Have you ever stared at your skin in the mirror and become transfixed on a zit, a scar, or another perceived flaw? Or have you been preoccupied with the notion that your nose is odd-looking? Imagine having the belief that these shortcomings are the only things that other people notice about you, and that these beliefs result in feelings of humiliation, self-hatred, and excessive self-criticism. Body dysmorphic disorder occurs when these thoughts and feelings take up too much time, significantly disrupt your everyday life, and/or produce considerable emotional discomfort (such as worry, depression, or self-consciousness).
To understand any disorder, we look at its symptoms or clinical features. Let’s see what the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) says about Body Dysmorphic Disorder.
Body dysmorphic disorder is characterised by the person being preoccupied with a physical feature they perceive as flawed, even though this is not obvious or a cause for concern to objective observers, and there is a history of a repetitive behavioural component focused on the perceived physical anomaly, such as obsessively looking in the mirror, grooming to cover or fix the perceived flaw, or asking others for assurance about their appearance without sitting down. According to the DSM-5, Body Dysmorphic Disorder often manifests between the ages of 12 and 13, with an average onset age of 16 or 17.
Subtypes of Body Dysmorphic Disorder
There are two subtypes of BDD: MuscleDysmorphia and BDD by Proxy.
1. A subtype of body dysmorphic disorder is muscle dysmorphia, or MD (BDD).MD is linked to a variety of attitudes and beliefs about oneself and others, such as the conviction that one's body is not muscular and physically huge enough, intrusive negative thoughts about one's body that cause distractibility and difficulties focusing, etc.
2. Body dysmorphic disorder by proxy (BDDBP) is a variant of BDD in which a person has excessive worry for perceived flaws in the appearance of another person. The majority of people with BDDBP obsess about their person of concern (POC) perceived defect(s) for more than an hour each day, and many spend several (e.g., 3-8) hours each day concerned by unfavourable ideas about the POC's appearance. The major POC is typically a close relative (such as a spouse or partner), but they can also be a parent, kid, sibling, or a total stranger
What can be the risk factors for developing this disorder?
According to the DSM-5, child abuse is a risk factor for BDD. Additionally, first-degree relatives who have OCD have a higher risk of developing BDD. 2013 American Psychiatric Association One risk factor is sexual trauma (Buhlmann, Marques, & Wilhelm, 2012). Trauma can cause a person to dislike their own sexual features or features that the assailant liked, such as their hair. Peer abuse, bullying, and teasing may be contributing factors to BDD (NHS, 2014), but one must also take into account the statistical concept of base rate because not all children who are molested, abused, bullied by peers, or otherwise maltreated will develop BDD. This means that there must be additional factors at play. Unbalanced or insufficient serotonin levels have been implicated as a cause.
How do you tell the difference between being unhappy with a part of your appearance and BDD?
Although many people dislike some aspects of their appearance, BDD is diagnosed when the individual's excessive time and mental effort interferes with daily functioning or results in severe emotional distress. Many people dislike some parts of their appearance. However, you may have BDD if: You think about your perceived deficiencies in your appearance for at least one hour each day (add up all the time you spend doing this); and your preoccupation with the perceived imperfections hampers your daily performance, or it significantly distresses you emotionally. At some point, you may have engaged in repetitive behaviour as a result of your concerns about how you appear.
How do we treat Body Dysmorphic Disorder?
BDD sufferers have access to both therapy and medication-based treatments. These therapies aim to lessen the anguish brought on by concerns about one's appearance and obsessive behaviours, which are also frequently present in BDD, while also improving the quality of life and general day-to-day functioning of persons who suffer from BDD.
The only psychological treatment for BDD that has empirical backing is cognitive behavioural therapy (CBT), which has been demonstrated to be effective in treating BDD symptoms in both individual and group therapy. The main goal of CBT is to teach clients how to alter their ingrained attitudes in order to think and feel differently. This entails developing the ability to withstand the discomfort of "exposing" their perceived flaw to others and refraining from rituals connected to concerns about one's looks.
BDD treatment options include medication as well. Pharmaceuticals, notably selective serotonin reuptake inhibitors (SSRIs), and other antidepressants are used. Note that other classes of medicines, including antipsychotics, benzodiazepines and sometimes even other medicines may be used either alone or in combination. Many BDD symptoms, such as compulsive thinking, depression, and anxiety, are lessened by these medicines.