Body Dysmorphic Disorder

Body Dysmorphic Disorder is an obsessive fixation with an imagined defect in one’s physical appearance or an exaggerated concern about a minimal defect which causes a significant disruption in the individual’s life. The concern is mostly concentrated on facial features, hair or odor. It often develops in adolescence and becomes chronic, leading to internal suffering. Often referred to as “imagined ugliness”, it is estimated that 1 in 50 people suffer from Body Dysmorphic Disorder.

According to the American Psychiatric Association, there are three major components of BDD. One involves the individual’s constant worry with an imagined defect in their appearance, creating more of an obsession if an actual deformity is present. The second is when the feelings of inadequacy cause significant stress or harm in social, occupational or other areas of functioning. The third requires that the person’s preoccupation with their looks is not related to another mental disorder, such as anorexia nervosa.

The sufferer may avoid social situations in fear of possible ridicule and being laughed at for their “ugliness”. Instead of seeking help from a psychiatrist, patients will turn to going under the knife, attacking the physical aspect rather than the mental problem. They may frequently consult many doctors, dermatologists and cosmetic surgeons, to rid them of their “disfigurement”. Some may even go as far as undergoing painful and risky procedures for relief, though the symptoms often worsen. Others have been known to try to “fix” their physical anomaly themselves, making it worse or leading to death.

Behaviors include constant glances in mirrors or reflective surfaces, to avoiding them altogether, elaborate grooming efforts to hide the “deformity” such as make-up or hats, repeated touching of the defect, and anxiety in the company of others. Extreme consequences of this disorder include suicide, suicide attempts and ideation. Studies have shown that 80% of individuals with BDD have considered taking their life, and 25% will attempt it.

BDD can lead to depression and is associated with Obsessive Compulsive Disorder and Delusional Disorder. Excessive worry about body odor, Bromosis, and concerns that one is infested by parasites, Parasitosis, are two disorders dealing with delusions. Treatment for Body Dysmorphic Disorder includes the use of medications such as antidepressant sertraline or fluoxetine, more commonly known as Prozac. Medications such as these can ease the person’s suffering, along with cognitive-behavioral psychotherapy. This type of therapy may involve helping the individual to resist their behaviors regarding grooming, encouraging them to take part in social situations and dissuading them from invasive surgeries.