Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a chronic mental illness sometimes referred to as "imagined ugliness" wherein the person becomes preoccupied with his or her minor or imaginary physical flaws. The person may seek out cosmetic procedures which do not satisfy him or her no matter what the outcome is. ^[1]

Epidemiology

BDD is often missed in diagnosis and is usually a hidden disorder thus actual rates are undetermined. One review shows that between 1 per cent and 4-5% of the population is affected by BDD at any one time and up to 12% of patients seen in dermatology clinics and up to 15% of patients in search of cosmetic surgery had a diagnosis of BDD. ^[2]

Causes

Exact cause is unknown. Theories suggest that problems with certain brain chemicals called neurotransmitters cause the disorder since BDD is often found in people who also have other psychiatric conditions. Other factors that may trigger BDD are: traumatic events or emotional conflict during childhood period, low self-esteem, people around the person who were critical of the individual’s appearance and pressure coming from friends and the society.^[3]             

Symptoms

Symptoms include being constantly worried with minor or imaginary physical flaws commonly in the skin, hair and nose like acne, scarring, facial lines, thinning hair, excessive body hair, large or crooked nose which is accompanied by time-consuming behaviours on the perceived flaws such as frequent skin picking, excessive  mirror checking, excessive efforts on hiding imperfection, too much comparison of self with others, excessively grooming and  constantly asking for  reassurance from others about how he or she looks. The person often wants and undergoes cosmetic surgery. ^[4] BDD may also result to problems at work or school, or in relationships due to the failure to stop focusing about the defect. The person has feelings of self-consciousness and tries to avoid the public and is usually feeling anxious when around other people.^[3]

Diagnosis

After complete history and physical examination are taken, the physician may order laboratory examinations. Psychological evaluation is necessary to assess thoughts, feelings and behavior patterns.^[1]

Treatment

To help relieve obsessive and compulsive symptoms of BDD, antidepressant medications are usually given which include elective serotonin reuptake inhibitors (SSRIs). Cognitive-behavioural therapy (CBT) also  teaches patients to be familiar with irrational thoughts and how to effectively change negative thinking patterns. Often, combination of these treatments is suggested.^[5] Social support is important.

References:

1. http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559
2. http://www.mind.org.uk/help/diagnoses_and_conditions/body_dysmorphic_disorder
3. http://my.clevelandclinic.org/disorders/body_dysmorphic_disorder_bdd/hic_body_dysmorphic_disorder.aspx
4. http://www.medicinenet.com/body_dysmorphic_disorder/article.htm
5. http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd