Dear Dr. Brothers: I think my friend is depressed. He is totally negative about everything, and doesn’t ever want to leave the house or talk about anything in his life. He’s always been a pretty sarcastic guy, but now this is making it really hard to talk about anything serious. He just laughs it off when he talks about how he hates his job and his life. How can I get through to him if he doesn’t want to talk or even think about his problems? -- M.P.

Dear M.P.: This can be one of the most frustrating things about having a friend who is suffering from depression. In many cases, the person doesn’t want to admit to him- or herself that he or she is depressed, and so he or she certainly will not admit it to you. Having an outsider’s perspective on your friend’s life and being able to critically analyze the things he says and does allow you to see that he may be depressed, while all he sees is his normal day-to-day life. And it’s likely he’s using sarcasm as a tool to avoid delving deeper into the causes of his dissatisfaction.

This may be one case in which it is less important that your friend realize he is depressed as a first step, and more important that he just starts by making a change. It can be really hard to change any aspect of your life, even if it’s one you hate, once you’re comfortable with it. The first step is the hardest. Try to suggest small changes that he could make that might jar him into realizing that he is indeed unhappy, and doesn’t deserve to be. Even if it’s something that doesn’t seem important to you, like a new haircut or a slight change in routine, it could be what he needs to gain some perspective. You can continue to try to talk to him, but the change you’re looking for in his life has to start with him, first and foremost. You should make sure that you’re there for him at every step, and not give up on him out of frustration.

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Dear Dr. Brothers: This may sound like a strange problem, but I can’t stop pulling my hair out. It started because I always used to pull out my eyebrows when I was stressed, but now I can’t stop, and I’ve started pulling out the hair on my head. It looks terrible, and I’m really embarrassed about it, but I still keep doing it, like a compulsion. How can I stop this terrible habit? Is there something really wrong with me? -- G.S.

Dear G.S.: It sounds like you are suffering from a disorder called trichotillomania. This is a neurological disorder that can resemble obsessive-compulsive disorder or a tic disorder, with a focus on pulling your hair out or picking at your skin. Like OCD, you feel a compulsion to do this repetitive behavior of pulling your hair, and can’t seem to stop. The pulling even may feel automatic, or you might feel an uncomfortable sensation that isn’t relieved until you pull again. Trichotillomania is not the same as OCD, though, and the treatments are different.

There is no definite cure for trichotillomania, but there are many options available for treatment. Up to 4 percent of the population is thought to suffer from this disorder, so you are not alone. Even if the urge to pull never totally disappears, you can learn to control it so you don’t have to be embarrassed by it anymore. In terms of treatments, you should see a psychologist. Cognitive behavioral therapy, sometimes in conjunction with certain medications, usually can reduce or eliminate your urge to pull. There also are many resources available on the Internet (you could start at the Trichotillomania Learning Center’s homepage, www.trich.org), from opportunities to connect with other people suffering from this disorder to educational information to treatment options and locations.