The average woman looks into a mirror about eight times per day, according to an overview article in The Daily Mail, and women might also use sunglasses, windows, phone cases, and other reflective surfaces to check on appearance issues when no mirrors are handy.
For some people, these daily checks are a source of extreme misery. That’s because these people see one or two things in the mirror that they assume are horrific, ugly, terrifying, and impossible to ignore.
The issue is body dysmorphic disorder (BDD), and according to the Anxiety and Depression Association of America, it’s a mental illness characterized by negative thoughts about appearance. Typically, people with this disorder focus on one specific body part, and they feel unable to overcome their feelings about that body part.
People with BDD may become convinced that their noses are just a little too long, or their hair is just a little too thin. They may be convinced that their eyes aren’t symmetrical, or that their ears stick out from their heads just a little too much.
These aren’t passing thoughts that might drift into and then out of a person’s mind on a regular basis. These are persistent obsessions about the body part that can cause a person extreme mental anguish.
Unless this condition is treated, it can lead to physical consequences as well.
Observing Signs and Symptoms
It’s hard to know how many people have BDD. For example, in an overview article published in Dialogues in Clinical Neuroscience, researchers say that it could impact as few as 0.7 percent of adults to as many as 2.4 percent of adults. That’s a huge gap, and it could be explained, in part, by the fact that many BDD symptoms are intensely private.
The thought patterns and obsessions about appearance characterize BDD, and most thoughts just aren’t visible. As a result, people with BDD might be able to keep their disorder hidden, especially in the early stages. But if left untreated, the condition tends to grow stronger and more severe, and when that happens, symptoms can get bigger and harder to control.
Someone with BDD may constantly ask for reassurances about appearance. This person might ask if his/her nose really is crooked, or if a haircut makes the nose less crooked, or if someone is looking at the crooked nose. This body part may come up in conversation over and over again, and it might be hard to ignore.
In addition, people with BDD may search for solutions to their issue by:
- Meeting with multiple cosmetic surgeons
- Buying bogus treatments online, like braces or splints
- Spending money on haircuts, hats, or clothing
- Purchasing a great deal of makeup or hair dye
These people may also spend hours and hours in front of the mirror every day, examining the body part and worrying over how they can minimize that body part. Sometimes, this extreme focus can keep people from working, meeting with families, or engaging in hobbies. The perceived defect consumes most of the person’s time.
Causes and Risks
Researchers aren’t quite sure what causes BDD, but according to Mayo Clinic, genes could play a role. The disorder is more common in people with family members who also have the disorder, so there might be some sort of genetic marker that’s passed from one generation to the next that causes these unusual thinking patterns.
Research quoted by the National Association of Anorexia Nervosa and Associated Disorders also suggests that unusual brain patterns could play a role. Researchers used specialized equipment to examine the brains of 14 people with BDD, measuring electrical activity while people looked at photos of their bodies.
Researchers found that people with BDD had lower levels of activity in some parts of the brain when compared to healthy controls.Studies like this seem to suggest that people with BDD have unusual brain cells that just don’t respond in a conventional way to very real and very common stimuli.
They see the world differently, and that makes them behave differently, too.
But this shift in thinking isn’t benign. People with BDD have severe lifestyle disruptions as they don’t have enough time to handle daily life and the demands of the disorder. The hours they spend looking at or attempting to fix the perceived problem are hours they should be spending in activities that bring them prosperity or joy. They can lose relationships, jobs, and opportunities because they can’t shift their thoughts to something that’s rewarding.
Writers for PsychCentral also suggest that BDD can lead to complete isolation. People with the disorder may become convinced that the defect makes them unfit to socialize with others. They don’t want to inflict their extreme ugliness on people they care about, so they may refuse to leave the home altogether. They may think that they’re doing others a favor by staying away from social situations.
In time, BDD can lead people to drastic decisions. The International OCD Foundation suggests that up to 80 percent of people with this disorder have thought about or attempted suicide.
People with BDD can’t magically cure their thought behaviors. Often, they need help from trained professionals in order to shift their opinions about their body part defects and their overall attractiveness.
People with BDD may believe that surgery could help them to feel better, particularly if the surgeon they meet specializes in the body part that seems to cause the most distress. But often, surgeries don’t make people feel better. After all, the problem doesn’t lie with physical anatomy. The problem lies in the way the person thinks about or reacts to that anatomical feature. A better approach involves tackling those thought patterns directly, so people can think differently about their bodies, no matter what they might look like.
Therapists might ask their patients to measure how others respond to the body part of concern. If the issue is one of a crooked nose, for example, therapists might ask people to pull hair back, remove hats, skip makeup, and walk from one side of the grocery store to another while counting how many people look only at their nose. The therapist might take the walk at the same time, doing the same counting. Then, the two might discuss the number (which is probably low). When they do, they might be able to start to combat the inner voice that tells the person that the crooked nose is unbearable. If few people looked at it, chances are, that thought isn’t accurate.
Practicing good self-care might also be vital for people with BDD. They might need to learn how to eat well, sleep through the night, exercise, and meditate. They might work on assertiveness or communication skills. They might pick up hobbies they’ve let fall away. These are steps that can remove obsessive tendencies, helping people to focus on life’s pleasures.
This kind of work takes time to complete, and sometimes, it’s best for people to do that work in an inpatient setting. Here, people work on changing thoughts and behaviors around the clock, and they’re free of daily stresses that could spark a relapse. But some people do quite well with BDD work done on an outpatient basis. It just depends on how much social support the person has at home.
Someone with a tight and supportive family can lean on those people during therapy, and they can feel safe and secure at home. Someone like this can do well in outpatient care. But someone living in a difficult home or in a lonely home might need the added support of a residential community. It’s really a personal decision.
Healing Is Possible
With therapy, people can learn to look past a perceived flaw, and they can start to focus on the beauty that’s within them and around them. Help is available, and healing is possible.
Without treatment, BDD can lead to a great deal of pain and misery, but the disruptive thought patterns that come with this disorder don’t have to persist.