October 30, 2007
Do you know a woman who is as beautiful as some Hollywood models and actresses, yet she believes she looks like a monster? Does she often spend hours in the mirror? She may suffer from body dysmorphic disorder, a preoccupation with a real or imagined physical defect.
Individuals with BDD experience excessive shame, anxiety, and often depression about their appearance. BDD sufferers often seek dermatologic or cosmetic surgical procedures and frequently use or avoid mirrors. Much of their self-worth is related to how they feel about their appearance.
Common complaints involve imagined or minor flaws of the head and face, but any body part can be the focus of concern. Individuals with BDD often are concerned about acne, wrinkles, paleness, scars, thinning hair, or the shape or size of body parts such as the nose, lips, or face. Some people with BDD have concerns focusing on body symmetry. Frequently, individuals with BDD are concerned with more than one body part.
More than 90 percent of individuals with BDD perform repetitive behaviors to check, hide, or attempt to improve what they perceive as a physical defect. These behaviors include checking the supposed flaw in mirrors or other reflective surfaces. Many individuals with BDD attempt to camouflage the perceived flaw with make-up, hair, clothing, or by altering their body position. Others engage in excessive grooming behaviors such as, but not limited to, combing, cutting, or styling their hair, while others pick at their skin in order to try and remove what they consider to be imperfections. Many BDD sufferers ask for reassurance related to the imagined defect and very frequently they compare their appearance with that of other people. The repetitive behaviors may take many hours per day and usually only provide very temporary relief from obsessions about their appearance.
Avoidance of social situations is very common. Individuals with body dysmorphic disorder usually have a difficult relationship with mirrors, often alternating between episodes of mirror avoidance and mirror checking.
BDD also causes high levels of occupational and social disability including; unemployment, absenteeism, lost productivity, and relational or marital problems. In the most severe cases, BDD may incapacitate the sufferer and keep them housebound. BDD research reports that suicidal ideation and suicide attempts are extremely high. Many BDD sufferers seek non-psychiatric treatment. Research estimates show that seven to 15 percent of cosmetic surgery and 12 percent of dermatological patients suffer from BDD. Left untreated, the torment of BDD can lead to hospitalization and suicide.