Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) may be at the root of some of the more overwhelming transformations that people can achieve with tattoos and piercing. Doctors speculate that those who feel the need to change their appearance to an extreme, such as Katzen, Lizardman, and Stalking Cat, are doing so because of an undiagnosed variation of BDD.

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (once called dysmophophobia) is considered by some doctors to be a variation on obsessive compulsive disorder. It involves a severe preoccupation with minor or imaginary flaws. The preoccupation leads to anxiety and stress to such a great degree that the sufferer is unable to function normally. For mild cases, the sufferer may still be able to leave home and work, but in more serious cases, the sufferer will be unable to work or socialize. If the preoccupation becomes extreme, the sufferer may commit suicide.

Many sufferers will use cosmetic surgery to “fix” their flaws, but the surgeries, regardless of how successful they are, do not make the sufferer happy. Instead, the sufferer will either find a new flaw to focus on or will be convinced that the original flaw is either made worse or not fixed.

The connection is made to individuals who use extreme tattooing, piercing, and body modification because many of the people who choose this route will say they do so because it feels like it should be there, or that it belongs there. They will often imagine that what they are doing is fixing something, or adding something that is missing. These reasons make some doctors feel that those people are suffering from a variation of body dysmorphic disorder.

How It Is Diagnosed?

Sufferers are diagnosed with body dysmorphic disorder when they have a preoccupation with an imagined defect or are excessively concerned with a slight physical anomaly, such as a large nose or a receding hairline. The preoccupation must be severe enough to impact their functioning and impair their ability to work or socialize. All other possible disorders, such as major depressive disorder, social phobia, obessessive-compulsion behavior, bulimia and anorexia, and schizophrenia, must be ruled out as possible problems.

Why Do People Get Body Dysmorphic Disorder?

No one is sure why some people suffer from BDD. It is surmised that the problem, like OCD, is probably caused by a combination of biological, psychological, and possibly even social and cultural factors.

How Is It Treated?

Body dysmorphic disorder is treated with both cognitive behavioral therapy and pharmacotherapy. Therapy is used when it is possible to treat the sufferer for symptoms of obsessive compulsive disorder. The therapist would assist the sufferer to stop repeating their behaviors, such as looking in mirrors and over-using make-up to “fix” problems, and eventually would move on to help the sufferer change the belief that there was a problem. Pharmacotherapy is done using various drugs, mostly SRIs, such as Fluoxetine, Paxil, Zoloft, Celexa, and Anafranil.

Online Resources for Those Suffering From BDD

Luckily, as body dysmorphic disorder is becoming more recognized, there are more resources for sufferers. If you think you may have this problem, please contact a doctor. If you are interested in learning more, you can visit these websites:

• The Mayo Clinic: Includes many helpful links, including when to seek help, how to self-treat, and coping skills.
• AtHealth.com: Contains an interview with Dr. Thompson, author of “Body Image Disturbance: Assessment and Treatment.”
• Northern County Psychiatric Associates: Presents an article by Dr. Carol E. Watkins about BDD and treatment options.

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