Trichotillomania (a psychological disorder related to impulse control, which leads the affected person to pull out their hair), although it can cause physical damage, is not considered self-harm. Trichotillomania typically has a compulsive component, and in most cases, this behavior is carried out with little to no awareness of it. Self-harm is a distinct phenomenon, and it is important to differentiate it from other similar behaviors, as the treatment is different.