I dug up, titled, “Cocaine-induced Trichotillomania,” discusses the case study of a twenty-four year old woman suffering from trich-like symptoms, attributed to her cocaine abuse. Her case evaluation states, “she also complained of constantly pulling out hair from her scalp, eyebrows, arms, axilla and pubic area. Noticeable hair loss from these areas was evident. On detailed enquiry, it became clear that she experienced this urge to pull out her hair only ‘under the influence’ of cocaine and this had been ongoing for the last year”(George/Hamdy 255).
It would appear that since the chemical components of cocaine (benzoylmethyl ecgonine) and Adderall (amphetamine and dextroamphetamine) are so similar, including their effect of the brain (increase norepinephrine and dopamine), that my Adderall abuse might of played a major role in the escalation of my trichotillomania symptoms. Since my trichotillomania developed before my substance use disorders, it’s safe to say that the Adderall wasn’t the entire problem, but after reflecting I definitely can say the urge to pluck became unbearable while under the influence.
“Patients abusing cocaine can experience tactile hallucinations, described classically as a sensation of bugs crawling under the skin—often called cocaine bugs”(George/Hamdy 255). These “bugs” are exactly what it felt like during an intense, ritualistic, picking, often during times of extreme intoxication while focusing to work on something. Before, or even while I was not under the influence, the only time I would pick would be on rare occasions of stress. In fact, I can’t even tell you most of the times because I don’t really remember. It was more unconscious in these instances. While under the influence of Adderall I would notice I was doing it, and couldn’t stop myself because of the “bugs,” nor did I really care to stop by that point in the first place….it felt good, what was “needed.”
George, Sanju, and Hamdy Moselhy. "Cocaine-induced trichotillomania." Addiction 100 Issue 2 (2005): 255-6.
Thursday, April 16, 2009
Wednesday, April 8, 2009
Should addictive disorders include non-substance-related conditions?
This article pertains to my exact question! Not exactly (but mentioned!) about trichotillomania in it’s entirety, this article asks the question, should non-substance-related disorders be considered addictive, or a SUD (substance use disorder)?
The main focus of this article pertains to PG (pathological gambling), which also happens to be an ICD (impulse control disorder) in the same classification as trich, as defined by the DSM (Diagnostic and Statistical Manual of Mental Disorders). Potenza states there would be both “pros” and “cons” to these definition changes in regard to ICD’s and other similar disorders. “There exist both pros (e.g. limiting confusion regarding the use of the term dependence—physical dependence versus DSM-defined, diagnostic dependence) and cons (e.g. the stigma generally associated with the term addiction) of making such a change”(Potenza 142). From my point of view the pros outweigh the cons. If a disorder shares the same characteristics as another it shouldn’t be categorized differently based on social stigma. These are medical issues that shouldn’t be viewed differently based on the views of society.
Potenza states, “One description of the core elements of addiction includes (modified from [3]): (1) craving state prior to behavioral engagement, or a compulsive engagement; (2) impaired control over behavioral engagement; and (3) continued behavioral engagement despite adverse consequences. If one adopts these components as core elements of addiction, other behavioral disorders, particularly those currently classified as impulse control disorders (ICDs), warrant consideration as addictions” (Potenza 143). Taking into consideration the substitution of “dependency” (as defined by the DSM) for “addiction,” the ICD category would most definitely be placed under the same grouping, as well as a list of other disorders. “Applying this definition, impulsivity has relevance to a broad array of psychiatric disorders including substance use, antisocial and borderline personality, bipolar, attention-deficit hyperactivity and impulse control disorders (ICDs) [7]”(Potenza 143).
“ICDs are currently grouped together in DSM-IV-TR in the category of ‘ICDs Not Else-where Classified’, and include pathological gambling (PG), kleptomania, pyromania, intermittent explosive disorder, trichotillomania and ICD not specified elsewhere”(Potenza 143). This alone should stand as proof that the means of classification could use a little adjusting.
What the entire situation seems to come down to is a “social stigma.” People are afraid, or ashamed, to be called an “addict,” or called out for facing addiction. The DSM even has a hard time using the word addiction, which leads to other, non-substance derived, disorders being placed in stupid categories like, “not else-where classified.”
“The current state of knowledge suggests that there exist substantial similarities between PG and SUDs. Further research is indicated prior to categorizing PG and other ICDs together with SUDs”(Potenza 142). After reviewing the article in its entirety, it’s clear that SUDs (substance use disorders), and ICDs (PG; most researched) are undeniably linked on a biochemistry, genetic, and environmental level. The only different feature seems to be a social understanding. Since this is a “new” approach to the categorization of these disorders it will probably take some time before any actual changes are made to the DSM. At the same time, for those that care to investigate it’s obvious that ALL of these disorders should be labeled as addictions.
Potenza, Marc N. "Should addictive disorders include non-substance-related conditions?" Addiction 101 (2006): 142-51.
The main focus of this article pertains to PG (pathological gambling), which also happens to be an ICD (impulse control disorder) in the same classification as trich, as defined by the DSM (Diagnostic and Statistical Manual of Mental Disorders). Potenza states there would be both “pros” and “cons” to these definition changes in regard to ICD’s and other similar disorders. “There exist both pros (e.g. limiting confusion regarding the use of the term dependence—physical dependence versus DSM-defined, diagnostic dependence) and cons (e.g. the stigma generally associated with the term addiction) of making such a change”(Potenza 142). From my point of view the pros outweigh the cons. If a disorder shares the same characteristics as another it shouldn’t be categorized differently based on social stigma. These are medical issues that shouldn’t be viewed differently based on the views of society.
Potenza states, “One description of the core elements of addiction includes (modified from [3]): (1) craving state prior to behavioral engagement, or a compulsive engagement; (2) impaired control over behavioral engagement; and (3) continued behavioral engagement despite adverse consequences. If one adopts these components as core elements of addiction, other behavioral disorders, particularly those currently classified as impulse control disorders (ICDs), warrant consideration as addictions” (Potenza 143). Taking into consideration the substitution of “dependency” (as defined by the DSM) for “addiction,” the ICD category would most definitely be placed under the same grouping, as well as a list of other disorders. “Applying this definition, impulsivity has relevance to a broad array of psychiatric disorders including substance use, antisocial and borderline personality, bipolar, attention-deficit hyperactivity and impulse control disorders (ICDs) [7]”(Potenza 143).
“ICDs are currently grouped together in DSM-IV-TR in the category of ‘ICDs Not Else-where Classified’, and include pathological gambling (PG), kleptomania, pyromania, intermittent explosive disorder, trichotillomania and ICD not specified elsewhere”(Potenza 143). This alone should stand as proof that the means of classification could use a little adjusting.
What the entire situation seems to come down to is a “social stigma.” People are afraid, or ashamed, to be called an “addict,” or called out for facing addiction. The DSM even has a hard time using the word addiction, which leads to other, non-substance derived, disorders being placed in stupid categories like, “not else-where classified.”
“The current state of knowledge suggests that there exist substantial similarities between PG and SUDs. Further research is indicated prior to categorizing PG and other ICDs together with SUDs”(Potenza 142). After reviewing the article in its entirety, it’s clear that SUDs (substance use disorders), and ICDs (PG; most researched) are undeniably linked on a biochemistry, genetic, and environmental level. The only different feature seems to be a social understanding. Since this is a “new” approach to the categorization of these disorders it will probably take some time before any actual changes are made to the DSM. At the same time, for those that care to investigate it’s obvious that ALL of these disorders should be labeled as addictions.
Potenza, Marc N. "Should addictive disorders include non-substance-related conditions?" Addiction 101 (2006): 142-51.
“A rare presentation of Rapunzel syndrome manifesting in the immediate post-appendicectomy period”
For my second academic annotation I chose the topic of “Rapunzel Syndrome” (trichobezoar; the human hairball), resulting from a disorder known as “trichophagia,” which goes hand-in-hand with trichotillomania. Trichophagia is a disorder where the individual removes a hair (trichotillomania), and either chews off the root, or chews on the entire strand, followed by spitting it out or consuming it. Individuals with Rapunzel syndrome happen to be the ones that swallow it, which results in a “human hairball” trapped in the stomach, “small bowel,” and/or the right colon. This “human hairball” causes bowel obstruction, which can lead to death if not surgically removed. “Rapunzel syndrome is a rare presentation of a trichobezoar, with 27 cases having been reported in literature so far. The cause of appendicitis in this case was due to luminal obstruction by hair concretions. If appendicitis is due to luminal obstruction by hair concretions, the patient should be investigated for the presence of a gastric or intestinal trichobezoar by endoscopy, ultrasonography or CT scan”(Nair 1).
I thought it would be important to do a little research on trichophagia since it’s the second part of the trich disorder I also suffer from. And although it’s not a main theme of my paper I feel it might be important when putting together the pieces of my “new” trich definition as “addiction.” Take this as a bit of humor, but when comparing trich with substance dependency as “addictions,” their similarities fall in line to the “dead end.” (Pun intended)
Although it may seem petty, or an insignificant observation, the truth is you can die from a drug problem if it goes on untreated, and you can die from trich, or trichophagia, just the same. I admit, this is a far-out correlation I’m trying to make, but is it really? Of the wide range of chemical substances available to become addicted to, some will possibly kill you on their first or second use, other’s will leave you dead in a few short years, and still some of the most dangerous addictive substances may take 20, 40, or 60 years to kill you. For instance, cigarettes and alcohol, two of the most widely used, and overused, drugs in the world, may take a lifetime (pun intended) to leave you dead.
So although cases of death related to trich and trichophagia, resulting from Rapunzel syndrome, are rare, they are only rare in origin to begin with. The number of drug addicts compared to the number of, not only trich, but also trichophagia, AND Rapunzel syndrome cases, are so drastic it creates this humorous response to their comparison. Even as an individual with trichotillomania and trichophagia I stand a rare chance of dieing from Rapunzel syndrome since I spit out the hair after I chew it (sorry that sounds sick). Still, the reality is if I suffered from sever trichotillomania, trichophagia, and consumed the strands of hair, leading to Rapunzel syndrome (which went on untreated, just like most drug addicts), there’s a good chance I would die. The uncontrollable urge to pluck, chew, and swallow would literally kill me since the human stomach can’t digest hair. Death from a disorder that is simply less known, doesn’t make it any less plausible.
“A 16-year-old, healthy girl was admitted with right lower abdominal pain, vomiting and fever of 2 days duration. On examination, she was febrile, with a pulse rate of 110/min. Abdominal examination revealed tenderness at McBurney's point with rebound tenderness and guarding at the right iliac fossa. Her investigations revealed a white cell count of 18,600/mm3 with 96% polymorphonuclear forms. Ultrasound imaging of the abdomen reported minimal free fluid in right iliac fossa. She underwent an appendicectomy through a Lanz incision. The appendix was inflamed and gangrenous. Terminal ileum and caecum were normal on inspection and palpation. On the 4th postoperative day she developed massive upper and central abdominal distension with severe vomiting. Her haematological and biochemical parameters were within normal limits. X-ray of the abdomen revealed intestinal obstruction. She underwent an exploratory laparotomy. There was a firm tubular mass tightly occluding the distal jejunum. The proximal extend of this was occupying the stomach. Through an anterior gastrotomy a black hard block of trichobezoar and its tail-like extension to the jejunum were retrieved”(Nair 1).
Now if that’s not an incentive to seek treatment, or “cure” her disorder, I don’t know what is. In a funny (not so funny) way, Rapunzel syndrome is like an overdose: HAIR KILLS!
Important Noted Information Regarding: Trichotillomania, Trichophagia, Rapunzel Syndrome, and Trichobezoars-
“Trichotillomania in children is a habit disorder and thus has a better prognosis in most cases. However, in adults the psychopathology is usually deeper and thus entails a poor prognosis. Trichotillomania can have a biological basis as two mutant versions of the gene SLITKR1 were found to be more common in trichotillomania patients. These mutations were found to account for only a small percentage of cases. Treatment modalities vary in childhood and adult varieties. Apart from psychotherapy, the drug treatment involves several agents including selective serotonin reuptake inhibitors (SSRIs) and domipramine. Recurrence of Rapunzel Syndrome is very uncommon, and does occur only if the patients are left untreated for their underlying problem. Intensive psychiatric follow-up is mandatory for preventing relapses”(Nair 1).
Nair, Manojkumar S., and Balachandran M. Nair. "A rare presentation of Rapunzel syndrome manifesting in the immediate post-appendicectomy period." Internet Journal of Surgery 14 Issue 2 (2008): 13
I thought it would be important to do a little research on trichophagia since it’s the second part of the trich disorder I also suffer from. And although it’s not a main theme of my paper I feel it might be important when putting together the pieces of my “new” trich definition as “addiction.” Take this as a bit of humor, but when comparing trich with substance dependency as “addictions,” their similarities fall in line to the “dead end.” (Pun intended)
Although it may seem petty, or an insignificant observation, the truth is you can die from a drug problem if it goes on untreated, and you can die from trich, or trichophagia, just the same. I admit, this is a far-out correlation I’m trying to make, but is it really? Of the wide range of chemical substances available to become addicted to, some will possibly kill you on their first or second use, other’s will leave you dead in a few short years, and still some of the most dangerous addictive substances may take 20, 40, or 60 years to kill you. For instance, cigarettes and alcohol, two of the most widely used, and overused, drugs in the world, may take a lifetime (pun intended) to leave you dead.
So although cases of death related to trich and trichophagia, resulting from Rapunzel syndrome, are rare, they are only rare in origin to begin with. The number of drug addicts compared to the number of, not only trich, but also trichophagia, AND Rapunzel syndrome cases, are so drastic it creates this humorous response to their comparison. Even as an individual with trichotillomania and trichophagia I stand a rare chance of dieing from Rapunzel syndrome since I spit out the hair after I chew it (sorry that sounds sick). Still, the reality is if I suffered from sever trichotillomania, trichophagia, and consumed the strands of hair, leading to Rapunzel syndrome (which went on untreated, just like most drug addicts), there’s a good chance I would die. The uncontrollable urge to pluck, chew, and swallow would literally kill me since the human stomach can’t digest hair. Death from a disorder that is simply less known, doesn’t make it any less plausible.
“A 16-year-old, healthy girl was admitted with right lower abdominal pain, vomiting and fever of 2 days duration. On examination, she was febrile, with a pulse rate of 110/min. Abdominal examination revealed tenderness at McBurney's point with rebound tenderness and guarding at the right iliac fossa. Her investigations revealed a white cell count of 18,600/mm3 with 96% polymorphonuclear forms. Ultrasound imaging of the abdomen reported minimal free fluid in right iliac fossa. She underwent an appendicectomy through a Lanz incision. The appendix was inflamed and gangrenous. Terminal ileum and caecum were normal on inspection and palpation. On the 4th postoperative day she developed massive upper and central abdominal distension with severe vomiting. Her haematological and biochemical parameters were within normal limits. X-ray of the abdomen revealed intestinal obstruction. She underwent an exploratory laparotomy. There was a firm tubular mass tightly occluding the distal jejunum. The proximal extend of this was occupying the stomach. Through an anterior gastrotomy a black hard block of trichobezoar and its tail-like extension to the jejunum were retrieved”(Nair 1).
Now if that’s not an incentive to seek treatment, or “cure” her disorder, I don’t know what is. In a funny (not so funny) way, Rapunzel syndrome is like an overdose: HAIR KILLS!
Important Noted Information Regarding: Trichotillomania, Trichophagia, Rapunzel Syndrome, and Trichobezoars-
“Trichotillomania in children is a habit disorder and thus has a better prognosis in most cases. However, in adults the psychopathology is usually deeper and thus entails a poor prognosis. Trichotillomania can have a biological basis as two mutant versions of the gene SLITKR1 were found to be more common in trichotillomania patients. These mutations were found to account for only a small percentage of cases. Treatment modalities vary in childhood and adult varieties. Apart from psychotherapy, the drug treatment involves several agents including selective serotonin reuptake inhibitors (SSRIs) and domipramine. Recurrence of Rapunzel Syndrome is very uncommon, and does occur only if the patients are left untreated for their underlying problem. Intensive psychiatric follow-up is mandatory for preventing relapses”(Nair 1).
Nair, Manojkumar S., and Balachandran M. Nair. "A rare presentation of Rapunzel syndrome manifesting in the immediate post-appendicectomy period." Internet Journal of Surgery 14 Issue 2 (2008): 13
“Styles of pulling in youths with trichotillomania: Exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms”
My first academic resource, by members of the “Trichotillomania Learning Center-Scientific Advisory Board”(TLC-SAB), discusses a study examining differences in trich severity, phenomenology, comorbid psychiatric symptoms, and functional impact across youths with varying degrees of the disorder. Through the use of an internet survey, individuals between the ages of 10 and 17 years old with chronic hair pulling disorders were asked to participate in order to be assessed as “high-focused” or “low focused,” and either “high-automatic” or “low-automatic” based upon their results.
I decided this would be a beneficial resource since I actually took the survey online at the beginning of the semester (as it is still up). Granted I’m outside the age span, it’s still interesting to read about their results as they may, or may not, pertain to me. It’s also an interesting piece as it pertains to one of the nations most highly regarded research centers for TTM disorder right here on the Milwaukee campus!
Researchers concluded, “Results demonstrated significant differences between pulling styles. More specifically, "high-focused" pullers reported more severe TTM and greater symptoms of anxiety and depression than "low-focused" pullers, and "high-automatic" pullers reported greater symptoms of depression than "low-automatic" pullers. Subsequent analyses suggest that, in comparison to youths with low levels of both automatic and focused pulling, those experiencing high levels of focused pulling but low levels of automatic pulling reported phenomenological differences and were more likely to engage in additional repetitive behaviors (i.e., skin picking, lip/cheek biting)”(TLC-SAB 1).
It’s interesting to understand the detailed differences in disorder for something as “simple” as removing a hair. Knowing now that “high-focused” = More severe TTM/Greater symptoms of anxiety and depression, than “low-automatic” pullers, “low-focused/low-automatic” = Less pulling overall, and “high-focused/low-automatic” = Reported phenomenological differences and more likely to engage in additional repetitive behaviors, will really help support a majority of my thoughts. All the results of this experiment are really saying is the more “conscious” the puller is of his or her actions, the higher level of severity. This may seem obvious, but for all intensive purposes, I’ve needed a reference like this to back up my essay with a well-regarded source, supported by actual research.
Flessner, Christopher A., et al. "Styles of pulling in youths with trichotillomania: Exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms." Behaviour Research & Therapy 46 Issue 9 (2008): 1055- 61. (TLC-SAB)
I decided this would be a beneficial resource since I actually took the survey online at the beginning of the semester (as it is still up). Granted I’m outside the age span, it’s still interesting to read about their results as they may, or may not, pertain to me. It’s also an interesting piece as it pertains to one of the nations most highly regarded research centers for TTM disorder right here on the Milwaukee campus!
Researchers concluded, “Results demonstrated significant differences between pulling styles. More specifically, "high-focused" pullers reported more severe TTM and greater symptoms of anxiety and depression than "low-focused" pullers, and "high-automatic" pullers reported greater symptoms of depression than "low-automatic" pullers. Subsequent analyses suggest that, in comparison to youths with low levels of both automatic and focused pulling, those experiencing high levels of focused pulling but low levels of automatic pulling reported phenomenological differences and were more likely to engage in additional repetitive behaviors (i.e., skin picking, lip/cheek biting)”(TLC-SAB 1).
It’s interesting to understand the detailed differences in disorder for something as “simple” as removing a hair. Knowing now that “high-focused” = More severe TTM/Greater symptoms of anxiety and depression, than “low-automatic” pullers, “low-focused/low-automatic” = Less pulling overall, and “high-focused/low-automatic” = Reported phenomenological differences and more likely to engage in additional repetitive behaviors, will really help support a majority of my thoughts. All the results of this experiment are really saying is the more “conscious” the puller is of his or her actions, the higher level of severity. This may seem obvious, but for all intensive purposes, I’ve needed a reference like this to back up my essay with a well-regarded source, supported by actual research.
Flessner, Christopher A., et al. "Styles of pulling in youths with trichotillomania: Exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms." Behaviour Research & Therapy 46 Issue 9 (2008): 1055- 61. (TLC-SAB)
Tuesday, April 7, 2009
The Silent Incubator
Incubator.
As I was writing my second draft last week I came across an interesting link between developmental processes, brain chemistry, and addictive behavior. While I was contemplating my personal experiences that might of brought me to the position I'm in today, I came across a few articles on the negative effects of incubators. The exploration of my past started with discussing my family history in terms of genetics and traumatic environmental factors. As I began to tell the story of my life I remembered my mother had told me I was forced to live in an incubator for the first three to four weeks of my life, due to an extreme premature birth. Knowing what I know now concerning child development I started thinking of the repercussions an enclosed environment would have on a new born. When you start contemplating the lack of stimulation, and crucial human interaction, it becomes a terrifying thought all by itself.
Granted I probably wouldn't have survived if I didn't have the incubator as an option, the negative reactions of the incubator should not be overlooked. That's how I concluded on writing about the negative effects of incubators, outlined in a flyer titled, "Audio Integrated ANC for Infant Incubators." "Negative effects of incubator noise: auditory damage, irregular oxygen saturation, disturbed sleep cycles, delayed speech and learning development, sensorineural hearing loss"(NIU 1). As discussed in my second draft oxygen flow (especially with a newly born), disturbed sleep, and delayed speech and learning development, all go hand in hand with addiction, trich, and a list of other disorders. That's why I found it important to look into this a bit more, since it did happen to me, and let alone the importance of the first 5 years, but the first month, it probably had more of an impact on me than I would of thought. Also, being that premature probably didn't help.
http://www.niu.edu/ee/labs/files/Audio%20Integrated%20ANC%20for%20Infant%20Incubators.pdf
As I was writing my second draft last week I came across an interesting link between developmental processes, brain chemistry, and addictive behavior. While I was contemplating my personal experiences that might of brought me to the position I'm in today, I came across a few articles on the negative effects of incubators. The exploration of my past started with discussing my family history in terms of genetics and traumatic environmental factors. As I began to tell the story of my life I remembered my mother had told me I was forced to live in an incubator for the first three to four weeks of my life, due to an extreme premature birth. Knowing what I know now concerning child development I started thinking of the repercussions an enclosed environment would have on a new born. When you start contemplating the lack of stimulation, and crucial human interaction, it becomes a terrifying thought all by itself.
Granted I probably wouldn't have survived if I didn't have the incubator as an option, the negative reactions of the incubator should not be overlooked. That's how I concluded on writing about the negative effects of incubators, outlined in a flyer titled, "Audio Integrated ANC for Infant Incubators." "Negative effects of incubator noise: auditory damage, irregular oxygen saturation, disturbed sleep cycles, delayed speech and learning development, sensorineural hearing loss"(NIU 1). As discussed in my second draft oxygen flow (especially with a newly born), disturbed sleep, and delayed speech and learning development, all go hand in hand with addiction, trich, and a list of other disorders. That's why I found it important to look into this a bit more, since it did happen to me, and let alone the importance of the first 5 years, but the first month, it probably had more of an impact on me than I would of thought. Also, being that premature probably didn't help.
http://www.niu.edu/ee/labs/files/Audio%20Integrated%20ANC%20for%20Infant%20Incubators.pdf
Pleasure Systems In The Brain.
Pleasure.
For my third annotation I decided to talk about this page on the "reward system," or rather the reward pathway, or reward circuit (mesolimbic system), of the brain. When it comes to discussing, not only drug addiction, but all forms of addiction it's important to understand the way our brain "learns," or conditions itself, when it comes to "receiving rewards."
"Neurological research has identified a biological mechanism mediating behavior motivated by events commonly associated with pleasure in humans. These events are termed "rewards" and are viewed as primary factors governing normal behavior. The subjective impact of rewards (e.g., pleasure) can be considered essential (e.g., Young, 1959) or irrelevant (e.g., Skinner, 1953) to their effect on behavior, but the motivational effect of rewards on behavior is universally acknowledged by experimental psychologists"(Bozarth 1). This stands as the introduction to Bozarth's essay on "pleasure systems in the brain. He basically describes how our behavior is governed from a biological, or chemical, stand point in the brain. Bozarth defines "rewards" in the brain as general feelings of pleasure in humans, something easily achieved through the use of addictive substances, or in terms of my discussion, trich disorder.
As previously discussed, since the actions associated with trich (i.e. hair plucking) are known to be a stress relieving activity, associated with the chemical interaction created from the removal of the hair follicle, it can just as easily become an addictive habit. Thus, by creating a "reward" path of removing the hair and releasing the "pleasure" chemicals in the brain, trich can become uncontrollable.
"Some drugs delivered intravenously can serve as rewards. Most drugs that are self-administered by humans are also self-administered by laboratory animals. The most potent drug rewards include the psychomotor stimulants (e.g., amphetamine, cocaine) and the opiates (heroin, morphine). These drugs are self-administered by laboratory animals that have surgically implanted intravenous catheters. Animals quickly learn to press a lever to intravenously self-administer drugs such as cocaine and heroin. This experimental preparation provides an animal model of human drug-taking behavior and hence a method to study the reinforcing properties of drugs; this reinforcing drug-action forms the basis for drug addiction in humans (see Bozarth, 1987b, 1990). It is important to note that addiction is defined as a behavioral syndrome where a drug seems to exert extreme control over the individual's behavior and is not defined by physiological withdrawal reactions such as those accompanying abstinence from some drugs"(Bozarth 2). This excerpt from Bozarth's essay does a nice job of showing how addiction, and the reward path of the brain go hand in hand. It more or less provides the scientific chemical and biological means of addiction. As specifically talked about in this article, after the "pathway" is created the drive becomes more intense to reach the same state of pleasure, and with the ease of pushing a lever, or simply using a drug, why wouldn't you? The scary thing is this so happens to be the way our brain learns, thinking from an unfashionable standpoint, and thus governing out behavior.
http://www.addictionscience.net/ASNreport01.htm
From M.A. Bozarth (1994). Pleasure systems in the brain. In D.M. Warburton (ed.), Pleasure: The politics and the reality (pp. 5-14 + refs). New York: John Wiley & Sons. (Note: Minor typographical errors appearing in the published version have been corrected.)
Bozarth, Michael A. Addiction Science Network. 6 Apr. 1994. State University of New York at Buffalo. 5 Apr. 2009.
For my third annotation I decided to talk about this page on the "reward system," or rather the reward pathway, or reward circuit (mesolimbic system), of the brain. When it comes to discussing, not only drug addiction, but all forms of addiction it's important to understand the way our brain "learns," or conditions itself, when it comes to "receiving rewards."
"Neurological research has identified a biological mechanism mediating behavior motivated by events commonly associated with pleasure in humans. These events are termed "rewards" and are viewed as primary factors governing normal behavior. The subjective impact of rewards (e.g., pleasure) can be considered essential (e.g., Young, 1959) or irrelevant (e.g., Skinner, 1953) to their effect on behavior, but the motivational effect of rewards on behavior is universally acknowledged by experimental psychologists"(Bozarth 1). This stands as the introduction to Bozarth's essay on "pleasure systems in the brain. He basically describes how our behavior is governed from a biological, or chemical, stand point in the brain. Bozarth defines "rewards" in the brain as general feelings of pleasure in humans, something easily achieved through the use of addictive substances, or in terms of my discussion, trich disorder.
As previously discussed, since the actions associated with trich (i.e. hair plucking) are known to be a stress relieving activity, associated with the chemical interaction created from the removal of the hair follicle, it can just as easily become an addictive habit. Thus, by creating a "reward" path of removing the hair and releasing the "pleasure" chemicals in the brain, trich can become uncontrollable.
"Some drugs delivered intravenously can serve as rewards. Most drugs that are self-administered by humans are also self-administered by laboratory animals. The most potent drug rewards include the psychomotor stimulants (e.g., amphetamine, cocaine) and the opiates (heroin, morphine). These drugs are self-administered by laboratory animals that have surgically implanted intravenous catheters. Animals quickly learn to press a lever to intravenously self-administer drugs such as cocaine and heroin. This experimental preparation provides an animal model of human drug-taking behavior and hence a method to study the reinforcing properties of drugs; this reinforcing drug-action forms the basis for drug addiction in humans (see Bozarth, 1987b, 1990). It is important to note that addiction is defined as a behavioral syndrome where a drug seems to exert extreme control over the individual's behavior and is not defined by physiological withdrawal reactions such as those accompanying abstinence from some drugs"(Bozarth 2). This excerpt from Bozarth's essay does a nice job of showing how addiction, and the reward path of the brain go hand in hand. It more or less provides the scientific chemical and biological means of addiction. As specifically talked about in this article, after the "pathway" is created the drive becomes more intense to reach the same state of pleasure, and with the ease of pushing a lever, or simply using a drug, why wouldn't you? The scary thing is this so happens to be the way our brain learns, thinking from an unfashionable standpoint, and thus governing out behavior.
http://www.addictionscience.net/ASNreport01.htm
From M.A. Bozarth (1994). Pleasure systems in the brain. In D.M. Warburton (ed.), Pleasure: The politics and the reality (pp. 5-14 + refs). New York: John Wiley & Sons. (Note: Minor typographical errors appearing in the published version have been corrected.)
Bozarth, Michael A. Addiction Science Network. 6 Apr. 1994. State University of New York at Buffalo. 5 Apr. 2009
Tuesday, March 31, 2009
Revised Proposal
In order to relate with the members of my group, my revised proposal discussed my interpretation of the academic approach. I discussed how I’ll be using my own personal experiences as way to further understand my topic, and by developing my thoughts over the course of the semester I hope to have a firm understanding on the relationship between Trich and addiction. When I first started searching for a topic I settled on the idea of Trich very quickly. I knew it was something I wanted to learn more about, for myself, as well as for others. After I started to develop my research project, and learn more about my topic, I decided to look into the link between Trich and substance abuse. In other words, how Trich is a form of addiction rather than a simple compulsive disorder.
Saturday, March 28, 2009
The 9 Minute Trichotillomania Cure!!!
THE CURE!!!
For my second blog post I wanted to write about this website I found claiming to have the “nine minute cure to Trichotillomania.” That being said, I would like to start off by saying before I even read it I doubted this lonely blog post had the cure-all concerning Trich, and after reading it over I was most definitely right. With that in mind I didn’t really choose this source for it’s “cure,” but rather it’s explanation of the disease. As I was scrolling down the page I came across a heading that said “Common trichotillomania symptoms include…” and here’s the list that followed:
1) Obsessive hair pulling that results in serious hair loss…
2) A sharp increase in tension right before you begin pulling your hair out.
3) An immediate sense of pleasure when pulling hair out.
4) Extreme distress in your social life, job, and every area of your life is affected by this condition.
Coincidentally I found a similar list of symptoms concerning heroin use…
1) Obsessive heroin use results in hair loss…
2) A sharp increase in tension right before heroin is injected.
3) An immediate sense of pleasure when heroin is injected.
4) Extreme distress in your social life, job, and every area of your life is affected by this condition.
Truth be told, the list of symptoms regarding heroin use is something I came up with, and while it may seem a bit funny, or out of place, the reality is everything I said is completely true. As I continued reading the article I found an interesting quote, “This is the dangerous cycle of trichotillomania, it actually becomes addicting to pull your hair out.” Well go figure!!!
As I was explaining in my previous post, recovery from chemical dependency may be perceived as a harder task than treating Trich, but is it really? When an outside chemical is introduced to the brain, especially a chemical it enjoys, a “path” or connection is made, usually one that leads to use in the future as a means of coping. When recovering addicts remove the chemical as the normal course of action when dealing with stress the brain craves it, it needs more and more. This is the reason for so many cases of failure with recovery, commonly referred to as a “relapse.” When connections are made in the brain chemically as a means of dealing with stress, which could be referred to as the “easy way out,” it becomes tremendously hard to reverse.
Incidentally, pulling hair also creates a chemical response in the brain, one that if abused could potentially lead to a full-blown Trich disorder…and guess what? HARD TO REVERSE! Since I want to be scientifically correct with what I’m trying to explain here I started searching for the “feel good” chemical pathway in the brain…I knew there was one, but I forgot the details….it’s been awhile since I learned the material, when I came across this, a “hair pulling scalp massage!”
Apparently “pulling hair” can be so enjoyable people will even pay for it, or in some cases demand it during sex! Now obviously in 99% of these cases the hair isn’t actually removed, but for individuals with Trich that do…can’t you imagine the RUSH!?!? So what is a “hair pulling massage?” According to the massage website, “A Gentle but firm pressure is used to glide from your scalp to the ends of each small section of hair. The resulting pressure at and beneath your scalp is both pleasurable and beneficial. Hair pulling scalp massage causes a release of tension in the micro muscles surrounding each hair follicle, restoring pliability to your scalp, and causing the relaxation response in your entire body.” …key words here being, “relaxation response in your entire body.” The page continued, “…The relaxation response lowers your heart rate and blood pressure, slows respiration, neutralizes stress chemicals, and counteracts the “fight or flight” response.”
“The hair pulling scalp massage releases endorphins, your body’s own natural pain killers, it is effective for: headaches (including migraines and sinus), whiplash, neck and shoulder tension, TMJ dysfunction syndrome, neurological trauma, nerve injury, body aches and stiffness, mental tension, and emotional upset. Taking into consideration that Trich is a destructive process unlike the scalp massage; there are still many similarities in effect.
That being said, Trich is similar to chemical dependency in that they both potentially involve chemical interaction with the brain. If an individual begins pulling their hair out as a means of coping, releasing the endorphins, he or she might have a hard time refraining from this course of action when confronted with stressful situations in the future. So for anyone out there with Trich that feels hopeless over something that might not be viewed as a “major issue” by the eyes of society, I say to you, find it as problem, find help, you’re addicted…Shit, I’m addicted.
“Hair Pulling Scalp Massage” Information.
Other interesting information from the “cure” article:
What Are Secondary Symptoms Of Trichotillomania?
Other common symptoms of trichotillomania include skin picking, nail biting, high levels of anxiety, panic attacks, obsessive thoughts.
Most trichotillomania suffers have embarrassment, frustration, shame, and depression about the condition...plus was worst is most people never want to share this condition with anyone, which makes it very difficult to get others to help you.
Denial of the condition is very common.
A bowel infection will be caused if the hair that is pulled is eaten on a consistent basis.
Why Do You Pull Out Your Hair?
Trichotillomania sufferers have developed what psychologists call "secondary gain." You unconsciously have a secondary gain for pulling out your hair. Some female sufferers even do it to sabotage their success with men because they do not like being hit on by the opposite sex.
What you must realize is that absolutely everything you do is out of a need to gain pleasure and avoid pain.
You're brain is wired to do this, it is your basic survival instincts to move towards pleasure and move away from pain.
Your brain always has a positive intent...even if it is pulling out your hair.
For my second blog post I wanted to write about this website I found claiming to have the “nine minute cure to Trichotillomania.” That being said, I would like to start off by saying before I even read it I doubted this lonely blog post had the cure-all concerning Trich, and after reading it over I was most definitely right. With that in mind I didn’t really choose this source for it’s “cure,” but rather it’s explanation of the disease. As I was scrolling down the page I came across a heading that said “Common trichotillomania symptoms include…” and here’s the list that followed:
1) Obsessive hair pulling that results in serious hair loss…
2) A sharp increase in tension right before you begin pulling your hair out.
3) An immediate sense of pleasure when pulling hair out.
4) Extreme distress in your social life, job, and every area of your life is affected by this condition.
Coincidentally I found a similar list of symptoms concerning heroin use…
1) Obsessive heroin use results in hair loss…
2) A sharp increase in tension right before heroin is injected.
3) An immediate sense of pleasure when heroin is injected.
4) Extreme distress in your social life, job, and every area of your life is affected by this condition.
Truth be told, the list of symptoms regarding heroin use is something I came up with, and while it may seem a bit funny, or out of place, the reality is everything I said is completely true. As I continued reading the article I found an interesting quote, “This is the dangerous cycle of trichotillomania, it actually becomes addicting to pull your hair out.” Well go figure!!!
As I was explaining in my previous post, recovery from chemical dependency may be perceived as a harder task than treating Trich, but is it really? When an outside chemical is introduced to the brain, especially a chemical it enjoys, a “path” or connection is made, usually one that leads to use in the future as a means of coping. When recovering addicts remove the chemical as the normal course of action when dealing with stress the brain craves it, it needs more and more. This is the reason for so many cases of failure with recovery, commonly referred to as a “relapse.” When connections are made in the brain chemically as a means of dealing with stress, which could be referred to as the “easy way out,” it becomes tremendously hard to reverse.
Incidentally, pulling hair also creates a chemical response in the brain, one that if abused could potentially lead to a full-blown Trich disorder…and guess what? HARD TO REVERSE! Since I want to be scientifically correct with what I’m trying to explain here I started searching for the “feel good” chemical pathway in the brain…I knew there was one, but I forgot the details….it’s been awhile since I learned the material, when I came across this, a “hair pulling scalp massage!”
Apparently “pulling hair” can be so enjoyable people will even pay for it, or in some cases demand it during sex! Now obviously in 99% of these cases the hair isn’t actually removed, but for individuals with Trich that do…can’t you imagine the RUSH!?!? So what is a “hair pulling massage?” According to the massage website, “A Gentle but firm pressure is used to glide from your scalp to the ends of each small section of hair. The resulting pressure at and beneath your scalp is both pleasurable and beneficial. Hair pulling scalp massage causes a release of tension in the micro muscles surrounding each hair follicle, restoring pliability to your scalp, and causing the relaxation response in your entire body.” …key words here being, “relaxation response in your entire body.” The page continued, “…The relaxation response lowers your heart rate and blood pressure, slows respiration, neutralizes stress chemicals, and counteracts the “fight or flight” response.”
“The hair pulling scalp massage releases endorphins, your body’s own natural pain killers, it is effective for: headaches (including migraines and sinus), whiplash, neck and shoulder tension, TMJ dysfunction syndrome, neurological trauma, nerve injury, body aches and stiffness, mental tension, and emotional upset. Taking into consideration that Trich is a destructive process unlike the scalp massage; there are still many similarities in effect.
That being said, Trich is similar to chemical dependency in that they both potentially involve chemical interaction with the brain. If an individual begins pulling their hair out as a means of coping, releasing the endorphins, he or she might have a hard time refraining from this course of action when confronted with stressful situations in the future. So for anyone out there with Trich that feels hopeless over something that might not be viewed as a “major issue” by the eyes of society, I say to you, find it as problem, find help, you’re addicted…Shit, I’m addicted.
“Hair Pulling Scalp Massage” Information.
Other interesting information from the “cure” article:
What Are Secondary Symptoms Of Trichotillomania?
Other common symptoms of trichotillomania include skin picking, nail biting, high levels of anxiety, panic attacks, obsessive thoughts.
Most trichotillomania suffers have embarrassment, frustration, shame, and depression about the condition...plus was worst is most people never want to share this condition with anyone, which makes it very difficult to get others to help you.
Denial of the condition is very common.
A bowel infection will be caused if the hair that is pulled is eaten on a consistent basis.
Why Do You Pull Out Your Hair?
Trichotillomania sufferers have developed what psychologists call "secondary gain." You unconsciously have a secondary gain for pulling out your hair. Some female sufferers even do it to sabotage their success with men because they do not like being hit on by the opposite sex.
What you must realize is that absolutely everything you do is out of a need to gain pleasure and avoid pain.
You're brain is wired to do this, it is your basic survival instincts to move towards pleasure and move away from pain.
Your brain always has a positive intent...even if it is pulling out your hair.
Claire's Trich Poem In Relation To Chemical Dependency
"Claire's Trich poem"
I decided to write about this as the first entry to my blog, not necessarily for it’s educational purposes, but because it got me thinking about my topic in a general manor. As you may or may not know, my goal is to find the link between Trich and other addictive behavior. For instance, lets say you happen to be an individual with Trich as well as an alcoholic. One day you decide, “I have a really bad drinking problem, I think I might need to get help.” My question is, if Trich goes untreated will treatment for alcoholism continue successfully? Or just the same, will treatment for Trich be delayed if the alcoholism goes on untreated?
Socially understanding that alcoholism tends to be difficult to treat, it’s important to understand that some cases of Trich can be just as difficult to manage. Although Trich is labeled as more of a compulsion than an addiction, like alcoholism, they both share common triggers of use or action. To make the separation more clear, alcoholism involves chemical dependency, where as Trich is simply an “addictive behavior.” The connections in the brain that are made concerning substance abuse and Trich are the same in that they both have closely related triggers, whatever they may be. So the difference in recovery is not necessarily determining the cause, but rather removing an intentional chemical reaction with one, and not the other. This is how they are different, but just as important, related.
That being said the larger question in regard to my example is if an individual is being treated for substance abuse will the triggers that cause Trich simply deplete alongside the chemical dependency treatment? It’s not my assumption that the Trich will stop completely by it’s own, but I have a strong feeling that the effects of Trich will deplete drastically over time.
This poem shows one thing if for sure, Trich is psychologically damaging, just like all other addictions. Most people suffering from addiction feel alone; feel as if they’re the only ones. They get down on themselves and ask questions like, “why me?” They also show the same detail in regard to covering up the issue. Most people suffering from addiction try to cover it up, or act like it isn’t happening. This is the same for those suffering with Trich. It’s common to attempt covering up the problem, which is why many cases of Trich go unnoticed.
So the point is there are most definitely connections between Trich and problems concerning addictions, other than the fact they both show repetitive behavior. They both show the same reasons for continued action, and although some addictions concerning chemical dependency may be harder to treat they are both undoubtedly in the same ballpark.
I decided to write about this as the first entry to my blog, not necessarily for it’s educational purposes, but because it got me thinking about my topic in a general manor. As you may or may not know, my goal is to find the link between Trich and other addictive behavior. For instance, lets say you happen to be an individual with Trich as well as an alcoholic. One day you decide, “I have a really bad drinking problem, I think I might need to get help.” My question is, if Trich goes untreated will treatment for alcoholism continue successfully? Or just the same, will treatment for Trich be delayed if the alcoholism goes on untreated?
Socially understanding that alcoholism tends to be difficult to treat, it’s important to understand that some cases of Trich can be just as difficult to manage. Although Trich is labeled as more of a compulsion than an addiction, like alcoholism, they both share common triggers of use or action. To make the separation more clear, alcoholism involves chemical dependency, where as Trich is simply an “addictive behavior.” The connections in the brain that are made concerning substance abuse and Trich are the same in that they both have closely related triggers, whatever they may be. So the difference in recovery is not necessarily determining the cause, but rather removing an intentional chemical reaction with one, and not the other. This is how they are different, but just as important, related.
That being said the larger question in regard to my example is if an individual is being treated for substance abuse will the triggers that cause Trich simply deplete alongside the chemical dependency treatment? It’s not my assumption that the Trich will stop completely by it’s own, but I have a strong feeling that the effects of Trich will deplete drastically over time.
This poem shows one thing if for sure, Trich is psychologically damaging, just like all other addictions. Most people suffering from addiction feel alone; feel as if they’re the only ones. They get down on themselves and ask questions like, “why me?” They also show the same detail in regard to covering up the issue. Most people suffering from addiction try to cover it up, or act like it isn’t happening. This is the same for those suffering with Trich. It’s common to attempt covering up the problem, which is why many cases of Trich go unnoticed.
So the point is there are most definitely connections between Trich and problems concerning addictions, other than the fact they both show repetitive behavior. They both show the same reasons for continued action, and although some addictions concerning chemical dependency may be harder to treat they are both undoubtedly in the same ballpark.
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