Body Dysmorphic Disorder: Where a Damaged Body Image Can Lead

Body Dysmorphic Disorder is often misunderstood or written off as a vanity-driven obsession, but the reality is quite the opposite; those with BDD often believe themselves to be irreversibly ugly or deformed. Vanity has little to do with it. Typically, Body Dysmorphic Disorder is classified as a mental disorder that involves possessing a distorted body image. Those who are diagnosed are generally severely critical of their appearance or self-image, despite that there may be no visible disfigurement or defect to anyone but the sufferer. BDD often develops as a particular focus on one or more body parts as the cause of distress, and contrary to popular opinion, only a relatively moderate percentage of those with Body Dysmorphic Disorder exhibit a focus that is size or weight-related. An estimated 25% - or slightly over that - of all undiagnosed people with BDD account for those with a weight and/or body size related focus, with 22% approximated for those among all confirmed sufferers. The face and nose are just as common for sufferers to fixate on, and those with BDD frequently have more than one area of concern.

Social and Mental Consequences of BDD:

Many people with BDD - generally considered to be of normal appearance by others - hold the belief that they are unspeakably ugly, and feel that they are therefore unable to engage in interaction with others (or otherwise participate in everyday social functions) for fear of ridicule and humiliation directed at their appearance. They can also be (and often are) aware of the more irrational aspects of the actions they may consider taking, but still feel they have no choice but to take them - such as when attempting to cut themselves off from the majority of human contact outside of their house. Sufferers tend to be very reluctant to seek help because they are afraid to be labeled as vain, or alternatively, laughed at for confessing the very real pain that they feel. They may also be too embarrassed or ashamed to discuss their symptoms with anyone - even with their friends and loved ones - simply because of the nature of their obsession.

Psychologists link BDD to the OCD spectrum of disorders because its symptoms combine obsessive and compulsive aspects. People with BDD may engage in repetitive behaviors linked to their appearance (such as repeatedly touching the feature that bothers them, or subconsciously drawing their own attention to it), and typically think or worry about their appearance for an excessive amount of time during the average day. This amount of time spent thinking about their appearance can build to an almost reflexive mental crutch that follows the person with BDD everywhere, and almost anything can induce a stage of social anxiety or panic in no time at all. This can make it difficult for someone with Body Dysmorphic Disorder to even go grocery shopping. In severe cases they may even eradicate as many social responsibilities as possible and restrict themselves to their home.

The Dangers of a Broken Mirror:

A major adversary of a person with Body Dysmorphic Disorder is something the majority of the population voluntarily uses daily: the common mirror. Often referred to as 'The Broken Mirror' disorder, this name does seem to fit BDD. Mirrors are reported as common magnifiers of feelings of anxiety in those with the disorder, especially with people who carries a pocket mirror to routinely check on their appearance. Repetitive checking of mirrors is all too common and can sometimes lead to someone with Body Dysmorphic Disorder experiencing great distress at seeing a reflective surface of any type - while at the same time still seeking them. It is an interesting anecdote that a large percentage of sufferers describe a mirror as showing a distorted image that portrays them as ugly or deformed in some way, and claims that 'their reflection has changed or worsened since they last saw it' are also frequent. 'The Broken Mirror' reference for BDD was most popularized by one of those most cited resource books on the disorder: "The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder," by Katharine A. Phillips.

Body Dysmorphic Disorder Can Take Its Toll on Long-Term Sufferers:

Chronically low self-esteem is characteristic of the disorder, mostly due to the value of one's self often being so closely tied to their perceived appearance. The prevalence of BDD is speculated to be about equal in men and women, through figures for both genders are not balanced in regards to those who actually seek aid; women are more likely to seek diagnosis and treatment for their Body Dysmorphic Disorder. Severe social anxiety is all too common for those suffering from the disorder, and BDD is also linked to an unusually high suicide rate among all mental disorders. "Phillips and Menard (2006) found the completed suicide rate in patients with BDD to be 45 times higher than in the general US population. This rate is more than double that of those diagnosed with Clinical Depression and three times as high as those with Bipolar Disorder" (Wikipedia, 2006).

Common Behavioral Practices Characteristic of People With Body Dysmorphic Disorder:

*A repetitive urge to check a mirror (or glance into reflective surfaces, windows, etc), typically accompanied by invasive thoughts that their appearance has changed somehow since they last checked their reflection, or sudden urges to make sure the body part in question 'looks alright'.

*An inability or severe discomfort when faced with the prospect of looking at their own reflection (also images of themselves, such as in photos).

*Compulsive touching to the area where the perceived defect is most focused, or repetitive touching solely to measure the extent of the defect.

*Some measure of social withdrawal, usually combined with strong depression.

*Constant seeking of reassurance from loved ones regarding the sufferer's appearance.

*Obsessive thinking and viewing of images of celebrities, models or other characters of whom the person suffering from BDD wishes to resemble. These can include fictional characters from books, movies, or even animated characters.

*Excessive grooming to hide or better their appearance, often done in hopes of disguising what they're truly worried about - eyebrow plucking, waxing, shaving, applying makeup, the changing and rechanging of clothes, etc.

*Feelings of anger, shame, and suicidal thoughts stemming from a strong belief that they're 'broken, unfixably ugly or disfigured' because of the way they look.

*An obsession with obtaining plastic surgery or having repeated surgery while gaining no satisfactory results from the process. In very rare cases, patients have contemplated doing surgical procedures on themselves in order to correct their perceived deformity, and in other cases still, some have actually attempted it with tragic results.

----------

Awareness of BDD:

I hope that this information has brought awareness to someone regarding the very real dangers for sufferers of Body Dysmorphic Disorder. If you think you or a loved one might have BDD or some other variation of compulsive worrying about your appearance which drastically interferes with your everyday life, please think about discussing the possibility with your doctor and/or seeking a psychologist with a special focus for sufferers of BDD.

---------

References:

Wikipedia - Information on Body Dysmorphic Disorder retrieved June 17th, 2007 from http://en.wikipedia.org/wiki/Body_dysmorphic_syndrome