BDD: It isn’t just Jacko!

Tens of millions worldwide suffer from it. 80% have considered suicide. And the suicide completion rate is double that of major depressive disorder. What emotional/mental disorder am I talking about?

Body Dysmorphic Disorder (BDD)

Imagine being consumed – beaten down – by the fact you have some sort of horrible defect in your physical appearance that will have others view you as repulsive? Of course, the defect(s) is perceived – others don’t notice.

So just what is BDD?

Very simply, it’s a condition characterized by over-the-top preoccupation with an imaginary physical defect. And the preoccupation is of such magnitude that one’s social, occupational, or educational functioning is turned upside down. BDD typically presents in adolescence and early adulthood. It strikes women and men equally.

Here’s a list of the top five areas of focus for those enduring BDD, beginning with the most upsetting…

  • Skin
  • Hair
  • Nose
  • Toes
  • Weight
  • Abdomen

In addition to being misdiagnosed, BDD is all too often misunderstood as an issue of vanity. Actually, the exact opposite is true, as those enduring BDD believe themselves to be incredibly difficult to behold. In spite of their great pain those enduring BDD often don’t seek treatment – men more than women. And two of the major reasons are a fear of being perceived as vain, and the sheer embarrassment of coming forth and being seen. Indeed, being terrified of harsh judgment and ridicule are foundational in BDD.

Oh, while I’m thinking about it; take another look at the top three areas on the list just above. Now think about Michael Jackson. Hey, I never knew the man and most often don’t trust the media; however, weren’t his skin, hair (remember it caught fire during the Pepsi commercial?), and nose three of his biggest issues? Interesting.

BDD is a very curious phenomenon. If you’re into categorizing, it’s a fit with the anxiety and somatoform disorders. And it could easily be a manifestation of an eating disorder. With regard to the anxiety disorders in particular, its social judgment piece makes it a great match with social phobia (social anxiety disorder).

Well, here are some common symptoms and behaviors of BDD…

  • Obsessive thoughts about a (perceived) appearance defect
  • Obsessive and compulsive behaviors related to the defect(s) – e.g.: the use of makeup to remedy a skin defect
  • Major depressive disorder symptoms
  • Delusional thoughts and beliefs related to the defect(s)
  • Social and family withdrawal, social phobia, loneliness and self-imposed social isolation
  • Suicidal ideation and behavior
  • Severe anxiety and panic
  • Poor self-esteem
  • Fear that others are noticing and mocking the defect(s)
  • Strong feelings of shame
  • Over-dependence on a significant other, family member, or friend
  • Inability to work or go to school
  • Problems with initiating and maintaining relationships
  • Difficulty with concentration
  • Substance abuse
  • Repetitive behavior – applying makeup, looking in the mirror
  • Seeing varying images of self when looking into a mirror
  • Body modifications
  • Mirror/reflection checking
  • Inability to look at one’s image – removing/blocking mirrors
  • Distractions such as outrageous clothing or behavior
  • Skin picking, hair combing, shaving, etc.
  • Irritability and aggression
  • Seeking of reassurance
  • Excessive self-work – exercise, dieting
  • Comparing body parts and appearance with others’
  • Obsession with research relating to repairs for the defect(s)
  • Obsession with curative procedures
  • Excessive enema use

Folks, this is very serious biz; and any notion of the existence of BDD calls for immediate intervention. Research has shown that the combination of cognitive behavioral therapy (CBT) and the serotonin/norepinephrine reuptake inhibitors (SSRIs, SSNRIs) can deliver a whole bunch of relief.

I’ve always enjoyed bringing to the fore specific emotional and mental disorders. And when these disorders have traditionally received little publicity, it makes me feel especially good.

Lots of support resources for body dysmorphic disorder out there. For example, why not try

Your thoughts, feelings, and experiences will help us all understand a very complicated issue. And that allows us to help ourselves and others. Won’t you comment?