Dysmorphophobia: What Do You Really See?

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“Mirror, Mirror, can’t you see? What you show is killing me?”

Meet Body Dysmorphic Disorder

Many of us want to look and feel good about our own appearance, feel confident and look the best. But constantly having crippling waves of anxiety, overspending time upon our appearance and our body can lead to a psychiatric condition called Body Dysmorphic Syndrome or Dysmorphophobia.

Body Dysmorphic Disorder(BDD) is defined as a psychiatric disorder where a person spends a lot of time worrying about the flaws in their appearance and usually, such flaws are not noticeable to others. This disorder can occur at any age but is commonly seen in young adults of both genders. It is difficult for these individuals to control their negative thoughts and unable to believe people who tell them that they look fine. 

BDD is said to cause such obsession with oneself that it begins to affect their social, work and personal lives. You would be surprised to know the many famous celebrities who suffer from BDD – Robert Pattinson, Marlyn Monroe, Kim Kardashian, Micheal Jackson and many more.

Image Source: https://resetyoureveryday.com/when-your-reflection-causes-suffering-the-many-struggles-of-body-dysmorphic-disorder/

Most of the celebrities and film actors undergo plastic surgeries by changing the colour tone of skin, facial features and body appearance– all in an attempt to look good.

Many married women & mothers suffer from BDD too as they succumb to tremendous anxiety of weight issues and hormonal changes in the body that affects their appearance. Many people who are over-conscious of the slightest increase in the weight or body contour leads them to undergo cosmetic surgeries, gastric bypass, liposuction and other similar procedures.

Many doctors are used to people presenting to them with photos of celebrities with the hope to emulate them. It is rather shocking to know that today, a lot of BDD individuals bring their filtered selfies to their cosmetologists wanting to achieve high cheekbones, big eyes, coloured and contoured eyebrows, prominent chin etc., to change their existing features and appearance of the face and body. This is termed as Selfie Dysmorphia or Snapchat Dysmorphia.

What are the Symptoms of Body Dysmorphic Disorder?

Ever wondered what a person with Body Dysmorphic Disorder is likely to present as? Here are some common signs and symptoms of the disorder.

  • Worrying or constantly checking their appearance, especially their face and spending excessive time in front of the mirror
  • Overspending time and comparing their physical appearance with others
  • Constantly engaging themselves looking at the mirror or picking at the skin
  • Taking a lot of effort to conceal flaws. For example: spending a long time combing their hair, applying makeup, choosing clothes, applying various creams lotions on the skin to make it smooth and shiny
  • Constantly checking their weight on the weighing scale and being over conscious about muscle tone, weight and shape of their body
  • Overemphasis on diet and exercise
  • Focussing too much on their clothing to hide certain body parts or features 
  • Concerns include the size of the penis, muscles, breasts, thighs, buttocks, also the presence of certain body odours
  • Repeatedly measuring or touching the perceived defect
  • Having problems in career or in relationships due to their inability to stop focusing on their perceived defect
  • Feeling self-conscious and not socialising
  • Feeling very anxious when around other people
  • Repeated consultations with medical specialists such as plastic surgeons and dermatologist to find ways to improve their appearance

What Causes Body Dysmorphic Disorder?

Image Source: https://www.midwoodaddictiontreatment.com/body-dysmorphic-disorder/

The exact cause of BDD is unknown. 

It may involve a problem with the size or functioning of certain brain areas that process information about body appearance. There are certain biological and environmental factors that may contribute to its development, including genetic predisposition, neurobiological factors such as malfunctioning of serotonin in the brain, personality traits, and disturbing life experiences.

BDD can occur also due to major depression and anxiety.

Biological factors: Genetically, few BDD patients have a first-degree relative such as a parent, child or sibling who also suffers from this condition 

Certain personality traits like neuroticism, perfectionism, introversion, sensitivity to rejection, unassertiveness, having schizoid or to make someone more susceptible to develop BDD.

Environmental factors: Media pressure may contribute to the onset of BDD, e.g. Desire to look like glamour models lead to unrealistic expectations and constantly consulting orthodontics to aesthetically change their facial features.

External factors: Teasing or criticism could play a contributory role in individuals who are genetically or environmentally predisposed.

Other Factors: Parents who have an excessive emphasis on aesthetic appearance or disregard it can trigger and cause low self-esteem too.

Other life experiences like sexual trauma, insecurity or rejection may be contributory factors too.

Associated Co-morbidities

BDD is commonly associated with other co-morbid conditions like:

  • Depression
  • Anxiety
  • Obsessive-compulsive disorders
  • Substance abuse like alcohol or drugs
  • Social phobia 
  • Eating disorders like Anorexia and bulimia
  • Personality disorders including paranoia and personality dependent disease.
  • Many people with BDD experience suicidal thoughts, and have attempted to end their life

Diagnosis

More frequently plastic surgeons or dermatologists may suspect such a disorder based on frequent complaints and repeatedly seeking surgical intervention. If a healthcare provider suspects BDD, then an immediate referral to a psychiatrist or psychologist is recommended.

Detailed medical history and examination can then lead to a diagnosis of BDD.

Treatment

Treatment options include Cognitive Behavioural Therapy and Medication.

Cognitive Behavioral Therapy

Image Source: https://thinkcbt.com/

CBT aims to change the way a person behaves by challenging their beliefs and thinking. A person can develop a better understanding of why they are thinking in a certain way and how this affects their behaviour.

CBT can help a person stop the negative thoughts that come automatically and encourage them to evaluate themselves more realistically and positively. Individuals can also learn healthful ways to handle urges or rituals, such as mirror checking.

Online CBT courses are also available as the covid pandemic has taken toll all over the world which may be more affordable than face-to-face counselling.

CBT for adults with BDD is effective in improving its symptoms and has also been shown to improve related symptoms, such as depression, insight, body image, self-esteem and social anxiety.

Medication

SSRI (Selective Serotonin Reuptake Inhibitors) which are a type of antidepressants eg. fluoxetine, fluvoxamine, sertraline & citalopram.

SSRI medications are also effective for BDD symptoms, and they also improve related symptoms, such as depression, insight, functioning, and quality of life.

Another antidepressant called clomipramine can also be given.

While CBT and SSRI have shown good results in the improvement of BDD more focus should continue on the effective treatment of the disorder.

If a person is diagnosed with BDD following supportive measures should be advocated:

  • Supportive Care & Encouraging Environment and Help to the sufferer by family and close ones.
  • Just letting someone know that you’re willing to lend an ear goes a long way.
  • Seeking a health counsellor or a therapist may help and improve the condition
  • Keeping busy or encouraging the sufferer to take up a hobby will keep the mind engaged.
  • Yoga, Meditation, Exercise, Walks can add to getting faster relief from this disorder.
  • Being Happy Positive and Confident is the most beautiful thing you can possess for a better tomorrow and future.
 Featured Image source: Image by Stephanie Ghesquier from Pixabay
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About the author

Dr.Nikita Pawar is a General Practitioner by profession and has completed her (MBBS PGDCR). She has previously worked in GMC Hospital Dubai & is currently attached to a hospital, corporate company and Clinics in Mumbai. She is passionate about medical article writing and always strives to maintain commitment towards achieving professional growth as she transitions from one phase of her career to the next.

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Comments

  • dr pradeep biwalkar December 8, 2020 at 7:24 pm
    1+

    Nice objective analysis of this problem of dysmorphophobia. One needs a high index of suspicion for early detection and at this stage Cognitive Behavioral Therapy is very rewarding. Depression and anxiety could coexist as co morbid condition or may even be effect of BDD ( Body Dysmorphic Disorder )
    The balance of various neuro transmitters like Dopamine, Serotonin, Endorphins and others in health and in depression is a complex subject and hence the drugs used also vary from Selective Serotonin Re uptake Inhibitors to re uptake enhancers.
    In such a scenario, I think importance of meditation, Yog and even brisk walking cannot be overemphasized.

    Reply
  • Anita January 4, 2021 at 11:42 pm
    1+

    I am in fact thankful to the holder of this web page who has shared this
    fantastic paragraph at here.

    Reply

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