Psychology: Body Dysmorphic Disorder

Articles on BDD:

The Basics of BDD

Body dysmorphic disorder: recognizing and treating imagined ugliness

Characteristics, Symptoms, Treatments

Videos on BDD:

BDD documentary

BDD explained in a radio podcast

Kati Morton talks about BDD

Book on BDD:

The Broken Mirror

ATTN: If you think that you might have BDD, here are some questions that you should go through with yourself or a trusted friend: King’s College Questions on BDD. If you need treatment, your best option is to visit a psychologist. Massachusetts General Hospital actually offers some no-cost treatment for people with BDD. You can e-mail them (bdd@partners.org), call them (617-726-6766), or just visit their website (www.mghocd.org/bdd). But, if the first two options are not an option for you at this time, here is a helpful online forum.

Okay so I didn’t want to overload you with a long informational post so I linked some helpful resources on BDD above. Also, you can check out yesterday’s short intro post on BDD. I figured blogging is about using your own voice, not regurgitating information from other sites. So go crazy with those links.

Today’s Post:

I really became interested in BDD last year when I saw a documentary (you can find it in the links above) on BDD. The subjects in the documentary wouldn’t even let the cameraman film their face. I thought wow maybe they really aren’t very good-looking. But, after they get more comfortable with the film crew, they let us catch glimpses of their face and guess what. Completely normal. I would not have given any of them a second glance. And just like that I was captivated by this tragically interesting disorder.

Imagine being in their shoes. Most of them wake up and immediately feel depressed. They walk over to the mirror and may spend up to five hours picking apart their appearance. If they go to work or school, they are usually late. But, many of them have not left their house for years. Then, once they are at work or school, they can’t concentrate on their work because they feel like everyone is judging them. So, many of them drop out of school and are fired from work.

In her book The Broken Mirror, Dr. Phillips says that, out of all the patients that she has seen, people with BDD are the most distressed. They live horrifically stressful lives. They cannot enjoy the best part of life on earth – people – because every time they are around others, they think that their appearance is being scrutinized and judged by those around them. This feeling of being under a direct spotlight may remind you of social anxiety.

However, that is a very significant claim to make: BDD sufferers seem more upset than those with anorexia, schizophrenia, etc., but it’s based on research. In fact, Dr. Philips says that BDD patients are so miserable that nearly all have considered suicide. They feel stuck inside their house. They have dreams and ambitions like everyone else, but they can’t go out into the world to work on them. So they stay at home, miserable, wanting to go out, but knowing that as soon as they do, they will panic and come back inside. Every moment spent in public is a miserable moment.

Dr. Philips even tells the story of one patient who actually made it out of her house. However, when she pulled up to a red light in her car, she was so sure that the people in the cars next to her were staring at her and thinking, “Oh my goodness she is so ugly,” that she actually left her car in the middle of the road and ran away.

So what kind of disorder does this look like to you? What kind of professional would you visit for help? To me, it seemed obvious from the beginning that this was a disorder of the mind and thus would require a psychologist. However, according to Dr. Philips, most of the people with BDD are going to the wrong doctors: plastic surgeons, dermatologists and dentists. They think, if I can just shrink my nose, get rid of my acne and straighten my teeth, then I will look normal enough and I’ll be okay. But, of course, it is never enough. For every flaw you fix, you will notice five more. It is a miserable and never-ending cycle.

I find this interesting. To people on the outside, the solution seems obvious. Not only this, but to people on the outside, there isn’t a problem to begin with. It’s like the patient has built a cage around themselves to hide in. People peer through the cage bars expecting to see a monstrous animal, but are confused – perhaps even a little disappointed – when all they see is a normal-looking boy or girl. They immediately begin to unlock the cage, but the person inside insists on keeping it locked.

This is what it may feel like if you know someone with BDD. Very frustrating. You think, “Why can’t they see that they are normal-looking? Everyone else can see it.” You want to shake them and say “Wake up! Start living! You look fine. No one is thinking that you are hideous looking.” But you have to remember that, just like social anxiety, BDD cannot be fixed just like that. It is much more complex.

BDD is primarily a disease of the mind. There is a disconnect between the left and right side of their brain. I’ll try to keep this simple. The left side of your brain processes details (think language, logic, reasoning), while the right side of your brain processes concepts (think emotion, creativity). Research suggests that people with BDD have trouble connecting the two sides and so they can become fixated on one detail (a flaw in their mind) on their face rather than seeing the whole picture. This once again is similar to social anxiety in that people with s.a. may focus on that one person who said something mean to them rather than on the majority of the people who would love to meet them.

I don’t have an expert solution for BDD. I am way too under-qualified to do that. But for some reason BDD really intrigues me and makes me very sad. I hate that there are people who could be teaching kids, making art, developing new software, or running a non-profit, yet they are stuck inside their house for something so, well, silly. Not that the disorder is silly – it’s very serious – but the whole concept of it if that makes sense. They look fine, but they can’t see that they look fine.  As much as they want to, they cannot make their minds be normal. They can’t just forget about their appearance. They can try to, but they will always run into mental blockage. A miserable and never-ending cycle.

I hate to end on that note, but that is the reality of some disorders.

I will just add that there are psychologists who are qualified, and who have found treatments that have proven effective. They have spent time and energy researching BDD in order to help others. Please see the links at the beginning of the post for more information.

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