Isn't this interesting? I was going to ask the very same question! I am 57 and I've been "twisting" my hair since I was nine years old. I used to be punished by my family for it. Once, my dad took scissors to my hair and cut out a huge chunk. (it was very long.) I have tried everything to stop. What I do is a combination of twisting, tying, and then tearing it out. Eventually I regressed to pulling out the twisted knotted strand of hair by the roots. I've been doing this for 48 years, and I can't stop. I've learned over the years coping mechanisms, like playing the piano or typing and I've been crocheting now for a few years. I try to do anything that will keep my hands out of my hair. When I learned what trichotillamania was, I actually cried. Just knowing that there is a name for it has helped. I've gone from long hair to short and then back to long. I do it much worse if my hair is long.
My older sister told me years ago that I was "masturbating" and that really upset me. I was a freak to my entire family.
But my biggest question is, do I have trichotillamania or is twisting and tying my hair in knots, then pulling it out something else...or worse.

pulling your hair out is trichotillomania, not twirling or twisting.

twirling your hair is not trichotillomania. Pulling y0ur hair out is trichotillomania. I wish all I did was twirl.

I actually read recently that twirling/twisting IS a part of trich because the pulling comes right after. There was never a time in my life where I twisted a strand of hair into a freakishly intricate knot and DIDN'T pull or rip it out. I feel a sort of vindication since finding this article. Now I know for a certainty what I've been doing all my life.