Body Dysmorphic Disorder

Body Dysmorphic Disorder (also known as BDD, body dysmorphia, dysmorphic syndrome, or dysmorphophobia), is a condition  that engages the conviction that one's own look or appearance is strangely  defective, therefore they feel hideous and unworthy, and that their issues are so serious and advanced that they can’t be repaired. The thoughts surrounding this condition are usually overwhelming. A common example is a person (more often a female) who is convinced that they are grossly overweight, and after repeated, obsessive examination in a mirror, they believe it, even though in reality they are grossly underweight, often to the point of being emaciated.

The disorder was first documented in 1886 by Enrico Morselli, who named the condition dysmorphophobia. BDD was recognized by the American Psychiatric Association as a disorder in 1987 with the revision to the third edition of the Diagnostic and Statistical Manuel (DSM).  The name has since been changed from dysmorphophobia to body dysmorphic disorder, as the original implies a phobia of people, not a reluctance to interact socially because of poor body image

About half of those diagnosed with BDD spend several hours a day trying to conceal or correct flaws that are perceived but often not reality.  Sometimes there is in fact a very small flaw, but because of a distortion in their perception, it appears to them to be hugely out of context and unreal. Along with this goes a great degree of social retardation or impairment, as well as problems in employment and/or education. Where does it come from? In many cases it can stem from factors of environment, genetics and social engagement. Approximately 1-2% of the population suffers from this, and again a larger number being women. It can occur in adults or children, but more often surfaces during adolescence during the period when the greatest amount of physiological change takes place. The sad fact is that this condition is amplified by bulling and abuse, particularly in a peer situation.

People living through BDD often wish to change or improve the characteristics of their physical appearance that they find unacceptable, often attempting cosmetic surgery or dermatological treatment, but this generally doesn’t resolve the symptoms.  Compulsive behavior such as picking of the skin is very common. Much of this results from shame or perceived imperfection. BDD has also usually considered a parallel to Obsessive Compulsive Disorder (OCD) and many of its characteristics.  BDD results in greater levels of depression and a greater fear of social interaction.

As far as treatment is concerned, classic cognitive behavioral therapy has had considerable success, coupled with group support such as 12-step and other programs.

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