Beyond the Mirror: Insights into Body Dysmorphic Disorder

BY: Neighbors’ Consejo|

Body Dysmorphic disorder (BDD) is a deeply distressing mental health condition that significantly impacts an individual’s perception of their own appearance. While many people have moments of insecurity, BDD involves an obsessive focus on perceived flaws, leading to severe emotional and psychological distress. This article delves into the complexities of BDD, exploring its symptoms, causes, and the profound effects it has on daily life. By examining personal experiences and current research, we aim to shed light on this often-misunderstood disorder and discuss effective approaches to treatment and support.

“Whether you are someone living with BDD, a family member or a professional who treats it, knowing the many ways that it can impact someone is an important step in the process of recovery”:

  • Probably the most alarming affects is the remarkably high suicide attempt rate amongst those with BDD, which is about 25%. Families and clinicians need to be keenly aware that this is a very high-risk population. Being mindful of doing a periodic risk assessment is very important. If someone is actively suicidal, hospitalization may be necessary to keep the person safe.
  • Depression, very few people with BDD report not suffering from depression, at least at some point. Fortunately, the medications most often used to treat BDD, the SSRI’s, are all anti-depressants.
  • Family problems. While the person with BDD obviously struggles the most, family members suffer, too. Watching someone you love get caught in the web of BDD is a terrifying experience. Worse is seeing the same person refuse psychological help and feeling paralyzed to help in any productive way.
  • Social isolation and anxiety: when one feels that he/she looks disgusting, social isolation seems like a natural consequence. Whether it is fearing rejection or the fear of being ridiculed because of their appearance or even because they may feel underserving of social contact, many people with BDD live a life of isolation.

The article “The Prevalence and Characteristics of Body Dysmorphic Disorder Among Adults in Makkah City, Saudi Arabia.”, mentions, “BDD patients have constant worries, anxiety, and sadness about their looks in a way that causes a significant impairment of function and interferes with their lives. They strongly believe they have a defect in their appearance, which makes them ugly or deformed. As a result, they become stressed.” Mayo Clinic considers that some symptoms are:

  • Being extremely preoccupied with a perceived flaw in appearance that to others can’t be seen or appears minor.
  • Strong belief that you have a defect in your appearance that makes you ugly or deformed.
  • Belief that others take special notice of your appearance in a negative way or mock you.
  • Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming or skin picking.
  • Attempting to hide perceived flaws with styling makeup or clothes.
  • Constantly comparing your appearance with others.
  • Frequently seeking reassurance about your appearance from others.
  • Having perfectionist tendencies.
  • Seeking cosmetic procedures with little satisfaction.
  • Avoiding social situations.

The International OCD Foundation mentions some important figures: “BDD affects an even higher proportion of people who are seen in a various health care settings (e.g., cosmetic surgery, cosmetic dental, adult orthodontia, dental, or mental health settings). For example, the prevalence of BDD is 11-13% in dermatology settings, 13-15% in general cosmetic surgery settings, and 20% in rhinoplasty surgery settings. BDD is more common in women than in men in general population studies (approximately 60% women versus 40% men) However, it is more common in men than in women in cosmetic surgery and dermatology settings.”

How is body dysmorphic disorder diagnosed? John Hopkins Medicine affirms, “a mental health professional will diagnose BDD based on your symptoms and how much they affect your life: You must be abnormally concerned about a small or nonsexist body flaw; your thoughts about your body flaw must be severe enough that they interfere with your ability to live normally; other mental health disorders must be ruled out as a cause of your symptoms.”

What is the treatment? “Cognitive behavioral therapy (CBT) is the most effective talk therapy. In CBT, you work with a mental health professional to replace negative thoughts and thought patterns with positive thoughts. Antidepressant medicines known as selective serotonin reuptake inhibitors usually work best for BDD.” And the Mayo Clinic affirms, “although there are no medications specifically approved by the U.S. Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental health conditions -such as depression and obsessive-compulsive disorder- can be effective.

In conclusion, Body Dysmorphic Disorder (BDD) is a pervasive and distressing mental health condition that profoundly impacts individuals’ perceptions of their own appearance. The severe emotional and psychological distress associated with BDD necessitates a comprehensive understanding of its symptoms, causes, and effects on daily life. By recognizing the high risk of suicide, depression, and social isolation linked to BDD, we underscore the importance of early diagnosis, effective treatment options like Cognitive Behavioral Therapy (CBT).

References:

Body Dysmorphic Disorder. https://www.hopkinsmedicine.org/health/conditions-and-diseases/body-dysmorphic-disorder.

«Body Dysmorphic Disorder – Symptoms and Causes». Mayo Clinic, https://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/symptoms-causes/syc-20353938.

«Impact of BDD». BDD, https://bdd.iocdf.org/expert-opinions/impact-of-bdd/.

«Prevalence of BDD». BDD, https://bdd.iocdf.org/professionals/prevalence/. Sindi, Samaa A., et al. «The Prevalence and Characteristics of Body Dysmorphic Disorder Among Adults in Makkah City, Saudi Arabia. A Cross-Sectional Study». Cureus, vol. 15, n.o 2, p. e35316. PubMed Central, https://doi.org/10.7759/cureus.35316

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