I wanted to write this blog about Body Dysmorphic Disorder (BDD) as it strikes a personal chord with me. As I get older I seem to be more self-conscious and less happy with the way I look; this may have something to do with the fact that my once slender size 8 figure has turned somewhat curvier over the years to a full size 12 and as much as I try to blame the clothes stores that they are shrinking the sizes I know I just need to get myself into the gym and keep at it. Now, whilst I probably have only a mild case of BDD and cannot begin to understand how someone copes with a mental illness. I am sure I am just one of many who struggle on a daily basis to be happy with themselves.
BDD is characterised as a persistent obsession with a perceived flaw in physical appearance. It is a relatively new diagnosis first described in the American Diagnostic and Statistical Manual of DSM 11 in 1987. Although a variation called “dysmorphhophobia” dates back as early as 1891 and was most famously used in a diagnosis by Freud for “The Wolfman”.
I have never been one to talk about my issues, whether I am feeling particularly low that day about how I look or feeling depressed about my life, if I am feeling upset about me, myself, who I am, I keep it in and face the next day as if I don’t have a care in the world. Is this a sustainable way of dealings with issues? Probably not! Like me there are many of us who don’t talk about how we are feeling and unfortunately for some they can’t see a way out.
It is estimated that nearly 2% of the population could be suffering from varying degrees of BDD. It can seriously affect your daily life, including your work, social life and relationships. BDD can also lead to depression, self-harm and even thoughts of suicide.
Some of the symptoms of BDD are:
- worrying a lot about a specific area of your body (particularly your face)
- spend a lot of time comparing your looks with other people’s
- looking at yourself in mirrors a lot or avoiding mirrors altogether
- go to a lot of effort to conceal flaws – for example, by spending a long time combing your hair, applying make-up or choosing clothes
- picking at your skin to make it “smooth”
The NHS website says they are two ways of treating people who suffer with BDD:
- if you have relatively mild symptoms of BDD you should be referred for a type of talking therapy called cognitive behavioural therapy (CBT), which you have either on your own or in a group
- if you have moderate symptoms of BDD you should be offered either CBT or a type of antidepressant medication called a selective serotonin reuptake inhibitor (SSRI)
- if you have more severe symptoms of BDD, or other treatments don’t work, you should be offered CBT together with an SSRI
If you or you know someone who is prescribed an SSRI remember the first two weeks are the hardest. This is when the antidepressants’ side effects may be at their strongest, which can lead to suicidal thoughts and anxiety. The person taking the SSRI will need to be closely monitored as they are a high risk in the preliminary stages of starting medication. It can take up to 12 weeks for SSRIs to have an effect on the BDD symptoms.
One of the ways in which the CBT treatment can help a BDD sufferer is by using a technique known as exposure and response prevention (ERP). This involves gradually facing situations that would normally make you think obsessively about your appearance and feel anxious. Your therapist will help you to find other ways of dealing with your feelings in these situations so that, over time, you become able to deal with them without feeling self-conscious or afraid. Although talking seems such a small thing to some people it can be a huge deal to someone else. To coin the phrase “it’s good to talk”. Just to be able to talk about our anxieties can save someone from having to start taking antidepressants or worse harm themselves.
So rather than looking at ourselves and seeing: thighs are too big, bum is too big, bum not big enough, nose too long, flabby stomach, too short, too thin, too tall… lets learn to love what we see and share it, tell people they are beautiful. Too much of what society talks about is concerned with judging and criticising how someone looks. We are set this impossible goal to live up to by celebrities and social media which are a major influence on how children today see themselves. So let’s try to share positive mental wellbeing rather than tearing ourselves and each other down.
If you are concerned you may have BDD or you think someone is suffering from it, get in touch with your local GP they will be able to advise you on the best next steps or contact the BDD Foundation they will have a list of all the support groups you can talk to: https://bddfoundation.org/about-us/contact/