What Is Body Dysmorphic Disorder/Body Dysmorphia (BDD)?

Body dysmorphia or body dysmorphic disorder (BDD) is a mental health condition characterized by an obsession with how you look. More specifically, it is about a perceived flaw in your appearance. This perceived flaw causes great distress. People with BDD can become so obsessed with their perceived flaws that other areas of their lives are affected.

The perceived flaw in one’s appearance could be minor. It might be barely noticeable by other people. For the person suffering, it is magnified and becomes a part of their everyday life. Body dysmorphia disrupts normal life by affecting their view of themselves.

Their self-perception might lead them to withdraw socially. They might miss important dates and appointments. More severe symptoms of BDD include substance use and suicidal thoughts.

The perceived flaw can cause a person with BDD to feel stressed, anxious, and depressed. It can impact their ability to function in day to day life. BDD is especially disruptive when it happens alongside addiction.

The journal Dialogues in Clinical Neuroscience reports that five to ten million Americans suffer from BDD. BDD is more common than anorexia nervosa (AN). Anorexia affects just over 3 million Americans, or 1% of the population, according to Medscape.

The cause of BDD is generally unknown. However, several common risk factors play a role. These are psychological, biological, and environmental factors. According to a report in Psychiatry Annals, potential causes of BDD include:

a eoman looks into a broken mirror
  • Abuse
  • Child Neglect
  • Having a relative with BDD
  • Bullying
  • Trauma
  • Beauty standards
  • Low self-esteem
  • Personality type
  • Critical parents

Traumatic experiences in childhood strongly relate to BDD. If you were abused or made to feel unworthy as a child, then the report claims you are more likely to develop BDD.

What Are the Signs of Body Dysmorphia?

BDD affects men and women. The journal Psychiatry Research explains that it usually begins in adolescence. Adolescence is a time of increased self-consciousness and vulnerability. When BDD occurs during this time, it can cause great distress. Adolescent BDD can lead to the development of anxiety and depression.

People with BDD usually develop certain habits, behaviors, and compulsions in response to their condition. Typical signs of BDD include:

  • Mirror checking
  • Nail-biting
  • Scratching, itching, picking skin
  • Hair pulling
  • Looking for reassurance about your appearance
  • Constantly comparing appearance to others
  • Touching the ‘flaw’
  • Comparing yourself to others
  • Expressing hatred about your appearance

These behaviors can vary in frequency and intensity throughout a person’s life. Many sufferers might use substances to cope with the difficult emotions that come with living with BDD. BDD is a serious mental health condition. This means that even though substance misuse might provide some relief, it is only temporary.

The symptoms and difficult emotions will return when the substances wear off. The use of substances is dangerous because, over time, it can lead to dependence and addiction.

Body Dysmorphia and Addiction

Addiction can affect anyone. It is a serious illness, and according to the Journal of Clinical Psychiatry, people with BDD are at a higher risk of developing an addiction. The emotional distress associated with the condition leads many sufferers to self-medicate with body and mind-altering drugs.

According to the U.S. National Library of Medicine, people with BDD are 2 – 13% more likely to have a SUD. One study even found that 68% of participants reported that BDD played a role in their drug dependency.

Body Dysmorphia and Substances of Abuse

The type and severity of BDD varies among individuals, as do the drugs used to cope. People with BDD often use substances that influence how they look. Weight and muscle mass are particularly common points of focus for people with BDD.

For example, steroids might be used to build excessive amounts of muscle. Cocaine is often misused for its ability to reduce appetite, thus making it a tool for weight management.

Body Dysmorphia and Cocaine

People with BDD are often willing to go to extreme lengths to control their appearance. It is common for those with BDD, particularly when there are issues regarding body weight, to use cocaine.

Regular cocaine use disrupts normal metabolic processing in the body. The weight loss that follows regular cocaine use happens because the body’s ability to intake and store fat is reduced.

Cocaine dependence can make recovery from BDD difficult. As the person stops using cocaine, they are likely to gain weight in a short space of time. This can bring on the difficult emotions of BDD and increase the likelihood of relapse.

Body Dysmorphia and Steroids

A specific type of BDD is muscle dysmorphic disorder (MDD). People with MDD do not feel their bodies are muscular enough. This condition is most often seen in sports settings, such as athletic clubs and gyms.

Note that a person who enjoys bodybuilding does not necessarily have MDD. However, they may have MDD if they use anabolic steroids or growth hormones to speed up and support muscle growth.

Research shows that steroid abuse is common. Around three million people regularly use anabolic steroids for bodybuilding.

  • Family history of body dysmorphic disorder or obsessive-compulsive disorder (OCD
  • Traumatic events, such as childhood neglect or severe bullying
  • Overexposure to sexual imaging and unrealistic beauty standards in the mainstream media
  • Having certain personality traits such as perfectionism
  • Living with other mental health disorders such as anxiety, depression, or bipolar disorder

Treatment for Body Dysmorphia and Substance Addiction

Cognitive Behavioral Therapy

Cognitive behavioral therapy, also known as CBT, is a form of talk therapy that involves frequent meetings with a mental health professional, with the ultimate goal of lessening the symptoms of a disorder. In the case of body dysmorphic disorder, cognitive behavioral therapy serves as a tool to identify the underlying causes for the disorder itself, and how to control triggers that give the client negative feelings about themselves. Therapists ensure a completely judgement free, safe space where clients are free to talk about their issues without fear of social repercussions.

Antidepressants

Antidepressants are sometimes prescribed for severe cases of body dysmorphic disorder, specifically in cases where self-harm tendencies or suicidal thoughts are present. Antidepressants aim to restore chemical balance in the brain by altering the levels of the neurotransmitters, dopamine, serotonin, and norepinephrine. Selective serotonin reuptake inhibitors (SSRI), are a form of antidepressant commonly used to treat body dysmorphic disorder. Those under 30 years of age will need to be closely monitored in the first several weeks of beginning doses of SSRI. Effects of SSRI may take up to 12 weeks to be noticeable, and doctors will slowly lower the dosage if symptoms of body dysmorphic disorder are no longer present. If SSRI does not help with reducing the frequency or intensity of symptoms, other forms of antidepressants may be prescribed.

Alternate Therapies

If neither of the above methods prove effective, there are several other therapy options available that may be recommended by health professionals on a case by case basis. Family therapy, group therapy, and yoga therapy can all be used to combat body dysmorphic disorder.

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