Hair pulling, or trichotillomania, now recognized in humans as an obsessive-compulsive disorder (OCD), was formerly classified as an impulse control disorder. The new definition helps us better understand and determine the cause, course, and therapy of the feline equivalent, psychogenic alopecia. One of the results of compulsive hair pulling in humans and cats is alopecia (baldness). The problem can be so mild as to be barely discernable or so severe as to warrant wigs for affected persons and to make cats diagnosable from the top of a double-decker bus with a telescope turned the wrong way round.
The Humble Beginnings
You’ve probably all seen cats groom themselves nonchalantly in moments of anxiety, stress, or indecision. People engage in similar behavior. If a person is in a situation of conflict, a stop-go situation, such as being stuck in traffic, they too engage in self-grooming to pass time and relieve the stress. Look to the side of you next time you’re stopped at a traffic light. Chances are the person in the car next to you will be looking in the driving mirror, straightening his hair or picking his teeth. These stop-go conflict behaviors are called displacement behaviors because the person or cat, when caught between two opposing objectives or drives, will displace into a third seemingly irrelevant behavior, in this case, self-grooming.
Now picture a situation in which the conflict is chronic and associated with anxiety. In this scenario, the self-grooming displacement behavior will be performed for prolonged periods of time to a point at which it becomes habit and is performed out of context. That is to say, even when the conflict is relieved, the cat (or person) continues to self-groom to the point of overgrooming. At this point, hair, sometimes skin and nails, too, are licked, chewed, damaged, and stripped, leaving telltale signs of depilation and damage. The areas most commonly involved are the abdomen and the inside of the limbs.
At this stage, the condition is diagnosable as OCD. There may be some slight skin damage but more often than not this is not the case. Where nails are chewed these can become shortened and frayed.
There are natural and nurtural components to the condition. It is more prevalent in oriental breeds of cat, possibly because they are more highly strung. Domestic moggies that have had a rough ride growing up, especially those that have been improperly socialized or abused as youngsters, seem to be more prone.
Conditions to “Rule-out”
Medical conditions that can be confused with psychogenic alopecia and must be ruled out before the diagnosis can be confirmed. These are:
The Clinical Picture
Not all cats with psychogenic alopecia respond to SSRIs. For those that don’t, the anxiety-reducing drug buspirone (Buspar) may be tried. It takes at least two weeks for the effects of buspirone to be seen. Side effects of buspirone are uncommon but include increased affection, increased playfulness, occasionally hyperactivity 30-40 minutes post-pilling, and occasional spats of aggression between formerly non-aggressive cats.