Body Dysmorphic Disorder Symptoms, Causes, Treatment

The body dysmorphic disorder, Formerly known as dysmorphophobia, it is characterized by the belief that a person has a physical defect that is actually imaginary, since their appearance is normal.

This belief not based on reality causes the person to become unrelated to others for fear that they will criticize or laugh at their ugliness. This psychopathological disorder can develop so much that the person who suffers it can lose their social skills.

Due to its characteristics, this disorder has also been called "imaginary ugliness". It is a psychopathology that begins in adolescence and affects both male and female sex.

One of the symptoms of this disorder is the ideas of reference; the person thinks that everything that happens around him / her has to do with him / her. This can lead to social isolation.

Article index

• 1 Symptoms
• 2 Most frequent perceived defects
• 3 Causes
• 4 Risk factors
• 5 Diagnostic criteria for the disorder (DSM IV)
• 6 Treatment
  • 6.1 Cognitive behavioral therapy (CBT)
  • 6.2 Medication
  • 6.3 Family therapy
• 7 Complications
• 8 Do cosmetic procedures work?
• 9 Conclusions
• 10 References

Symptoms

Here are the main symptoms of people with body dysmorphic disorder (BDD):

• They think they have unreal blemishes.
• Constant worries about blemishes.
• They want to improve the appearance that they consider problematic and may consider dermatological treatments, cosmetics or cosmetic surgeries. However, these treatments do not usually solve the problem..
• Treatments can be done by themselves or by others and can lead to a worsening of the problem.
• They may show repetitive or compulsive actions such as camouflaging themselves (with clothing, makeup, or hats).
• They constantly look in the mirror or avoid it.
• High levels of depression and social phobia can occur.
• Suicidal thoughts.
• The need to ask other people for an opinion on one's own physique.
• Avoid appearing in photos.
• Ideas about suicide or suicide attempts can occur in this disorder.

Most frequent perceived defects

These are the most common imaginary defects in these people:

• Hair
• Nose
• Skin
• Eyes
• Head or face
• Body constitution
• Lips
• Chin stomach or waist
• Teeth 
• Legs knees
• Breasts / body muscles
• Ears
• Cheeks
• Rear
• Penis
• Arms
• Neck
• Front 
• Muscles
• Shoulders
• Hips

Causes

It is not known specifically what causes CDD. Like other psychopathological disorders, it can result from a combination of factors:

• Genetics: some studies have shown that BDD is more common in people whose relatives also have the condition, indicating that there could be a gene associated with this disorder.
• Environmental: the environment, experiences and culture can contribute, especially if there are negative experiences related to the body or self-image.
• Brain: abnormalities in brain structure may play a role.

Risk factor's

The risk factors that make the appearance of the problem more likely are:

• Negative life experiences, such as bullying.
• Social pressure or expectations of beauty.
• Having another psychiatric disorder such as anxiety or depression.
• Having family members with the same disorder.
• Personality traits, such as low self-esteem.

Diagnostic criteria for the disorder (DSM IV)

A) Preoccupation with an imaginary defect in appearance. If there is a small abnormality, the person's concern is exaggerated.

B) Worry causes anxiety or significant harm in social, work, and other important areas of life.

C) The worry is not explained by another mental disorder (for example dissatisfaction with body shape or size in anorexia nervosa).

Treatment

The main recommended treatments are:

Cognitive behavioral therapy (CBT)

A meta-analysis found that cognitive behavioral therapy is more effective than medication 16 weeks after starting treatment.

It is believed that it can improve the connections between the orbitofrontal cortex and the amygdala.

The goal is to teach patients to recognize irrational thoughts and to change negative thought patterns to positive thoughts..

Medication

Selective serotonin reuptake inhibitors (SSRIs) are included, which can help control obsessive symptoms.

SSRIs are a type of antidepressant that increase the brain's levels of a neurotransmitter called serotonin.

Family therapy

Social support is important for the success of treatment, being important that the family knows what BDD is and how to proceed to treat it.

Complications

There can be several complications caused by BDD:

• Social isolation.
• Social phobia.
• Shortage of personal relationships.
• Difficulty getting to work or training.
• Low self-esteem.
• Repeated hospitalizations.
• Depression.
• Anxiety.
• Suicidal thoughts and behaviors.
• Obsessive compulsive disorder.
• Eating disorders.
• Substance abuse.

Do cosmetic procedures work?

Although it appears that a surgical procedure could correct the imaginary defect, it does not correct the disorder or relieve its symptoms..

In fact, people do not feel benefited from the surgeries, they can repeat several times or even sue surgeons for negligence.

Conclusions.

It is recommended that the person with BDD go to a mental health professional -psychologist or psychiatrist- to evaluate their case and establish a diagnosis and treatment..

Cognitive-behavioral therapy is the most effective treatment and plastic surgeries should be avoided, at least until the psychopathology has been treated and corrected.

References

1. Hunt TJ, Thienhaus O & Ellwood A (July 2008). "The mirror lies: Body dysmorphic disorder." American Family Physician 78 (2): 217-22. PMID 18697504.
2. Grant, Jon; Won Kim, Suck; Crow, Scott (2001). "Prevalence and Clinical Features of Body Dysmorphic Disorder in Adolescent and Adult Psychiatric Inpatients.". J Clin Psychiatry: 527-522.
3. Hartmann, A. "A comparison of self-esteem and perfectionism in anorexia nervosa and body dysmorphic disorder". The journal of nervous and mental disease.
4. Prazeres AM, Nascimento AL, Fontenelle LF (2013). "Cognitive-behavioral therapy for body dysmorphic disorder: A review of its efficacy". Neuropsychiatric Disease Treatment.
5. Image source.