Body Dysmorphic Disorder
Dear Dr. LeCrone:
My 20-year-old daughter has struggled for years with mental health issues including anxiety, depression and poor self- esteem. My daughter’s therapist has diagnosed her with body dysmorphic disorder. Will you please write on this topic?
-A reader in Oklahoma
Dear Reader:
Body dysmorphic disorder (BDD) is described as an excessive preoccupation with a real or imagined defect in your physical appearance.
Almost everyone has some body feature that he or she would like to modify. In the case of BDD, the individual will go to great lengths to modify the body feature with such things as surgery, exercise and diet, or cover it up with makeup and clothing.
People with this disorder often see themselves as unattractive and may avoid social situations.
The social isolation can then lead to depression and more anxiety.
Common BDD obsessions involve:
• Moles and freckles
• Acne
• Minor scars or skin aberrations
• Too much facial or body hair
• Too little hair on head
• Size and/or shape of genitalia
• Breast size
• Overall size, shape and/or symmetry of the face or another body part
BDD is prevalent in about 1 to 2 percent of the population; however, this is thought to be an underestimate because BDD frequently is underdiagnosed. Patients are often ashamed and never reveal their feelings to anyone.
Frequency of BDD is about the same for men and women.
BDD usually begins in adolescence, a time when young people are generally most sensitive about their appearance. However, many sufferers wait until later in life before seeking help.
Although BDD sufferers may spend hours in front of a mirror, they are not being narcissistic but rather are thinking of themselves as being hideous or ugly. They are often aware of the inappropriateness of their behavior but have difficulty in controlling it.
The causes of BDD are unclear, but certain biological and environmental factors may contribute to the development of the disorder, including genetic predisposition, personality traits and life experiences. Unfortunately; the media glorifying youth, model types and perfection doesn’t help and gives rise to cultural issues.
The standard treatment for body dysmorphic disorder is a combination of medications, often antidepressants, and cognitive behavior psychotherapy. Treatment involves reducing the obsessive thought patterns and compulsive behaviors of the BDD sufferer, which helps the sufferer correct irrational ideas and unhealthy thought patterns and gain comfort with his or her physical appearance.
I wish your daughter the best with her treatment.
