Dating someone with body dysmorphic disorder

Body dysmorphia was a huge part of my life when I was growing into my 20s. I would quite literally gasp at the numbers that reflected back at me on the scale, as they never represented what I had perceived in the mirror just minutes prior to the weigh-in. As a recovered anorexic , body dysmorphic disorder oftentimes goes hand in hand. I am proud to say that, for the most part, I have also recovered from body dysmorphic disorder.

What It's Like To Live With Body Dysmorphic Disorder

Illustration by Vivian Shih. But after a series of unsuccessful auditions, she began to lose confidence in herself. I hated my waistline, how my hair looked, my complexion, my height. It was horrible. She began to experience intense feelings of social anxiety. On the occasions that she could bring herself to leave the house, she dressed in baggy clothing and tried to hide her face.

I said to myself, 'I am depressed, I hate my body. I need to see a doctor. And if that doesn't work, nothing will. I'm not pretty enough to live. It was at this point that Natalie called a suicide hotline; the operator recommended she see a therapist. Soon after, she was diagnosed with body dysmorphic disorder BDD. S population suffers from BDD, a body-image disorder characterized as an excessive fixation, or preoccupation, with an imagined defect in appearance.

In many cases, it can lead to severe emotional distress and difficulties in day-to-day living. Common behaviors among BDD patients include skin picking, excessive tanning, a constant need for reassurance from others about their looks, and hair concerns. Though studies have concluded that BDD affects men and women roughly equally, there are differences in the types of preoccupations: Women are more likely to be occupied with their hips, their weight, their skin, and camouflaging perceived flaws with makeup.

With men, there's a large focus on body build often resulting in muscle dysmorphia , genitals, and hair thinning. In the most extreme cases, people with BDD are rendered incapacitated—unable to work, attend school, socialize, date or even walk outside due to an overwhelming anxiety that they'll be judged or ridiculed based on their appearance.

The effort that people put into looking better is often a way for people to feel safe. Although BDD causes people to obsess over their appearances, experts emphasize that the condition is far from superficial. Those who suffer from BDD may have difficulty maintaining relationships , and tend to cover up a body part, or several body parts, that they deem defective with makeup or extra layers of clothing also referred to as " safety behaviors ". These rituals, or compulsive behaviors, are time-consuming, repetitive, and result from a need to diminish negative thoughts about their appearance.

Most people with BDD don't want to look perfect—they want to look good enough to fit in. People with BDD have anxiety because they don't want to be humiliated. I am depressed, I hate my body. For the majority of people who suffer from BDD, this lack of safety and shame often develops during adolescence and early teen years, when kids are most susceptible to judgment from their peers.

While the root cause of BDD has yet to be determined, doctors cite brain abnormalities , genes , and environmental factors such as media images and a cultural fixation on appearance as contributing factors to low self-esteem and fixation on one or more flaws. Common in males with BDD, hair concerns stem from a fear of hair loss or going bald and can drive patients to cover their hair with caps, hairpieces, wigs, and scarves, while some undergo cosmetic procedures and hair transplantations.

Patients also focus excessively on facial hair, or having too much or too little body hair, and go to extreme lengths to remove it by shaving, waxing, or plucking in order to reduce anxiety—which can be a very time-consuming ritual that can result in infection, disfigurement, and scarring. In his senior year of high school, Matt started to fixate on his hair, spending hours examining it in the mirror, feeling uneasy when it was out of place, and adjusting it until it felt perfect.

But once he graduated high school, and moved back to his home state of Utah, Matt's symptoms manifested into a full-blown obsession. I kept noticing that I would go back to the bathroom and fixate on it. I couldn't pull myself away from the mirror. Soon, things started to get worse, and eventually Matt's life started spiraling out of control. It was just really paralyzing.

I couldn't hold a job for a number of years. I was simply tied up in the bathroom. It's embarrassing. I spent so much time fixating on my appearance that it dominated my waking hours. I wasn't able to function. I was holding back a lot," he says. Many doctors aren't trained in recognizing the telltale signs of BDD, leaving those suffering from the condition vulnerable. A Program For Overcoming Body Image Problems , believes that while patients may hold back information about their symptoms, the problem also lies with physicians.

Before BDD was as well known, it was very common for patients to just tell me that they had been in treatment for many years and that their BDD was never diagnosed and they were never asked about it. Even when healthcare providers do possess the tools to identify and treat BDD, the lack of clinics specializing in treating the condition in the US can prevent patients from receiving appropriate care.

In Wilhelm's opinion, widening the network of access is a huge priority. As Wilhelm sees it, one of the most pressing priorities is training providers throughout the country in how to best treat BDD. Since the mids, he has been working with Katherine Phillips, the founder and director of the BDD Program at Rhode Island Hospital and author of The Broken Mirror , to come up with treatment manuals, modules, and therapy studies for providers working with BDD patients.

One of their main focuses is Cognitive Behavioral Therapy CBT , a treatment that, over time, helps patients to pinpoint the source of their anxiety and change their maladaptive thoughts, such as, "I'm unlovable. We work a lot on self-esteem as part of the treatment, because when patients often come in, their entire self-worth is tied in with their appearance concerns, and over the course of treatment it changes. For some patients, CBT proves extremely useful: When she started therapy, her symptoms, which included depression and bulimia, were so severe that they were keeping her from attending class and work.

In her first few sessions, her doctor used perceptual mirror retraining , a technique used for developing a healthier relationship between patients and mirrors, before transitioning her to CBT treatment. It wasn't so much me realizing, 'Oh, I'm beautiful, I'm a good person. Along with CBT treatment, other BDD treatments include exposure response prevention —which places patients in situations that confront their fears until the fear subsides, and works to prevent patients from engaging in avoidance or escapist behaviors—and selective serotonin reuptake inhibitors SSRIs , antidepressants like Celexa, Prozac, Paxil, and Zoloft that are used in the treatment of major depressive and anxiety disorders.

While there are no medications approved by the FDA to treat BDD, studies and clinical trials have shown that SSRIs are safe to use and often lead to patients becoming less stressed, less anxious, and their quality of life has shown to significantly improve over time, especially when paired with CBT. But [the ones that have been conducted] all show that these medications are often really helpful in decreasing the preoccupations, the compulsive behaviors.

The urges aren't as strong, and it improves anxiety and suicidality. Every expert interviewed emphasized the importance of looking at BDD holistically and working to address the root causes of the disorder in treatment. Everybody's symptoms come from a different etiology, and our job is to find out who the patient is and then treat them based on how their BDD developed.

As treatment and research steadily evolves, the need for BDD awareness among doctors and the public is vital. While an increase in media attention in the last few years has led to a better understanding in how BDD develops over time, and how best to treat it, there are still significant gaps in education, both for providers and those suffering from the condition. Like Wilhelm, Phillips believes that not only do clinics providing BDD treatment need to be more accessible, and that more studies need to take place, but that awareness for people experiencing symptoms of BDD needs to improve.

I encourage people to give it a try. Those who suffer from body dysmorphic disorder fixate obsessively on one or more perceived flaws in their appearance, resulting in depression and social anxiety—and, in extreme cases, thoughts of suicide. This article originally appeared on Broadly.

If you know someone who has become depressed and is excessively preoccupied with his or her appearance, consider the following information regarding body. We all feel insecure about our appearance from time to time, but when you're struggling with body dysmorphic disorder, you battle obsessive.

They constantly compare themselves to others. Thanks, gym owner, but your message is not motivational. When you feel a conversation heading the way of a competition about who can feel the worst about themselves, put a stop to it. Try this: When you're telling your friend you understand this is real for them, always finish with "there is help", Morgan says.

Body dysmorphic disorder BDD is a serious mental illness.

Aaron was a senior in high school, and his grades had begun to decline. He seemed depressed. Aaron was determined to find the perfect product for his hair.

Personal Stories

You find yourself not wanting to participate in social activities like dating, playing on a team sport, or eating lunch with your classmates. Even going to and sitting in class can be tough. You are so concerned about your appearance that you spend hours trying to fix or hide aspects of your body. Many teens with BDD take near-constant photos, examining their looks from certain angles. You might also get stuck in front of the mirror checking to see if your nose looks as big as the last time you checked, styling your hair, or picking your skin.

8 Things You Should Know About Body Dysmorphic Disorder (BDD)

It's a psychiatric disorder related to obsessive-compulsive disorder OCD. People with BDD spend at least an hour per day but often even longer thinking about a flaw in their appearance that's either minor or not there at all, says Danyale McCurdy-McKinnon, Ph. About 2. BDD seems to occur just about evenly in men and women, though men are more likely to have preoccupations with muscle size or genitals, says Fine Shepphird. In fact, the subset of BDD called muscle dysmorphia which is characterized by distorted thoughts about muscle size, shape, and leanness is almost exclusively diagnosed in men. For example, they might think their nose is distractingly huge or misshapen when it's objectively ordinary. Whether the object of their focus is something real or imagined, a person with BDD would experience consuming preoccupation with it and also believe that their "flaw" makes them hideous or even disfigured, says McCurdy-McKinnon. People with BDD engage in compulsive or repetitive behaviors, explains Fine Shepphird, like constant mirror checking, obsessively picking at their skin or hair, or excessively exercising, grooming, or comparing themselves to others. In severe cases, people may also seek cosmetic surgery to "correct" whatever they perceive is wrong.

Illustration by Vivian Shih.

I would look around the room, avoiding everything but his or her eyes and pretend as though I was really , truly racking my brains, but I knew that I had no idea of the point which I became a body dysmorphic. It just happened.

14 Brutal Truths About Loving Someone With Body Dysmorphic Disorder

Here are a few things you can say to someone with body dysmorphia that will actually help them, instead of making them feel worse. Like so many mental illnesses, body dysmorphia can be incredibly painful to talk about, especially because the sufferer will fear seeming shallow or vain or calling more attention to the perceived imperfection. Make your relationship with them a judgment-free zone, allowing them to openly discuss how they feel with you. Simply having empathy for what they are telling you is so, so powerful. They may prefer for you to distract them by doing fun activities that can help take their mind off their disordered thoughts. Some good ideas: Potentially triggering activities can include exercise, clothes shopping, or eating out, since they can all trigger negative thoughts or worries about their body. If you think you or a loved one is struggling with body dysmorphia, there are many valuable resources available to help better understand BDD and the many ways it can manifest itself. You are definitely not alone. Arielle Tschinkel August 28,

6 things you can say to someone who has body dysmorphia that actually help

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Individuals with body dysmorphic disorder BDD have markedly poor social functioning; however, previous reports may underestimate impairment. Scoring on certain functioning measures such as the Social Adjustment Scale-Self Report SAS-SR potentially excludes more severely ill individuals from some domains, thereby possibly underestimating functional impairment. To explore this issue, 73 individuals with BDD who reported having no primary relationship and were therefore excluded from scoring on the SAS-SR Primary Relationship domain were compared to 58 individuals with BDD who had a primary relationship. Subjects without a primary relationship had significantly poorer global social adjustment on several measures. They also had poorer scores on the Global Assessment of Functioning Scale and greater severity of BDD and depressive symptoms at a trend level. This underestimation may pertain to other domains of functioning, other disorders, and certain other functioning and quality of life measures.

When I was a teenager and had my first encounters with the opposite sex, some remarks were made publicly about how my genitalia looked. It was humiliating and triggered a year obsession with my physical appearance. The symptoms of BDD I displayed were checking myself physically, sometimes measuring myself times a day. This resulted in all sorts of awkward social situations! I would also spend long periods of time staring into mirrors. Being disgusted and ashamed of what I saw, I would then spend long periods avoiding mirrors altogether. Believing that everyone could see what I saw, I began isolating myself. I did travel but found it very difficult to function.

Even though an estimated 1. Body dysmorphic disorder BDD , the obsessive preoccupation with one's own skewed self image and a perceived flaw s , can cause anxiety, depression, and pervasive thoughts. The obsession, while varying in degree, can severly impact one's happiness and quality of life. Because of the stigma that often follows the idea of vanity, many people who struggle with this disorder also don't openly talk about it. For someone who struggles, self-worth can be more than just a challenge to find. And loving someone who deals with BDD and giving them your support means more than providing compliments and reassurance.

In order for this disorder to be identified and treated earlier in life, we need to bring it into the spotlight. BDD isn't usually diagnosed until your 20s, but my earliest memories of encountering my BDD date back to when I was around 9 years old. I saw a picture of myself, and I first became aware of my horrifying appearance. I remember being inconsolable as I realized I was fat, deformed and generally hideous. When I was getting ready; when I saw my friends and compared myself to them; when I saw an attractive person in the street; when I saw someone on television or in a magazine; whenever I saw a mirror or reflective surface; and whenever I was in a crowded public space.

CBT for BDD - Rob Willson - Body Dysmorphic Disorder (BDD) Conference 2015, London
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