Patients with hair-pulling disorder are often accompanied by symptoms such as depressed mood and anxiety, but do not necessarily develop depression; as hair-pulling disorder worsens severe depression may occur, even meeting the diagnostic criteria for depression.
Hair-pulling disorder and anxiety and depressive disorders may co-exist in patients, but it cannot be said that a person with hair-pulling disorder will necessarily become depressed; therefore, the presence of hair-pulling disorder is best treated with active intervention and treatment.