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What is Body Dysmorphic Disorder?

Body image and the public’s or society’s influence upon it is often discussed in great detail and with a great amount of disdain; however, what is often neglected is how our own internal thoughts and brain wiring effect our body image. It is easy to blame the photographs of thin models we see everywhere for a poor body image or for setting unrealistic expectations for our own body, but what happens when we look in the mirror and see something completely different then what is really there? This is Body Dysmorphic Disorder. Clinically, body dysmorphic disorder is a chronic mental illness in which someone becomes fixated on a perceived flaw in their body, generally either minor or imagined. These feelings are so strong that they are unable to stop thinking about them and cause feelings of depression and shame, sometimes leading to isolation due to the fear of others seeing said flaw.

This disorder leads to frequent if not constant intense obsessing over your body and it’s perceived imperfections. This causes significant, clinical distress and interferes with your quality of life. Unfortunately, it is difficult to improve this on your own, as often time visually you will see this imperfection every time or most of the times you look at yourself. The cause of the distress may be weight or a single body feature. No matter what the perceived issue is, the thought of it causes extreme discomfort and low self-esteem. Sometimes, this may lead to extreme actions to correct the flaw, such as disordered eating, extreme exercise, excessive cosmetic surgery, or isolation. Unfortunately, sometimes even when one issue seems to be resolved, the focus can shift to another part of your body. Frequent areas of concern are: facial features (skin, nose, wrinkles, blemishes), hair (thinning, balding, straight, curls), general appearance of skin, weight, breast or genitalia size, body structure, or muscle shape and size.

Sometimes these negative thoughts and fears are based off of a realistic trait; a scar from surgery, poor skin quality, or weight issues. Other times, these fears and obsessive thoughts are based off of a trait that is imagined to be negative. Either way, no matter how much someone tries to convince you that it is not true or is not a problem, you are unable to believe them. You may want to believe them, but at times you cannot. This concern and rumination not only takes an extreme emotional toll, but can also have quite a significant negative impact on your daily life by leading to difficulties in performing or attending your job, school, or social events.

Symptoms of Body Dysmorphic Disorder:

  • Preoccupation with physical appearance
  • Extreme self-consciousness
  • Either frequent examining of self in mirrors or extreme avoidance of mirrors
  • Strong belief that there is something wrong with your appearance
  • Fearing that others notice this flaw in your appearance and focus on it as well
  • Isolation or avoidance of social situations
  • Seeking reassurance about your appearance from others
  • Feeling or seeing little improvement after measures have been taken to correct the issue (i.e. cosmetic surgery or extreme weight loss)
  • Excessive or extreme grooming, exercise, or diet
  • The need to cover up perceived flow through clothing, makeup, facial hair, etc.
  • Frequent comparing of your appearance to others
  • Fear of or reluctance to be in pictures

While it is not exactly known what causes body dysmorphic disorder, it is suspected that it is a combination of abnormalities in brain structure or chemistry, genetics, and environment. It typically starts in adolescence, but can start as early as young childhood and can last well into adulthood. Both males and females are affected by body dysmorphia. People who have a family member, especially a parent or sibling with the disorder may be more likely to develop it themselves either due to the genetic predisposition or due to the environment created and taught behaviors and beliefs. Certain life situations, such as traumas, or personality traits may also lead a person to be more susceptible to developing the disorder. Other psychological disorders may contribute to the start of body dysmorphia or worsen the symptoms. And of course, societal influence and pressure plays a significant role in body image and can lead to the development of the disorder or worsen its symptoms if already present.

Difficulties or Consequences Associated with Body Dysmorphic Disorder:

  • Extreme weight fluctuations caused by unhealthy methods
  • Unnecessary or extreme cosmetic procedures
  • Difficulties forming meaningful and healthy relationships
  • Academic or Occupational difficulties
  • Low self-esteem
  • Psychological or medical hospitalizations
  • Depression, anxiety, eating disorders, obsessive compulsive disorder, or other disorders
  • Suicidal thoughts or actions

Fortunately, there are a number of treatment approaches available that can reduce the impact and symptoms of body dysmorphic disorder. In some situations medication can be useful in reducing the mental health issues that may lead to or result from the disorder. However, cognitive behavioral therapy has been one of the most effective methods in treating it. CBT will focus on learning about the disorder, understanding your thoughts and feelings, learning how to cope with emotions and teaching healthy manners in which to express them, and teaching ways to combat the distorted and intrusive thoughts that lead to body dysmorphia.

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