Other anxiety related
diagnoses that can cause
the psychosocial maladaptation
is hair pulling.
Hair pulling, the patients I have
seen who have trichotillomania.
I have seen people who I would not
know they had trichotillomania until,
after they feel comfortable with
me, they put their hair up,
and I noticed big
circles of baldness,
or they may not have any eyebrows
and they have just pulled
all the eyebrows out and
they will put a pencil mark
or I might notice on their arms,
that there are patches circles
where there is no hair.
These are anxiety related diagnosis because
when the person is pulling their hair,
they actually have
a momentary relief
from that level of anxiety
that they chronically feel.
Hoarding is another psychosocial
maladaption to anxiety.
Hoarding is when people are
unable to part with possessions,
regardless of their worth.
And homes can become unlivable.
If you have ever been in the
home of a person who hoards,
there may be just a small center
line that you can walk through.
I've had to visit homes, where young
adults that I have been treating,
I can't understand where their
anxiety disorders are coming from.
And when I asked to
do a house visit,
I find out that one or both
of their parents are hoarders
and there is stuff everywhere, and they
are not allowed to throw anything out.
And it has given rise
to their own anxiety.
There's also body dysmorphic.
And if a person has anxiety
related to body dysmorphic,
they believe that their
body is defective.
They believe that there
is a true defective area
or possibly the whole body
and they see it as defective.
Now body dysmorphic belongs to something
called the somatoform disorders.
Somatoform disorders present
as physical symptoms,
symptoms that would normally point
to a medical disease process.
But when we investigate them,
we find that there are no
organic pathological processes,
or any other mechanisms that would
support the medical diagnosis.
All are associated with
and very long term help seeking.
And it is difficult.
Because when persons who have somatoform
disorders get an actual disease,
oftentimes it's hard for them to find
practitioners who take them seriously.
Now, their presentation might include
pain, for example, maybe stomach pains,
or sexual symptoms or or
For example, they might say,
"I'm paralyzed, my left leg is paralyzed."
And when they walk in, it's like,
you really see a person who can't walk.
Or they might say,
"I'm seeing double."
They might actually be blind.
They tell you, they are
blind, they are blind.
But when you actually go
and you do all the tests,
you can't find any facts that
support either their GI symptoms,
or the sexual symptoms,
or the neurological symptoms.
Other somatoform disorders
And hypochondriasis is when the person
is telling you what's wrong with them
and there is nothing that
you can find wrong with them.
So if you have in your lexicon now, "Oh,
that person is such a hypochondriac."
You want to take that
out of your lexicon,
because it is a
And the person is not doing
this just to make it up.
They are feeling what
they're telling you
even though there
is no medical basis.
There is conversion
disorder where the person
might have a loss or change in
one of their body functions.
They may have a pain disorder
or they might have a somatization
disorder with they come in
multiple somatic symptoms.