Body Dysmorphic Disorder
Dying to Look Good
The jokes and quips like, ‘does my bum look big in this?’ and the length of time it takes to get ready for a night out are often rooted in light-hearted fun. However, for approximately 3% of people, how they feel about their looks, body and image can have severe implications on life, home, work and relationships.
Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD) is a complex diagnosis, leading sufferers to experience obsessive thoughts and behaviors related to their body and appearance. The thoughts control the person to the extent that they can think or feel little else; often making extensive plans and going to any lengths to change the perceived imperfections.
BDD affects men and women in equal numbers and can often be seen to begin in adolescence or early adulthood, although later onset is not uncommon. BDD is often seen to coexist with substance use disorders, eating disorders or other drug and alcohol issues. Those affected describe using substances or behaviors to distract from the emotional pain and distress of s life with BDD.
It is very usual for those experiencing BDD to focus on flaws or issues that are not obvious or only noticeable under scrutiny to others. In the view of the BDD sufferer the flaws will be so extreme that they will go to any lengths to change, remove or disguise parts of themselves that they will describe as disgusting. Ritualistic behaviors, isolation and avoiding situations are common as the symptoms progress. Clothing, cosmetics and surgery that camouflage the disliked areas are utilized and rituals can become part of long routines to minimize the exposure of the ‘flaws’. Disruption to this routine or additional problems (acne breakouts, hair problems, rashes or injury) can cause further depression, anxiety, anger and often rage. The internal rage may promote incidents of self harm leading to shame, guilt and other unpleasant experiences.
Mark* (we have changed the names to protect anonymity), a 32 year old BDD sufferer. Marks battle with body image and self hatred began following an episode of bullying at primary school. He describes how he now finds it impossible to have relationships, something he has battled with for over 15 years. His hatred of his body, prompted spiraling depression, low self esteem and dwindling confidence. Having twice dropped out of university, Mark found it more difficult to leave the perceived safety of his home. Mark believed that others would find his body, face and hair as repulsive as he found it himself. Mark self medicated with alcohol and later moved on to opiates. His condition became so severe that in times of extreme depression and intoxication, he attempted to cut his stomach to remove perceived ‘fat’. Mark was admitted to a psychiatric residential facility for the care of both his BDD and cooccuring addiction disorders.
Fiona Markham, Clinical Director at The Wave explains that BDD often presents in the offices of aesthetic consultants as patients attempt to make, often drastic and continual changes to their appearances. ‘Social isolation, around hours of obsessive observation of body parts, extensive planning and sometimes self mutilation can be seen in cases of body dysmorphia’, Fiona adds, ‘it is not unusual to hear clients also suffer from depression, social anxiety, issues with drugs and alcohol or sometimes preferring to swap reality for friendships in a virtual world’. Fiona further explains that eating disorders, self harm and suicidal thoughts and plans can form part of the collective symptoms of BDD. ‘Increased Suicidal thoughts and planning can pose a real risk and should be reviewed by a mental health professional’, adds Fiona. Fiona has recently created a specialist program, known as ‘Alice’s Room’; assisting those who identify with BDD and associated disorders from the Kuala Lumpur luxury residential facility.
Seeking Effective Treatment
Treatment for Body Dysmorphia often requires impatient or residential care, with assistance from a psychiatrist and mental health team. The Wave, Kuala Lumpur advises that clients with BDD or families who recognize obsessive behaviors similar to those described above, consultant a mental health provider for advice.
Exposure therapy, CBT and motivational interviewing can assist patients in reality checking and confronting ‘black and white’ thinking styles. With the guidance of a good therapist, who has extensive experience in treating BDD, remission is possible and long term recovery is achievable in many cases.
If you or someone that you love has identified with any of the symptoms described above, contact you GP, on call psychiatrist or The Wave clinic.