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Archive for March, 2008

The Blahs

I’m in an icky mood.  I just feel blah.  I can’t put any further description to it, but I don’t particularly like it.  My mood has been all over the place the past couple days.  I’m irritable and grumpy and lazy.  I can’t figure out why and it is getting on my nerves.  If anything, I should be doing better right now.  Pulling has been frequent too.  I’ve had no real mental capacity to stop myself from pulling.  I have a minimal awareness of it even happening, which is a definite step backwards.  What is going on?

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Anger

Aside from the usual pulling issues, anger has been my problem this week.  Each time I take a shower, I find myself consumed with anger and sadness that the “stylist” cut off so much more length than she was supposed to.  I shampoo my hair and there is just nothing there where it should be.

I know it is stupid, and I know I shouldn’t let it upset me so.  I know that being angry won’t make my hair come back or grow any faster.  More than likely the stress of it causes the opposite to happen.

I try to just breathe through it, let it go, and move on.  I try to be reasonable about the fact that it could/should grow back.  But that doesn’t help me to put my hair in a ponytail now.  It doesn’t help me to cover up the hair piece that I now can’t wear because I don’t have enough length to cover the edges of it.  It makes me sad.  It makes me upset that I have $120 in various hair pieces that I can’t use at all right now.

In the end, I guess I should be glad to have this problem at all.  I could be back wearing wigs again and constantly worrying that the wind will blow that off rather than just showing a bare spot on my head.  I know it is all relative, and maybe with it short I will discover something new I can do with my hair that I’d never thought of before.

I just have to figure out how to stop being so angry that this happened.  Suggestions?

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Aaargghhh :-(

I’m really really sad.  I went to get my hair trimmed up today and she didn’t do what I wanted at all.  My husband says “don’t worry it will grow back.”  I know that in theory it will.  I have TTM though.  That makes the whole growing thing a whole lot harder.  I worked for a year to get any length at all and now it is almost all gone.  I’m afraid since I don’t like it at all, that it is going to make it even harder to resist pulling it all out.  I had it to the point that I could pull it back into a ponytail for dance class and then wear a scarf over the bangs area.  I can’t really do that now.  It doesn’t cover the bald spots like it used to.  I told her I wanted it to brush just above my shoulders, but it is more like 3 inches above my shoulder.  Even if I brush it perfectly straight it hardly brushes above my shoulder.

I really could cry.

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Olanzapine helped trichotillomania in small study.(Clinical Rounds)

Jane Salodof MacNeil . Skin & Allergy News.  March 2007 v38 i3 p61(1).
Full Text: COPYRIGHT 2007 International Medical News Group

PARIS — Trichotillomania was highly responsive to olanzapine in a small, randomized, placebo-controlled trial that suggests repetitive hair-pulling may be closer to tics and Tourette’s syndrome than to other obsessive-compulsive disorders.
Eleven of 13 patients (85%) on olanzapine (Zyprexa) improved during the 12-week trial reported by Dr. Michael Van Ameringen at the annual congress of the European College of Neuropsychopharmacology. Only 2 of 12 patients (17%) on placebo were able to stop pulling out their hair.
Dr. Van Ameringen, codirector of the anxiety disorders clinic at McMaster University in Hamilton, Ont., said he and his colleagues began testing antipsychotics because treatments for obsessive-compulsive disorder have been largely ineffective in patients with trichotillomania.
The investigators wondered, he said, whether the condition might be closer to tics and Tourette’s syndrome, disorders characterized by compulsive urges and ritualistic behavior that also do not respond to the selective serotonin reuptake inhibitors (SSRIs) used for obsessive-compulsive disorder.
“We found a very robust effect in our study (85% vs. 17%)…. It would be one of the biggest drug-placebo differences in psychiatry if it holds up in larger trials,” Dr. Van Ameringen said in an interview at the meeting.
The investigators had previously studied haloperidol (Haldol) with good results in this population though not in a placebo-controlled trial, he said. They also have had positive clinical experiences with risperidone (Risperdal) and quetiapine (Seroquel), he added.
Dr. Van Ameringen said he would like to see a large, randomized controlled trial with one of the new atypical antipsychotics if he could find funding. Eli Lilly Canada provided medication for the olanzapine trial.
The 25 participants ranged in age from 18 to 35 years, with a mean age of 33 years and an average duration of illness of 21 years. The mean age of onset of trichotillomania was 12 years. Seventeen patients were female.
Nearly two-thirds of the patients had no previous treatment for trichotillomania, despite a Clinical Global Impression-Severity (CGI-S) score of 4 or more at baseline. The scalp was the most common hair-pulling site. Next were the eyebrows and eyelashes.
Patients randomized to olanzapine started on 2.5 rag/day for the first 3 weeks. The dose could be titrated up to 20 mg/day for the last 4 weeks. It was titrated down for 1 week before being stopped after completion of the study. The average dose at the end point was 10.8 mg/day of olanzapine and 19.2 mg/day of placebo.
Investigators used several outcome measures, including photographs, the Structured Clinical Interview for DSM-IV, and the Minnesota Trichotillomania Assessment Inventory. The CGI-Improvement scale was the primary efficacy measure.
All but two patients finished the trial; both dropouts were in the placebo group at week 10.
Dr. Van Ameringen reported the average time to treatment response was 8.2 weeks with olanzapine and 10 weeks with placebo.
The investigators calculated the effect size as 1.34 on the CGI-S scale and 1.01 on the Yale-Brown Obsessive-Compulsive Severity Scale for trichotillomania.
All patients but four (who were in the placebo group) experienced side effects during the trial, Dr. Van Ameringen said.
Dry mouth and fatigue were the most common adverse events reported with olanzapine, each occurring in 54% of patients. Other common side effects were increased appetite (46%), headache (39%), and weight gain (39%).
Trichotillomania patients can tolerate the side effects, Dr. Van Ameringen said. “When they start gaining weight, then we switch to a different atypical.”
BY JANE SALODOF MACNEIL

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Yep, that would be me.  Well, not really.  I just have felt really busy lately.  My blogs have been suffering as a result.  In addition, I just haven’t had much to post about it.  The pulling is just the same old thing.  Some days are decent.  Some days are really bad.  The Effexor is helping some with my mood, but not like when I first started taking it.  I still have this underlying “blah” feeling and no motivation to do anything.  I get interested in doing something, but can’t seem to get myself together enough to actual do it unless I’m pushed by some outside force, like my husband.

My headaches have been worse lately too, so that doesn’t help.  Tonight I want to get sewing and baking done.  I have time, but I don’t feel good.  The idea of committing the brain power to complete either task just does not appeal to me.  Going to bed or sitting on the couch sounds much better.  Ugh.  It is ongoing for me.

I’m trying some new things lately.  I’m starting my Holy Basil again.  It is an herbal supplement recommended by my friend, a homeopathic practioner.  It helps to block corizol, the stress hormone.  I was taking it a year ago when I had success in growing my hair out.  I stopped taking it after the wedding, assuming that I wouldnt’ need it after wedding planning was finished.  But, just in case it really was what helped me to stop pulling for a while, I’m taking it again.  In addition, I’m becoming religious in listening to my audio books in the car and sometimes in the house.  The only place I can’t do it is at the computer, because I can’t listen to the story and type out thoughts at the same time.  I’ve also started seeing a kinesologist about my headaches to see if he can help me any more than other doctors have.  I’ve only been in for two appointments, but I’m hoping that if their “magic” works and my system gets itself all balanced out, maybe the serotonin will start flowing and the pulling will subside, or at least the urges will be easier to fight.

I’ll keep you posted.

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