QUESTION:

My mother has BPD. I have Post Traumatic Stress Disorder, Major Depression and Trichotillomania. My questions are: what is the relation between all these labels? Secondly, when I sit alone at night and pull hair, I go into a trance. Is the trance part of the PTSD's "numbing" or is it part of the TTM?

DR. HELLER'S ANSWER:

First of all they're not labels but medical diagnoses. Lazy, stupid, fat, etc. are labels.

Trichotillomania seems to have two causes, although others are possible as well. I have about a dozen patients with it, and these two have always been present: BPD and OCD.

Sometimes hair pulling is an obsession/ritual behavior that reduces anxiety. Sometimes it's a self-destructive BPD dysphoria symptom - since it stops the dysphoria.

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