Are you constantly worried about your appearance? Let's talk about Body Dysmorphic Disorder (BDD)!

It's normal for us to think about little things about our appearance sometimes. But have you ever spent hours thinking about a 'flaw' you think you have in your appearance, and felt a lot of pressure and sadness about it? Do you still feel the same way even when others say 'there's no such thing'? Then this may be about something that is very important to you.

What is Body Dysmorphic Disorder (BDD)?

Simply put, Body Dysmorphic Disorder , or BDD for short, is a mental health condition. What happens is that you view your own physical appearance in a very unfair way. The thoughts and feelings you have about your appearance can completely cloud your mind. Ultimately, BDD can have a huge impact on your happiness in life and the way you feel about yourself.

We all have different body features, right? That's normal. But someone with BDD feels that one or more features of their body are 'major flaws'. Because of this belief, you spend a lot of time thinking about what you think is 'wrong' with your body and trying to change it.

This is very important: There is an increased risk of self-harm or suicidal thoughts and behaviors with this condition (Body Dysmorphic Disorder). If you are thinking about harming yourself, or if you suspect that someone you know is at risk, please seek help immediately. Immediately see a doctor, a mental health counselor , or go to the nearest hospital emergency room. You can also get free counseling services from places like 1926 Sumitrayo in Sri Lanka.

Are Body Dysmorphic Disorder and Body Dysmorphia the same thing?

Now you might be wondering if Body Dysmorphic Disorder and Body Dysmorphia are two different things. No, they are two names for the same condition. Body Dysmorphic Disorder is the technical name for this condition. But Body Dysmorphia is the name most people are familiar with.

How common is this condition (BDD)? Who can develop it?

How common is BDD? In fact, experts say that about 2.4% of adults in the United States have it. In other countries, the figure is between 1.7% and 2.9%. Although there is little specific data on how common it is in our country, it is a condition that can develop in anyone.

Who is more likely to develop BDD? It often starts when you're young, around the age of 12 or 13. Two-thirds of people with BDD develop it before the age of 18. However, it can sometimes start later in life.

What are the symptoms of BDD?

Okay, so what are the symptoms of BDD? Since it affects the way you see yourself and how you feel about your appearance, the symptoms can vary. Let's look at some of the most common symptoms:

• You spend hours thinking about at least one thing you think is a 'flaw' or 'blemish' on your body. Even if others say it's not a big deal, they probably don't even notice it. Also, you constantly compare your appearance to others'. Imagine, Nimali feels that her nose is a little long. She thinks about it all day, looks in the mirror, and asks her friends, 'Does my nose look long?' Even though her friends say, 'No, it's not like that,' Nimali isn't sure.
• The temptation to constantly check your appearance in a mirror or on a shiny surface like a window, or to ask other people for their opinions. Some people avoid posing for photos or looking in the mirror because of the pressure they feel when they see their appearance.
• Changing your appearance frequently. For example, tanning, changing your hair style frequently, or changing your clothes frequently.
• Taking selfies regularly to check your appearance, or using photo filters to hide or change the parts of your appearance you don't like.
• The fear of others looking at you and judging you for the parts of your body you don't like, the fear of being laughed at, the feeling of anxiety. Some people even have panic attacks when they see parts of their body they don't like in the mirror.
• Feeling ashamed or disgusted about your body, your appearance, especially in areas you think are problematic. People with body dysmorphic disorder (BDD) often use words like 'ugly', 'disgusting', 'deformed', 'abnormal', 'defective' or 'unpleasant' to describe themselves or their body parts.
• Compulsive grooming behaviors that are harmful , such as hair pulling (Trichotillomania) and skin picking (Dermatillomania) . These are separate mental health conditions from BDD and require different treatments.
• Avoiding situations where you think others will see parts of your body that you don't like. This can interfere with your work, schoolwork, or cause you to avoid social events and meetings.
• Continuing to resort to medical procedures, especially cosmetic surgery, with the intention of 'fixing' the parts of your appearance that you don't like.
• Having thoughts of harming yourself or committing suicide because of your appearance.

Muscle dysmorphia

Another specific form of BDD is muscle dysmorphia . This is when you have negative feelings about your body shape and the appearance of your muscles (either all over your body or in one or a few areas). You often think things like, 'I'm too thin', 'I don't have enough muscles'.

Insight into this situation

Now, people with BDD can have different levels of insight into their condition. 'Insight' means they know that their way of thinking is irrational and unrealistic. However, just having that insight doesn't stop the condition from having an impact. Doctors also consider this insight when diagnosing the condition, because it can affect the way they treat BDD.

There are three main levels of understanding:

• High or moderate awareness: This means you know that the criticisms and beliefs you have about your body are not necessarily, or often not, correct.
• Low self-awareness: At this level, you think that your beliefs and criticisms about your body are often true.
• Lack of understanding: People who are unaware of their BDD condition often develop delusions that reinforce their beliefs. This makes them believe that their negative feelings about their body are justified. Delusions are when you cling to your beliefs even when there is evidence that they are wrong. People who are unaware of their condition may not be able to understand that their beliefs are wrong. About one-third of people with BDD have this level of understanding.

Why does this (BDD) occur?

Experts still don't fully understand how or why this happens, but they suspect that several factors contribute to it:

• Genetics: If someone in your family (i.e. a close relative such as a child, parent, or sibling) has BDD, you are three to eight times more likely to develop it.
• Changes in brain structure, chemistry, and function: In people with BDD, certain parts of the brain become overactive or do not work as expected. These changes make it difficult to control the thoughts and actions associated with the condition.
• Cultural Influences and Popular Media: Different cultures have different standards of beauty and appearance. Popular media, culture, or a combination of both can influence your (BDD) thoughts and behaviors. Think about it, in our society sometimes ideas like 'you have to be white', 'you have to be thin' are spread, right? They can also influence this.
• A history of childhood abuse, neglect, or bullying: If you have had bad experiences as a child, you are more likely to develop BDD. Also, being teased and bullied by others increases this risk.

What other complications can occur due to BDD?

People with BDD are more likely to have other mental health conditions, including:

• Anxiety disorders.
• Depression.
• Eating disorders.
• Obsessive-Compulsive Disorder (OCD).
• Substance use disorders ( including steroid use disorder in people with muscle dysmorphia).

How is this (BDD) diagnosed?

There are no specific medical tests to diagnose BDD. A mental health professional (such as a psychologist or psychiatrist ) can diagnose BDD by talking to you about your symptoms, thoughts, behaviors, and lifestyle. BDD is diagnosed using specially designed questionnaires or checklists (screening tools). They check to see if you meet the criteria for the condition.

Is it difficult to diagnose (BDD)?

Often, people with BDD are diagnosed with the condition 10 to 15 years after symptoms have developed and become severe enough to meet the criteria for the condition. One reason for this is that they may not recognize that these thoughts and feelings are symptoms of a mental health condition. Or they may be too embarrassed or afraid to ask for help.

Therefore, if you or a loved one notices these symptoms, it is very important to talk about it and seek help. If you talk about it and get help before it gets worse, you or your loved one can avoid the worst effects of this.

How is BDD treated? Can it be cured?

BDD cannot be cured completely. However, it can be treated. Like many mental health conditions, BDD is treated with a combination of different methods. The main ones are:

• Psychotherapy: This is the technical term for mental health treatment. It involves talking about your feelings and experiences and helping you develop helpful thinking and coping strategies. The two most common types of treatment for BDD are Cognitive Behavioral Therapy (CBT) and Family Therapy .
• Medications: Antidepressants are a type of medication commonly used to treat BDD. These medications help control the symptoms of BDD. This makes it easier to manage your thoughts and behaviors. They can also enhance the results of other treatments, such as psychotherapy.

What are the complications or side effects of the treatment?

There are different types of medications to treat BDD. Their side effects can vary. Therefore, it is important to ask your doctor about any complications or side effects you may experience.

What can you expect if you have (BDD)?

If you have BDD, the effects may seem minor at first, but they can get worse over time. Negative thoughts and feelings about your body affect your thinking and behavior. As they become more intense, you may feel more and more stressed about your appearance. They can also start to affect and change your life. It can make it difficult to study, work, and socialize with others.

The longer BDD is left untreated, the worse it usually gets. That's why it's important to get diagnosed and treated for Body Dysmorphic Disorder as early as possible. Early diagnosis and treatment can help stop the symptoms and effects of BDD from getting worse.

(BDD) How long will it last?

(BDD) is a treatable and often manageable condition. However, unfortunately, it cannot be completely cured, and it does not get better on its own. Once it develops, it can be a lifelong condition.

However, when you receive treatment for BDD, you can experience a period of remission, where your symptoms are reduced, weakened, or even completely gone. Although relapses are possible, where symptoms return and become more severe, effective treatment can help manage BDD and limit its impact on your life.

What is the outlook for this situation?

As we mentioned, BDD is a treatable condition. Research shows that between 50% and 80% of people who receive treatment with medication experience a reduction in symptoms, or a reduction in severity. They are also less likely to have relapses, where symptoms recur.

Experts strongly recommend combining medication with psychotherapy because it helps you develop thinking and coping strategies that can help you deal with the thoughts and feelings that come with BDD.

Left untreated, Body Dysmorphic Disorder can severely disrupt your life. Self-harm and suicide are also common among people with BDD who do not seek treatment. About 80% of people with BDD have suicidal thoughts. And one in four people with BDD will attempt suicide. People with BDD are 45 times more likely to die by suicide than those without BDD. Therefore, early diagnosis and treatment, especially for those who develop BDD before the age of 18, is extremely important. If you are having these thoughts, please do not go it alone. Talk to someone you trust immediately, or see a doctor or mental health counselor. You can also get free counseling services from organizations like 1926 Sumithra in Sri Lanka.

Can BDD be prevented?

Can Body Dysmorphic Disorder be reduced or completely prevented? Experts still don't fully understand why it happens. Therefore, there is currently no way to prevent it or reduce the risk of developing it.

How do I take care of myself?

If you have Body Dysmorphic Disorder (BDD), there are several things you can do to help yourself:

• Take your medications exactly as prescribed. Many people with BDD feel better and their symptoms improve with medication. Do not stop taking these medications without talking to your doctor. Doing so can cause serious side effects and can increase your thoughts of harming or killing yourself.
• See your mental health professional as recommended. Seeing a mental health counselor can help you develop thinking and behavioral patterns that can help you cope with the thoughts and feelings that come with BDD. While medication alone can be helpful, regular psychotherapy along with medication can increase the effectiveness of both treatments.
• Avoid cosmetic surgery. Many people with BDD feel that they need cosmetic surgery or other procedures to change their appearance. However, these procedures usually do not help. In fact, when changes are made to the appearance through surgery or other cosmetic procedures, the symptoms of BDD are more likely to worsen and become more severe. This can lead to a cycle of cosmetic surgery.

What can I do if I suspect my loved one has BDD?

A person with BDD may not be able to understand that they have the condition. If this happens, they may resist attempts to seek medical help. If your loved one is showing symptoms of BDD, here are some things you can do:

• Listen. If someone with BDD is trying to open up to you and talk about their feelings and what they believe about their body, they are often afraid, insecure, and do so with a lot of trust in you. Listening can show them that they are not alone and that there is someone who loves them no matter how they feel about themselves.
• Don't dismiss their concerns. Don't tell someone with BDD, "There's nothing wrong with your body." While this may seem helpful, it can make them feel like they can't talk to you or ask for help.
• Don't judge or argue. People with BDD may not be able to understand or process evidence that contradicts their feelings and beliefs about their body. Arguing with them can prevent them from seeking help or make them feel even more isolated.
• Encourage them to seek help. Some people worry that having a mental health condition will make them feel inferior and treated differently. Talking positively and openly about mental health services can help reduce the stigma. This can make it easier for your loved one to talk to a mental health counselor . You can also help them get help by calling them and helping them make an appointment, or by going with them to those appointments.

There are many resources that can guide you on how to help a loved one who may have BDD. Taking the time to learn more about these organizations and the condition itself can help you be better prepared to support your loved one.

What areas of the body do people with BDD worry about the most?

When people have BDD, there are certain areas of the body that they worry about, have negative thoughts, or feelings about. The most commonly affected areas are:

• Skin: If you have acne or other blemishes, you may experience body dysmorphic disorder (BDD), especially regarding your own skin tone.
• Face: BDD often affects the way people think about their face. People with BDD often worry about the size, shape, or specific parts of their face, especially the nose, lips, eyes, and teeth.
• Stomach: People with BDD sometimes worry about the size or shape of their stomach and abdomen.

Depending on gender, BDD is more likely to affect specific parts of the body. For example:

• Hair (especially facial hair that doesn't match how you feel about yourself, hair loss, and the amount of hair in certain areas of the body).
• Chest and/or breasts.
• Thighs, hips or buttocks.
• Genitals (especially the size of the penis or the overall appearance of the genitals).

Is there a connection between (BDD) and (OCD)?

Yes, BDD and Obsessive-Compulsive Disorder (OCD) are related conditions. OCD and related conditions make up a whole group of mental health conditions, and BDD is part of that group. Many people can have both OCD and BDD at the same time.

Body Dysmorphic Disorder (BDD) affects the way you see yourself, causing you to judge yourself unfairly and harshly. If you have this condition, you may feel that there is something wrong with your appearance. This may make you feel anxious, fearful, depressed, or want to change or fix your appearance.

However, BDD is a medical condition that interferes with your ability to see yourself as you really are. With treatment, you can work against these negative thoughts and feelings. That way, you can prevent them from changing your life.

Things we should remember from this story (Take-Home Message)

Okay, so now you have a better understanding of what we've been talking about (Body Dysmorphic Disorder - BDD) . The most important thing to remember is that you're not alone. If you have persistent, uncontrollable thoughts about your appearance that are affecting your daily life and happiness, don't just dismiss it as something trivial.

• BDD is a mental health condition, not a weakness.
• There are treatments for this. This condition can be largely controlled with psychotherapy and, if necessary, medication.
• The sooner you seek help, the better. There is no need to be ashamed or afraid. See a trusted doctor, psychologist, or psychiatrist .
• Turning to cosmetic surgery to 'fix' your appearance is often not a solution, and can actually make the situation worse.
• If you are having suicidal thoughts, please seek help immediately. There are people ready to help you. (e.g. 1926 Sumitrayo).

Your worth is not determined by your appearance. You have the right to escape this situation and live a happy life. Get the help you need to do so.

` Body dysmorphic disorder, BDD, body image, mental health, appearance anxiety, cosmetic surgery, suicidal thoughts