Addicted To The Blade
Body dysmorphic disorder (BDD) is a body-image disorder that causes people to ruminate about perceived bodily flaws for hours each day. Their obsessions about their perceived appearance becomes overpowering and they do not believe others who tell them “you look fine.” It is not clear what the cause of BDD is. It is believed to be multifactorial: genetics, malfunctioning of serotonin in the brain, personality traits or peer abuse.
Their negative thoughts often cause severe emotional distress and interfere with their daily functioning. When it gets severe, they may miss school or work and start to isolate themselves in order to prevent others from seeing their “defect.” Their social life may also start to wither away; they cannot take any chances to have their “bodily flaws” witnessed.
People with BDD do not actually have any major bodily flaws. Their “flaws” are imagined but sometimes there might be a slight imperfection in which they blow it out of proportion. It often develops in adolescence and affects men and women almost equally. Men with BDD are often preoccupied with their muscles and genitals.
People with BDD may exhibit compulsions in order to try to hide or improve their flaws. These include:
- Constantly changing clothing
- Skin picking
- Checking mirrors habitually or avoiding mirrors altogether
- Comparing a body part to others’
- Wearing makeup or hats
- Undergoing multiple plastic surgeries (“addicted to the blade“)
The surgeries usually are of no help. Patients with BDD will often return for further operations to work on the previous surgery’s imperfections. That is why when a patient with BDD asks a psychiatrist for a referral to a plastic surgeon, the requests are usually denied.
People with BDD often have comorbidities such as major depressive disorder, OCD or social anxiety. The depression is triggered by their emotional distress and painful quality of life. The OCD is a manifestation of the obsessions and compulsions tied to the imagined defects. And the social anxiety develops from a fear of public humiliation.
The two main treatment options for patients with BDD are cognitive behavioral therapy and antidepressants. CBT helps patients recognize their irrational thoughts and behaviors and replace them with healthy and positive ones. Antidepressants such as SSRIs help relieve the obsessions and compulsions.
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