Me, the picture this article is based on
Body dysmorphic disorder or BDD is a mental illness characterized by a skewed perception of the self. People with BDD spend large amounts of time obsessing over and trying to “fix” a physical flaw that they believe they have. Often this flaw is more imagined than real. Take for example, people who become addicted to plastic surgery. No matter how many procedures they get, in their minds, they always fall short of perfection.
I remember watching Dr. 90210, a show about a plastic surgeon and his practice in Beverly Hills, California. Not only did it appear that his wife, who got skinnier and skinnier every episode, had a titch of this disorder, but it also seemed to plague many of his patients. On one episode, a woman who’s body was on par with a Victoria’s Secret model came into the office for a consultation. She said that her thighs were fat. It was pretty anticlimactic when she revealed her thighs and pointed out the region of imperfection because there was none.
I didn’t realize that I too had a bit of this BDD. I always feel fat and bloated. I am still trying to lose “that last twenty pounds.” And it wasn’t until I saw a recent picture of myself that I realized that I might be suffering from the disorder.
When I talk about wanting to lose twenty more pounds, my family often looks at me like I am crazy. They say things like “where is that twenty pounds gonna come from?” And I roll my eyes, believing that they are clearly lying to me. When I saw a recent picture of myself, I gasped. I could not believe how thin I was. I never would’ve guessed I was so small, and the realization was shocking. Internet dating again, I had initially put the picture up on my profile because I looked so thin. A few of the guys I had been talking to said that they liked the picture but would prefer some that “showed my curves.” I was disgusted by this comment. Were they politely hinting at seeing more revealing pictures of me? Pictures that were possibly if not borderline pornographic? I suspected that was what they were insinuating until then I looked at my picture a second time. I was head to toe covered. Long jeans. A black t-shirt with a long sleeve black thermal underneath it. If I had thrown some black fabric over my head, you could’ve easily mistake me for a nun. I gasped at my shrouded appearance. This too was part of the BDD.
Some people with BDD think they are really fat. Like me in that photograph, they wear extremely loose fitting clothing to cover their imperfections. Seeing this picture was certainly a wake up call. However, I often feel that I am bloated and my pants are too tight. It is not only after I eat that I feel that way. A friend pointed out that it is psychological.
When I was in high school, I steadily weighed ten pounds less than I did in this picture, and even then, my mother told me that I was fat. So even at that low weight, every time I looked in the mirror, my brain imprinted the idea that I was fat. So now that I have a body that is ten pounds heavier, I still have a mind that considers my weight minus ten pounds to be overweight.
What I am currently experiencing was obviously not a new struggle with weight and self-perception, but something that started before I was a teenager. I did receive counseling for it and recall one particularly savvy counselor. She had large sheets of paper on the wall and asked me and the other girls to draw a life-size picture of how big we thought looked. She then had us stand against the drawing. Of course, we were much thinner than we perceived ourselves to be. She said that a study was done in the same fashion and that researchers found on average people with BDD portrayed themselves to be on average 20lbs heavier than they actually were.
The disease itself is characterized by obsession, depression, anxiety, avoidance, shame, alcohol/ drug abuse, perfectionism and troubled relationships. Sufferers of BDD are also plagued with compulsive behaviors attached to the misperception of the self. Some of those compulsions include: constantly looking in the mirror or an inability to look at oneself in the mirror; camouflaging or attempting to camouflage the perceived defect; compulsively touching said defect; self-harm; constant exercise and dieting; and repeated plastic surgery.
It was obvious from my shrouded appearance that I was exhibiting some of these compulsions. In fact, I rarely post pictures of myself on my blog and usually prefer not to call attention to my physical self.
According to Wikipedia, “in research carried out by Dr. Katharine Philips, involving over 500 patients, the percentage of patients concerned with the most common locations were as follows;”
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It is my guess that at least 90% of people would have some part of their body that plagues them with BDD. What do you think?
Ph Lord.. I have enough for everyone to go around.
You are such an itty bitty thing.. BUT I know how you feel EXACTLY.
HUGGGGGGGGGGGGGG
Pssh you’re gorgeous!! Awwww thanks! That makes me feel great!
I am so sorry for anyone suffering from that disorder. I was talking to a co worker today who is 134 and 5’7″. Her doctor says 135 and up is normal so she is a little worried. She has nervous bowel disorder and the stress of living in the city and not having much money and boy troubles is tough. She is exercising all the time and people are telling her she is too thin. I told her to drink milk shakes. I think I am the opposite. I think I am thinner than I am. It is such an illusion. That is why I like good sex. It makes your body sing and that is a good thing.
Hahah- I like how you think- thinking the opposite- I like that!
I suffer with BDD. It began 27 years ago. OCD followed 2 years after onset. Through my constant experience with many psychiatrists/psychologists who are BDD experts- & my obsessive research- I know more than I ever wanted. Though it is understandable, the comments here and in most forums show a complete misunderstanding of the severity of BDD. As an example, it has a suicide rate that is rivaled by only the most severe of mental illnesses.
In my opinion, you may have an eating disorder. Though eating disorders share some similarity to BDD, each is a separate diagnosis. And after an expert, the right diagnosis follows as crucial steps in ultimately getting the proper treatment.
It is encouraging that you cite Dr. Philips, as she is probably the worlds leading authority on BDD. However, only a minute % of the population suffer from BDD. Your 90% guess is 100% wrong. I say that with all due respect.
Yes, just about everyone worries about appearance. But that is a far cry from BDD. It is also vital that people close to you understand that BDD-if you in fact have it-is not vanity. It actually is the complete opposite, which most can’t fathom.
For you, getting the right diagnosis from an expert is crucial. As far as online resources, BDDcentral.com is the best site I have come across. I wish you the best. And I am sorry for my lengthy comment.
Thank-you for you insightful comment!
Your welcome. I may not have been a help to you, but it is highly satisfying to me when I have helped fellow sufferers- whether BDD or OCD. There is no better feeling. Even the finest doctor cannot personally identify w/ this.
Don’t get me wrong. I am hardly healed of my problems, and there is no cure. I have gone through periods of great relief, as well as depths of misery. Though I don’t want to depend on meds my whole life, it seems inevitable. And while the right combination of meds may work for someone over the long run, that has not been my experience.
Nothing was more heart-braking when after 8 months of great relief at age 25, my meds stopped working. Since then, it is a constant battle to find that “magical” pill – and the most effective for me have been off-label. You learn that you will never be the same person you once were. If I can manage – function – it is a success for me. Thank God I can manage right now, but I have learned it may not be the same tomorrow.
Ya I have to say seeing that recent picture of myself was a wake up call to be more aware of the reality of the situation- though I still feel fat and bloated- always in my stomach area- even as we speak, right now.
By the way, you truly are beautiful. After rereading your words, maybe you do have a “bit” of BDD – rarely post pictures, loose clothing. Whatever the words to describe it, you are doing a great service by writing about BDD – Many are not aware, or don’t believe they have it.
W/ BDD – one truly thinks they are ugly. I dont think you believe that. Most often, the BDD sufferer is actually handsome/pretty. And u can tell a BDD sufferer all day that they are handsome/beautiful, but that does nothing in long term.
The following may or may not help you, but:
Your feelings & beliefs are your opinion, not a fact. So why give importance to thoughts/feelings? The problem is not the initial anxiety-provoking thought – I feel bloated. The problem is reacting to it in any way – trying to prove it true or false, trying to fix it, or fighting it. All these reactions give importance to the initial thought, and only cause further strife that leads nowhere in the long run. And it is inevitably repeated.
Compulsing/reacting alleviates anxiety in short term, but only reinforces destructive pattern. The answer is not to react to the initial thought. It is hard, but letting it pass w/out catering to the urge to react is the answer. The initial feeling will dissipate, usually in a few minutes or so. Maybe less.
It gets easier as u “train” brain to not react. Also, I have “learned’ to try and live w/ uncertainty. To go on in uncertainty. We do this all the time, w/out even knowing it. For example, I don’t know if my nephew will come home safe from school. But if this is even a conscious thought, it is fleeting at best.
The anxiety u feel at first thought/feeling, in and of itself, is not so bad. Everyone thinks anxiety is to be never felt. But we all feel it – whether in social situations, speaking, etc. But most don’t run from the anxiety – it dissipates w/ time, while some d0 run,eg, running home to “safety” from a social situation. The more you avoid anxiety provoking situations, the more frightening it will get.
Much of the above does not apply to you – I hope not. I am only guessing that u may react to initial feeling in non-productive way. Finally, know that others’ words about your appearance are also just opinions. Not facts. W/ BDD, most, including me, let how they think they look determine how they feel about themselves. This can change from one mirror to next, to a reflection from car window, etc. But mirrors lie. And there is no evidence that beauty correlates to a happy life – there are countless “ugly” people who live perfectly “normal” lives. A BDD sufferer has to try and change the value he puts on looks. I apologize for commenting so much.
“Compulsing/reacting alleviates anxiety in short term, but only reinforces destructive pattern. The answer is not to react to the initial thought. It is hard, but letting it pass w/out catering to the urge to react is the answer. The initial feeling will dissipate, usually in a few minutes or so. Maybe less.” this sounds like this is key…
Don’t apologize- I encourage commenting- how long have you been suffering with BDD?
Hi. Though I wrote above it began 27 years ago, it’s been 25. I miscalculated. I was 17 when it started. Though I knew something was wrong/I changed dramatically, it took me 6 years to seek help. I believe an anxious/stressful event that I suffered triggered a genetic predisposition. I look back & I know if I reacted to this event differently – seemingly a trivial at the time – my whole life would have been different.
Before BDD, I was a happy-go-lucky kid, played sports just about every day, just comfortable/natural in my own skin. My childhood was wonderful. I didn’t even realize at the time how lucky I was. I also am pretty smart, which I have wasted in large part. I have not participated in life since then, with sporadic good times.
I sort of began to “quit” life. Withdrew slowly. Quit basketball & baseball teams in my senior year of high school. BDD dominated every second of my life. I had a girlfriend previous to onset, who I continued to date until age 23. After onset, I treated her differently – accused her of cheating all the time when I actually was guilty, repeatedly asking her 4 reassurance about how I my face looked, etc. Though we also had great times, I put her on a roller coaster – one moment all was good, the next not so good.
Though looking back is a losing proposition, I believe/know I would also have a family now, as well as a productive career. I am still dependent on my parents. Sorry to vent.
i just wonder WHERE DOES THIS COME FROM??? is this exclusive to our times and in first world nations? i can’t imagine the women in Darfur, Haiti or Afghanistan suffer from issues like this. did our great or great great grandparents have to deal with these problems? maybe living hand to mouth in survival mode drives all these problems out of ones mind.
In response to Paul, this comes from “a chemical imbalance”, which is triggered by a stressful event. Through my reasearch, I read at one time a “chemical imbalance” is impossible – but despite the description – it is definitely inb the brain. I personally know this to be true via sporadic alleviation of my symptoms from meds alone.
Environment, I believe, plays a role – in that looks are so “important” in our culture. I can only speak for myself/my opinion, but nurture alone cannot cause this.
It is not exclusive to our times/western culture. It has been documented as early as 1800’s I believe, though under a different name. Trust me, women/men all over the world suffer from this. Though they in large part must have no clue what they suffer from/put a name on it. It is a disorder, just as bipolar, major depression, schizophrenia, etc.
About parents/grandparents, yes, they reacted differently. If they suffered minor depression, I’m sure stayin busy helps. If they had a more sewrious disorder such as this, they remained silent in shame and didn’t know what was going on in their head. I believe many turned to drugs/alcohol as medication. People then, and today, just say “brush it off”. Or believe sufferers are just lazy when housebound.
No one can truly identify w/ this unless they have it. It is natural/understandable to believe it is just vanity or overly concerned w/ looks. And unlike cancer and the like, this is unseen. But believe me, it is the complete opposite of vanity and a sufferer would do anything to get outside of themselves – to stop focusing on their looks.
My Dad/Grandfather are old-fashioned. They really don’t “buy” any mental illness. When my Dad questions my need for meds, I explain I need them just as he needs high blood pressure medication. Still, I know he is skeptical.
I recall an instance when I was suffering real bad. In trying to explain it to my Dad, I said I would gladly have my right arm cut off instead of BDD. And I meant it completely.
It is so irritating to me how people treat mental illness. The meanest people (that I know) who are anti meds etc and don’t believe in depression and all this etc are usually people who need the meds the most…
I wonder too and suspect maybe this and other things have always gone on just perhaps “unnamed” and “undiagnosed.” I wonder about eating disorders and those complexes among nations with food shortages..
“.. meanest people (that I know) who are anti meds etc and don’t believe in depression and all this etc are usually people who need the meds the most…” – I agree, and it is ironic.
The brain is a funny thing.
Eating disorders & OCD involve the same part of the brain & the same cklass of meds are prescribed for both. I may be wrong, but eating disorders – years ago – were thought to be caused by psychological & social factors only, when we now know biology also plays a part.
I know for myself the meds that have helped most – when combined w/ an SSRI – are only “approved” for ADD, anxiety, and even epilepsy – which I don’t have.
I believe – through my own experience & research – that some illnesses thought to only involve serotonin or serotonin/norepinephrine do not. To my knowledge, dopamine is the other neurotransmitter involved w/ mental illness. But I believe there are 100’s – some yet to be discovered.
I say whatever works for a person is great. But I do believe some cases of mild depression/anxiety may not call for meds as 1st line of defense – when exercise, behavioral therapy, diet may help. Maybe the rampant TV commercials play a factor in this.
I know for myself, I wish I wasn’t at the mercy of meds.