Body dysmorphic disorder

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Body dysmorphic disorder (BDD) is a mental problem where people think they look different to how they really look. People are usually said to have BDD if they are extremely critical of their body, even though there may be nothing noticeably wrong with it. If there is something wrong with their body, it is usually so small that a person without BDD would not be unhappy about it at all. People claim that they are insecure, but BDD is far worse.

Most people without BDD may not like some parts of their body, but people with BDD believe that they are so ugly, even though they are not, that they find it difficult to talk or exist with other people, or live normally, scared that other people will be mean to them because of the way they look. People with BDD often do not look for help because they are afraid others will think they are just vain, or they may feel too embarrassed to talk to other people as they think they are so ugly.

BDD is a somatoform disorder. People with BDD may look at themselves in the mirror too much, or some people with BDD may actually try not to look in the mirror. Both of these are possible for a person with BDD. They usually think about their body for more than one hour per day, and in bad cases, can stop talking to other people, and may stay at home. People with BDD often have very low self-confidence, because they believe that a person's value is linked to what they look like, and because they do not think that they are beautiful themselves, they do not think they have much value.

History[change | change source]

Sigmund Freud had an important Russian person (Sergei Pankejeff) with him in the past, who would have been classified as having the disorder in modern times. Freud named him "The Wolf Man", to protect Pankejeff's identity. Pankejeff was so unhappy with his nose that he could not live a normal life.

Cause[change | change source]

It is unknown what the full cause of BDD is. However, research shows that a number of things may be the cause:

The chemicals in the brain. If the amount of serotonin is too low, one of the brain's neurotransmitters which gives us 'mood' and 'pain', may help cause body dysmorphic disorder. Scientists can not explain this chemical problem in the brain, but it may be hereditary (passed down from parents to child).

Obsessive-compulsive disorder. Many people with BDD also have OCD, where the person does things without wanting to. If people have had, or have a genetic link to OCD, the person may be more likely to have BDD.

Generalized anxiety disorder. Many people with BDD also have generalized anxiety disorder. This disorder is where the person worries about things a lot, which makes them have anxiety about things in their life, for example, about their body, as in BDD.

Development[change | change source]

Adolescence is a time where the body goes through many changes, such as acne, and these can be difficult for people, and this is when BDD begins

BDD usually develops in adolescence, a time when people usually worry about their appearance the most. However, many people with BDD suffer for years before they look for help. When they do look for help to Doctors, people with the problem often say they have other problems, for example, depression, social anxiety, or obsessive-compulsive disorder, but do not say their real problem is with the way they look. Most patients can not be convinced that the problem they have with their body is only 'imagined', and that they are seeing a 'changed' view of themselves, because people do not know much about BDD, compared to other mental problems, for example OCD or others.

Diagnosis[change | change source]

The DSM (Diagnostic and Statistical Manual of Mental Disorders) IV says that a person must have the things written below if they have BDD:

  • Being unhappy with an imagined problem on their body. If a small problem is there, the person is unhappy with it more than they should be.
  • The unhappiness causes large problems in talking to other people, having a job, or living a normal life.
  • The unhappiness is not caused by a different mental problem (for example, unhappiness with weight in Anorexia Nervosa).[1]

Features of BDD[change | change source]

People with BDD spend hours getting ready to go out
Make up is often used to cover up the imagined 'problems'

A person with BDD will often do these things:

  • Look in the mirror a lot, look in reflective doors, windows and other reflective surfaces.
  • If the person does not look in the mirror a lot, they will try not to look in the mirror or at photographs ever, and will often not have mirrors in their home.
  • Touch their skin a lot to feel the 'imagined' problem.
  • Wanting other people to say good things to them about the way they look a lot.
  • Asking other people about the way they look a lot.
  • Not talk to people a lot.
  • Not having much confidence
  • Comparing the way they look to people they want to look like a lot. This may be of celebrities, or people in their life.
  • Doing exercise or having diets more than normal.
  • Doing these things a lot: combing hair, plucking eyebrows, shaving, etc.
  • Using medicine to change the body shape and body size.
  • Wanting plastic surgery or more than one plastic surgery, more than normal.
  • In some extreme examples, patients have tried to do plastic surgery to themself.

Where on the body the 'imagined' problem can be[change | change source]

Dr. Katharine Philips did research, with more than 500 people with BDD, on the percentage of patients unhappy with the most common parts of the body;