Trapped in a crooked mirror: The distorted reality of Body Dysmorphic Disorder (BDD)

“I had always been a size eight all my life. You know, the slim, perky, firm boobs, toned thighs, flat stomach kind of girl,” said Tammy under a pseudonym. “I have always been conscious about my looks, so I LOVED my body and was doing everything possible to keep it just the way I liked it.”

When Tammy got married in 2016, life and her body took a downward turn, and it felt like the walls were closing in.

“I married an emotionally abusive man who utilised every opportunity to tell me how my body was changing and how I now look nothing like the girl he married. It was a mess,” she said. “It got so bad that he was purposely starving me at some points during the pregnancy because I was adding a lot of weight. It’s safe to say I carried the pregnancy alone without any form of support from the idiot that got me pregnant,”

For Tammy, all the abuse and bad words got to her so badly that she started “hating her body in the mirror.” It was only when she had her son that she realized she had gone two sizes up from 8 to 14. “I hated my body so much, that it drew me to tears,” she said.

The abuse, combined with the drastic change caused by pregnancy, enforced the idea that there was something really wrong with Tammy and her body. Her once-loved body became one she couldn’t look at in the mirror—a body she so desperately wanted to change.

Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder (BDD), otherwise known as body dysmorphia, is a consistent fixation on things people think are wrong in their physical appearance. According to the Anxiety and Depression Association of America (ADAA), people with BDD genuinely believe they look ugly, unattractive or even hideous because of their perceived flaws. Still, in reality, these flaws are invincible or even non-existent in the eyes of people around them. Because of this fixation on their physical appearance, people with BDD face severe frustrations and distress trying to nitpick their appearance or change the so-called “flaw”.

BDD and Obsessive Compulsive Disorder (OCD) are very similar in the ways they manifest. People with BDD and OCD have fixations that cause them immense stress and anxiety. However, people with BDD are more likely to experience depression, thoughts that life isn’t worth it, and suicidal attempts.

BDD primarily revolves around perceived flaws in physical appearance, leading to distress and preoccupation with these flaws. OCD involves intrusive thoughts and compulsive behaviours, which can encompass various themes beyond appearance, such as cleanliness, safety, or orderliness.

Contrary to popular opinion, BDD is not due to conceitedness or being egotistic, but it is an actual mental condition that can be so debilitating to the point of feeling worthless and unlikeable, much like imposter syndrome.

Body parts BDD patients fixate on

According to ADAA, people with BDD focus on one or more body parts, including but not limited to:

• Skin
•  Hair
• Nose
• Chin
• Lips
• Chest
• Legs

The concerns often relate to the shape, size, colour, position and symmetry of the body parts listed above. Because of these concerns, people with BDD would try to pick, cover, undergo life-altering surgeries and many more, all in an attempt to correct and restructure their presumed flaws in the way they deem acceptable. On acreage, people with BDD spend three to eight hours obsessing about these perceived flaws and, similarly, trying to correct the flaws.

“I swore never to have another child because of that experience. Don’t get me wrong, I love my son to bits and would die for him, but I am NEVER having any other baby.”

What causes BDD?

BDD is a prevalent mental issue that is triggered by multiple existing or obtained psychological issues. According to a Mind article, no one really knows what causes BDD. However, it can affect all genders, with more women being diagnosed than men. Here are a few contributing factors to the development of BDD:

Abuse or bullying

Experiencing bullying and abuse, similar to Tammy’s situation, can lead to the development of a negative view of oneself. This negative self-image can serve as a direct pathway to developing Body Dysmorphic Disorder (BDD).

Low self-esteem

If you have low self-esteem, you may become fixated on the ‘flaws’ you need to fix to improve your perception of yourself. However, this fixation on your appearance can force you to value only how you look rather than who you are, aggravating your decision to pick and correct your appearance in the ways you can.

Fear of being rejected

If you believe you must look a certain way to have or maintain relationships, you may fixate on your appearance to ensure everything stays perfect. When the friendship or relationship ends, you start to fixate on the flaws that could trigger the person to end the friendship or relationship.

“I started seeing my body as a piece of shit; it looked nothing like the body I had before; my boobs were no longer firm due to breastfeeding, my stomach wasn’t as flat anymore, and I had a lot of stretch marks.”

Media beauty standards illustrate perfectionism

The media constantly churns out information about what should and shouldn’t be for body types. But realistically, not everyone can achieve a particular aesthetic or have a specific body type. Chasing perfectionism by comparing yourself to the body types portrayed on social media, TV, and magazine covers will lead you down a spiral of self-deprecation and, in the long run, trigger a case of BDD.

Genetics

Research indicates that Body Dysmorphic Disorder (BDD) may be more prevalent among individuals with family members who also have BDD. However, it can be hard to figure out if traits like always thinking you look ugly or constantly checking yourself in mirrors come from your family or if they’re just something you’re born with.

“The whole body shaming part is just a tiny bit out of everything I went through, and I am trying to forget. Therapy will force me to relive it all.”

Treatment options for BDD

Because BDD is strictly psychological and behavioural, with  no single cure, limited treatment options are available:

• Cognitive-behavioural therapy (CBT) identifies and challenges negative thoughts and beliefs about one’s appearance. Individuals can develop healthier attitudes toward their appearance by learning to recognise and modify distorted thinking patterns.
• Exposure and Response Prevention (ERP): ERP involves gradually exposing oneself to situations that trigger anxiety about appearance and resisting the urge to engage in compulsive behaviours, such as excessive mirror-checking or seeking reassurance from others.
• Medications: Selective Serotonin Reuptake Inhibitors (SSRIs), a type of antidepressant, are often used to ease anxiety and depression linked to BDD. They’re typically combined with therapy for better results.

Like Tammy, many people refuse to get treatment for the condition simply because of how traumatising it can be to address the cause of the issue. For other people, they simply don’t know they are suffering from BDD.

BDD can significantly impact daily functioning and quality of life, but with appropriate treatment and support, individuals can learn to manage their symptoms effectively. Seeking help from mental health professionals, building a support network, and practising self-care strategies can all contribute to improved coping and well-being for individuals living with BDD.

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