can be a fine line between validation and a cry for help. If a friend
or family member constantly asks about their appearance, they could be
showing early signs of body dysmorphic disorder.
psychiatric diagnosis given to patients who have a perceived flaw or
defect in their appearance," says Dr. Thomas Heinrich, professor
of psychiatry and family medicine at Froedtert & the Medical
College of Wisconsin.
by the condition often perceive imperfections in their body that
others cannot see. "They become preoccupied to the point where
they engage in repetitive behavior to relieve that anxiety," says
Heinrich. "This most often involves the skin, the face and hair,
but really any body part can be involved from the patientís point of
Two percent of
the general population has body dysmorphic disorder at any given time,
and 5 to 10 percent of dermatology and plastic surgery patients suffer
from BDD, Heinrich says.
to present to the clinicians who they think can help with that. They
donít usually come to psychiatrists," Heinrich says.
dealing with the disorder often have a desperate view of their
appearance, routinely categorizing themselves as
"monstrous," "hideous" or "ugly."
Heinrich treats these patients by focusing on the suffering as a
result of the perceived defect rather than trying to convince them the
defect doesnít exist.
really believe in this defect. You work on correcting what we call
those cognitive misinterpretations. These people will think that
people are pointing at them behind their back or laughing at them, and
the therapist will work to disprove those beliefs to the patient,
confronting those false beliefs by asking Ďhas anybody ever laughed
at you?í This will help the patient realize that their beliefs are
not true necessarily," explains Heinrich.
disorder can also lead to eating disorders. "People can view
themselves as being bigger than they are," says Dr. Zobeida Diaz,
a psychiatrist with Aurora Psychiatric Hospital who works with
families and adolescents dealing with eating disorders. "This
condition worsens with the more weight they lose. The brain amplifies
Diaz says the
best course of treatment here is also not to argue with falsely
perceived defects in appearance. "We focus on patients eating
more meals," she explains. "A starved mind canít think
clearly. Feeding improves that and can get patients to question their
thoughts about their body image."
There are clear
warning signs of body dysmorphic disorder. "If someone you know
spends a lot of time engaged in worry, constantly checking mirrors,
adjusting their clothes or makeup, those could be signs of
dysfunction," Heinrich says.
unnecessary diets, drastic changes in diet, avoiding family meals or
declining invitations to go out to eat ó those are red flags,"
displaying those warning signs should be encouraged to seek help,
starting by consulting their regular doctor, who could recommend
appropriate therapy. Treating BDD in its earliest stages can result in
a high rate of overall success in patient recovery.