Body Dysmorphic Disorder
Body Dysmorphic Disorder is a type of mental disorder in which the person is obsessed with minor flaws in his physical appearance, and seeking comfort or respite turns to cosmetic surgery.
More often than not the people diagnosed with BDD are preoccupied with skin or physical defects which are not readily visible to other people, and even if they are they are not particularly cared by others. Hence, the sufferer cares too much while actually there is no need for it at all. Even after the patient has underwent a surgery to fix the “flaw” he is endlessly unsatisfied due to the same condition. The person continues to feel “ugly” despite of all kinds of methods and treatments for the physical defects.
The symptoms of BDD are akin to those of OCD (Obsessive Compulsive Disorder) and certain kinds of eating disorders. Eating disorders and BDD both make a person become overly concerned about his appearance, or in technical terms- body image. A major difference between these two though, is that while a person with eating disorder is overly worried about his overall body image/ physical appearance, a person with BDD is mainly concerned about a specific element/area of his physical appearance.
While the exact cause of BDD is still unknown, there are a few theories that try to shed some light on the matter. One such theory suggests that BDD is developed in a person due to the malfunctioning of certain areas of the brain which process information regarding the body appearance in an individual. This theory makes more sense than other theories since BDD is often accompanied with other psychological disorders such as anxiety and major depression in people.
Some additional factors which are believed to cause BDD or trigger it include-
Low Self-Esteem– People with low-self esteem are highly vulnerable to the development of BDD. In fact, low self-esteem is known as one of the strongest triggers of BDD.
Childhood Traumas- Certain traumatic events experience by a person at a young age can lead to the development of BDD along with other mental disorders such as depression, or neurosis.
Parental and Peer Influence- Some unfortunate people who have parents or other close people who are overly critical of their appearance can lead them to develop low self-esteem followed by the development of BDD.
Since the people who have BDD are rather shameful of themselves, have low-self esteem, and are themselves unwilling to admit the condition, it is quite difficult for diagnosis to be made. This is also the reason why majority of BDD cases go unrecognized and untreated. Even if a person finds out that he has BDD he is generally reluctant or embarrassed to consult a doctor for the same. It is only sometimes when a person repeatedly comes for plastic surgery a doctor is able to understand the issue.
A doctor starts the diagnosis by inquiring about the life history of the patient, and evaluating it all followed by a physical exam. If the doctor feels that the patient might indeed has BDD then he refers him to a psychiatrist or a psychologist, who will then start a treatment accordingly.
There are no risk factors that directly influence the developmental probability of BDD. However, some indirect factors that are believed to increase the risk of BDD development include-
- Development of low-self esteem
- Having biological relatives with BDD or similar psychological conditions such as severe anxiety, depression, etc.
- Critical assessment of the physical appearance by family or friends, etc.
Just like most psychological disorders there is no way to prevent BDD. However, one way BDD can be eliminated easily without any major emotional damage is to start the treatment as soon as the symptoms manifest. By providing a pragmatic and rationalistic understanding of BDD to the patient the disorder can be prevented from snowballing into a highly damaging neurosis.
Treatment of BDD generally involves a combination of the following therapies-
- Psychotherapy– Psychotherapy involves on the changing of thoughts and thinking (cognitive therapy) and behavior (behavioral therapy) of a person diagnosed with BDD. With the help of counseling and gradual alternation of thought process the person is made to believe that he needn’t maintain false image of himself, and elimination of the compulsive behavior is carried on.
- Group Therapy – In the former a BDD individual is made to sit and talk with other people diagnosed with BDD on a routine basis, in the presence of the psychologist or another person with appropriate acumen and experience. This helps in bringing insight to the individual and helps him understand himself better.
- Medication- Along with counseling medication if given can fasten the treatment. Generally antipsychotic medicines such as pimozide, aripiprazole, are prescribed to the patient.