My boyfriend has body dysmorphia
How to Show Up for Someone You Love With Body Dysmorphic Disorder
Heidi, 33, shares a similar viewpoint. She tells SELF that “supportive language and listening without judgment helps.”
In addition, don’t try to offer advice or ask them questions about why they don’t think they’re attractive, Heidi adds—just listen. Let them know that you’re there for them and that you’re sorry they’re hurting.
2. “Even though it may feel like it sometimes, you are not alone.”
It can feel isolating for people with BDD when they feel as if no one can understand their symptoms and the challenges they face. But the reality is that BDD affects millions of people, and mental health experts generally consider it a common disorder.
Reminding loved ones about this is a good way to help lift some of the loneliness: “To a person suffering from BDD,” Heidi says, “life is scary, painful, and isolating. Remind them they’re not alone, because inside their mind, they are.”
By telling loved ones that their feelings are not uncommon, it can help them feel understood and more willing to open up about their symptoms. But make sure you refrain from saying things like, “So many people experience BDD. It's not a big deal.” Though you might be trying to offer support, to people with BDD, it is a big deal, and just because other people also have BDD doesn’t make their own symptoms and emotions any less real.
3. “What you're feeling is absolutely valid, but remember that BDD gives you a distorted view of yourself.”
It might be tempting to tell someone with BDD that their symptoms are only in their head and that you don’t see the things they see—but doing so can be dismissive. “To say that it’s all in their heads…is a put-down,” Dr. Phillips says. “It minimizes the concern in a way that’s not helpful.” Avoid this kind of language, and instead let them know that while they might see flaws, they see themselves differently than how others see them.
If you want, point them towards the research. In recent years, Dr. Phillips says, brain-imaging research has shown that people with BDD see things differently than others. “It’s not that they’re hallucinating,” she explains, “but their brains seem to be good at pulling detail out of what they’re seeing. They have difficulty with the ‘big picture,’ or what we call holistic visual processing.” The details of what people are looking at—the shape of a particular body part or asymmetry in certain features, as examples—overtake the big picture and create a distorted view, Dr. Phillips explains.
Simon, 47, who wrote a book on his experience with BDD, suggests that instead of offering reassuring phrases (e.g. "Your nose looks fine”), remind them that what they see is a distortion of themselves. “My partner likes to say, ’I know you are struggling at the moment, but you also know these thoughts are not fact,’ ” says Simon.
4. “It sounds like your symptoms are making you look for reassurance. Is there anything we can do to help take your mind off that?”
With BDD, you can get caught in a cycle of negative thoughts about appearance, and it can be debilitating for people with the condition. If your loved one is experiencing intense symptoms and looking for reassurance about how they look, Dr. Phillips suggests staying away from reassurance seeking, as it can create an unhealthy pattern that continues the harmful cycle of negative thoughts. Compliments may reduce the anxiety that a person feels about their body, but only temporarily, Dr. Phillips points out. And it could lead to them demanding reassurance regularly and create a loss of trust down the road if you don’t always provide that for them.
7 Ways to Help Someone with Body Dysmorphia & Where To Find Treatment
Find out the signs of body dysmorphia and how to help someone who struggles with this disorder.
Body dysmorphic disorder, also called body dysmorphia or BDD, is difficult for people who struggle with it. It can also be challenging for the loved ones of someone with body dysmorphia. If you have a friend or loved one with body dysmorphia, you may wonder how you can help them.
You may wonder how to help someone with body dysmorphia, especially when you feel like you have no control of the situation. It’s important to realize body dysmorphia is a diagnosable mental disorder.
Treatment can be effective for body dysmorphia, but you can’t force someone to get help if they aren’t ready. While you can be a support system, you can’t “cure” your loved one of the disorder.
So, what can you do? How can you be a support system and how can you help someone with body dysmorphia?
Understanding Body Dysmorphia
You may have misconceptions about what body dysmorphia is and what it isn’t. Learning more and working on understanding body dysmorphic disorder can be one of the best ways you help your loved one.
Body dysmorphic disorder is a mental disorder where the affected person is preoccupied with perceived physical flaws. Thoughts of these flaws can be overwhelming and all-encompassing. Someone with body dysmorphia may find it difficult to think about anything else, however, to others the flaw is either very minor or may not be noticeable at all.
In some cases, a person with body dysmorphia may seek procedures or cosmetic surgeries to fix the perceived flaws. However, even following cosmetic procedures, the person will often go back to obsessing about the flaw once again.
Anywhere from 1.7 to 2.4 percent of the population is affected by body dysmorphic disorder, according to the Anxiety and Depression Association of America (ADAA).
Recognizing the Signs of Body Dysmorphic Disorder
When someone has body dysmorphia, they may obsess over their appearance for hours or even entire days. This obsession is out of their control, and it’s difficult to focus on anything other than what they see as their physical imperfections.
Body dysmorphia can lead to avoidance of social situations and can create problems at school or work. Relationships may also be challenging.
Signs of body dysmorphia include:
- Attempting to hide the “flaws” through certain clothing, makeup, etc.
- Comparing oneself to others
- Seeking cosmetic procedures and surgeries
- Repetitively looking in the mirror or avoiding mirrors
- Excessive time spent on grooming
- An overwhelming feeling the flaw perceived makes them ugly or deformed
- Believing that the perceived flaw will lead to negative judgment or mocking from others
Other body dysmorphia signs are:
- Seeking reassurance from others
- Social isolation
- Skin picking or other compulsive behaviors
Features people with body dysmorphia most often become preoccupied with include:
- Facial features such as the nose, wrinkles or blemishes
- Hair (in particular baldness or hair thinning)
- Muscle size (muscle dysmorphia)
- Breast size
- Skin appearance
7 Ways to Help Someone with Body Dysmorphia
When someone has body dysmorphia, they may realize the beliefs they have about their appearance or flaws aren’t true, or they may believe they are true. It varies from person-to-person.
Tips on helping someone with body dysmorphia include:
- Work on steering conversations away from their appearance or what they see as flaws.
- Avoid trying to make someone feel better by talking about your own insecurities or flaws. This can just spiral into a more negative conversation.
- Provide them with space to talk freely and openly with you about their feelings.
- Even if you can’t understand your friend’s feelings, work on understanding that their feelings are real to them. Don’t mock or minimize their feelings.
- If your friend or loved one can take small steps, celebrate those.
- Encourage your loved one to get help for body dysmorphia.
- Recommend online therapy services like teletherapy.
Where to Get Help for Body Dysmorphia
If your friend is wondering how to get help with body dysmorphic disorder, or where to get help, resources are available.
As a friend or loved one of someone with body dysmorphia, you can be helpful by exploring treatment resources or options and letting that person know what you find if they’re ready.
Psychotherapy is one of the main body dysmorphia treatments. Cognitive behavioral therapy is the type of therapy most often used. When someone receives cognitive behavioral therapy for body dysmorphia, the focus is on helping them recognize and change their negative thoughts.
The Food and Drug Administration doesn’t specifically approve any medications currently for the treatment of body dysmorphia. Off-label some medications can help with symptoms. Selective serotonin reuptake inhibitors (SSRIs) may be prescribed, for example.
To learn more about treatment for body dysmorphia that co-occurs with substance use disorder, contact The Recovery Village. Programs for substance abuse also include treatment for co-occurring disorders like body dysmorphia.
Related Topic: Start Online Therapy for BDD & Co-Occurring Substance Abuse
If you or a loved one are struggling with body dysmorphia, the Nobu app gives you access to a variety of tools, resources, and mental health professionals that can help. It is free and for anyone that is looking to reduce anxiety, work through depression, build self-esteem, get aftercare following treatment, attend teletherapy sessions and so much more. Download the Nobu app today!
Editor – Renee Deveney
As a contributor for Advanced Recovery Systems, Renee Deveney is passionate about helping people struggling with substance use disorder. With a family history of addiction, Renee is committed to opening up a proactive dialogue about substance use and mental health. Read more
Medically Reviewed By – Nanci Stockwell, LCSW, MBA
A dynamic leader and award-winning business strategist, Nanci Stockwell brings years of industry experience in behavioral health care to her role at Advanced Recovery Systems. Read more
Body Dysmorphic Foundation. “Family and Friends.” (n.d.) Accessed January 16, 2019.
Anxiety and Depression Association of America. “Body Dysmorphic Disorder (BDD).” (n.d.) Accessed January 16, 2019.
The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.
causes, symptoms, treatment and psychotherapy of dysmorphophobia in women
Dysmorphophobia syndrome is manifested by excessive concern about one's appearance, a desire to improve it, which subsequently turns into a painful state. A person feels dissatisfaction with his appearance, despite any changes. The reasons for the development of the disorder are the genetic predisposition of the diseased. Dysmorphophobia affects both women and men. For many, appearance is the main value on which success with the opposite sex and personal happiness depend. Also, the symptoms of the syndrome often appear in adolescence, regardless of gender, when a person evaluates himself as critically as possible.
Dysmorphophobia is directly related to mental disorders. Treatment should be carried out under the supervision of a specialist. Seeing a psychiatrist and psychotherapy will help you cope with the manic desire to improve your appearance, allow you to love yourself and recognize your uniqueness.
- Disease description
- Dysmorphophobia in adolescents
- Diagnostic methods
- Disease symptoms
- Treatment of dysmorphophobia
- Cognitive behavioral therapy
- Group and individual therapy
- Appeal to professionals
Description of the disease
Dysmorphophobia syndrome is a mental state in which a person is overly concerned about his appearance, cannot adequately assess the features of his own body, and does everything to correct far-fetched shortcomings. When upset, men and women begin to get involved in plastic surgery and diets. Often this leads to bulimia and anorexia.
When upset, there is a fear that it will not be possible to achieve an ideal figure. In this case, symptoms of severe depression develop, suicidal thoughts appear. Since all the problems are in the psyche, the perception of appearance by the sick and others is very different. Treatment of the disorder in women and men requires deep psychotherapy.
It is very important to teach the patient to value himself, because with dysmorphophobia there is no end point in transformations - the patient constantly finds new imperfections.
Dysmorphophobia in adolescents
It is adolescents who most often suffer from dysmorphophobia. When you grow up, you pay more attention to your appearance. Any features of one's own body and shortcomings are perceived negatively by the psyche of a teenager. The syndrome is often referred to as delusional, hypochondriacal, overvalued or obsessive disorders. It develops on fears that are associated with the characteristics of the human psyche.
The decision to treat body dysmorphic disorder is based on the presence of three features:
- painful certainty that there is a shortcoming - real and exaggerated, or far-fetched;
- relationship idea;
- depressed mood.
The main difficulty lies in the fact that adolescents hide their thoughts and fears, so treatment often begins after serious attempts to change their appearance.
If a teenager has symptoms of an illness, then he urgently needs a consultation with a psychiatrist and treatment with the help of psychotherapy. It is possible to notice the syndrome if you carefully observe the child, fix strange changes in behavior, habits, clothing style. The sick person most often stops sharing his experiences with loved ones, does not answer questions about a bad mood.
Relatives may notice indirect symptoms:
- excessive attention to oneself, search for an angle in which flaws will be invisible - a person constantly carries a mirror with him;
- painful attitude to photography - photos are removed from prominent places, because they allegedly serve as evidence of imperfections.
The disease must be treated by a psychiatrist, the patient also needs psychotherapy, without treatment the disease can progress. In the future, adult women may face problems in their personal lives and stress due to body dysmorphic disorder.
As a rule, patients do not see the problem and the need for psychotherapy. Symptoms of the disease can be noticed by relatives and relatives.
According to the MBC-10 for body dysmorphophobia, the patient must have the following signs:
- preoccupation with an imperfection or disease of a physical nature that progresses rapidly;
- focusing on one or two organs;
- existing disorders are used to manipulate others;
- self-treatment, passion for various diets.
When symptoms are detected, it is necessary to understand the causes of their occurrence. The specialist will need to exclude the presence of other mental disorders.
Symptoms of the disease
Excessive anxiety syndrome is manifested by a constant desire to look at one's reflection, evaluating appearance, fear of being photographed. Women who are overly concerned about their appearance constantly ask loved ones about their defects and try to hide them.
The development of dysmorphophobia syndrome affects all spheres of life, because the patient loses interest in studies, work, and strives for social isolation. In the absence of treatment, as a rule, there is an excessive passion for sports, diets. Women are beginning to save money for surgical operations. There may be problems such as:
- alcohol abuse;
- loss of concentration;
- panic attacks;
- search for ways to get rid of existing defects.
In women, symptoms include wearing a lot of make-up, wearing oversized clothes to hide imperfections. It is important to start treatment as soon as possible. It is necessary to apply psychotherapy, and sometimes medication is required.
Causes of occurrence
There is a direct relationship between the effectiveness of psychotherapy treatment with an accurate understanding of why the syndrome of dysmorphophobia appeared. A man or woman can develop the disease for the following reasons:
- biological - disorders of neurotransmitter metabolism, anomalies in the development of the brain, the presence of a genetic predisposition of a woman or a man;
- psychological - injuries associated with criticism, lack of love and attention;
- social - pressure from the media, promotion of unhealthy body parameters, activation of fears associated with loneliness;
- personal - dysmorphophobia syndrome is characteristic of people with such qualities as timidity and insecurity, perfectionism, neurosis, increased sensitivity to criticism.
In rare cases, women or members of the opposite sex need treatment for the syndrome because of schizophrenia.
Body Dysmorphophobia Treatment
Body dysmorphic disorder in adolescents, women and men is treated with highly specialized psychotherapy. As a rule, during an exacerbation of depression, drug therapy is prescribed. It is possible to use antidepressants, tranquilizers to exclude suicide attempts, reduce anxiety and stabilize the condition.
Psychotherapy sessions begin in the second stage of treatment. Experts say that it is impossible to convince a woman or a man of wrong thoughts. Therefore, work is underway to adopt its appearance. It is strictly forbidden to allow plastic surgery or strict diets, as this leads to an exacerbation of the syndrome.
Treatment of body dysmorphic disorder is most often carried out on an outpatient basis, in advanced cases hospitalization is possible. This is necessary if psychotherapy does not help, there have been suicide attempts, the patient secretly continues to try to change himself. Treatment in a hospital allows you to isolate the patient from the effects of negative factors and eliminate the risks of deterioration.
Cognitive behavioral therapy
Cognitive behavioral therapy is often used to treat a woman or a man. This approach is aimed at helping the patient get rid of the rituals associated with the constant assessment of their shortcomings. In the process of treatment, self-reflection is necessary:
- tracking one's condition;/li>
- fixing the appearance of negative thoughts;/li>
- overcoming negativity.
Cognitive Behavioral Therapy is aimed at making patients aware of their condition to the full extent and the dangerous consequences for health. This is the main condition for a successful recovery. This method can be combined with medication or other types of therapy.
Group and individual therapy
With various disorders of adequate perception of one's own body, it is important to combine individual work with group sessions. This approach provides the following benefits:
- important insights when face-to-face communication with a psychotherapist has reached an impasse;
- the opportunity to look at the problem from the outside;
- development of empathy, friendly support;
- receiving strength to fight the disease from people who are faced with the same problem;
- association with those who have already returned to society to a normal way of life;
- Get more resources and help to prevent relapse.
Groups can also be visited after the end of the main course of treatment as a fixative therapy or preventive measure.
With the development of the syndrome, patients usually seek help from dermatologists, nutritionists, and plastic surgeons. This not only does not bring relief, but also aggravates the course of the disease. Recovery is possible only when working with a qualified psychiatrist and psychologist. Properly used psychotherapy allows you to get a noticeable effect in 82% of cases if the patient continues to be treated. The support of loved ones contributes to a faster recovery. Multi-family therapy may be used.
Many patients benefit from the use of antidepressants. The choice of drug and dosage should be prescribed by the attending physician.
CIRC specializes in helping patients with body dysmorphic disorder. We use British guidelines for diagnosis and treatment, we use only modern methods to combat anorexia, bulimia and other disorders.
We offer professional outpatient and inpatient care. Full understanding of the problem without judgment and pressure. The clinic employs the best specialists who undergo supervision and regularly improve their qualifications abroad. To sign up for a consultation in Moscow, call +7(499) 703-20-51 or fill out the online form.
consider itself a freak: how dissatisfaction with its own appearance becomes a disease of
from first -hand
to consider itself a freak: how dissatisfaction with its own appearance becomes a disease of
Maria Vinogradova, Svetlana Durba
31 July 2017 12:33
for dysmorphophobia a person considers some features of his appearance to be real deformities, while other people do not even notice them. Afisha Daily spoke with a woman with body dysmorphic disorder, as well as with a psychiatrist and psychologist, about the borderline between self-dissatisfaction and mental illness.
28 years old
I had problems with the perception of appearance at the age of eleven. I wanted to adorn myself, dress up in fashionable clothes, but my mother did not spoil me with fashionable things and forbade me to put on makeup. It was a tragedy because I couldn't even hide my pimples. It seems to me that if at that age I had learned to love myself, there would be no dysmorphophobia.
At school, I realized that I was dumb. Classmates did not let me forget that my nose is like that of Baba Yaga, and my legs are crooked and short. For the rest of my life, I remember the situation when we played "weak", where you had to complete a task or get a kick, and the phrase sounded that it's better to get a kick than to kiss me. Since then, I began to increasingly look for flaws in myself and find them.
I started going to a psychotherapist when I was a teenager, but because of my age I didn't take treatment seriously. My mother also took me to medical hypnosis: there they calmed us down with a speech, and then whispered some kind of suggestion about loving yourself into each ear. I never slept there and mostly thought about myself. As an adult, I again began to go to a psychotherapist, to whom my mother also sent me. Then depression and social phobia were added to dysmorphophobia. The doctor said some banal things about how we are all beautiful and we need to love ourselves, and once said that I have an iconic face. Now I continue treatment with a psychotherapist: I drink sedatives, antidepressants, neuroleptics - mainly so as not to be nervous and not take everything to heart.
I can't talk about my ideal of beauty - it causes great mental pain, I get angry. My sore spots are my whole face, as well as my eyes, chin, nose, short crooked legs. I didn’t do plastic surgery, because it seems to me that this is a betrayal of my parents: I’m very afraid of offending my mother, because everything that doesn’t suit me in appearance came from her.
Sometimes I may cry in the street because I am ugly, when a woman "must be beautiful." It is very painful to meet this message in films or literature. Now I cry less often, but before I could not listen to romantic music, read poetry, because they were written for beautiful people. The word "beauty" for me is a trigger (a word or an event that makes a person experience psychological trauma. - Approx. ed. ).
I constantly convinced myself that I was a slim blonde, I imagined myself to be her. It seemed that life was easier for them, and I would never become like that. At some point, I became addicted to mirrors: I had to look every second to see if everything was in order with my appearance. I don't use webcams and I can't stand uninvited guests - I'm afraid that someone will see me at the wrong time.
Dysmorphophobia brought me to misandry. I was very angry with men, because it was because of their greed and lust that terrible standards of beauty arose, because of which I feel ugly. Everything would not be so tragic if it were not shouted from behind every corner that a woman must be attractive "meat".
I love kind words, even if it's outright flattery - it means that you are somehow important to the person. I feel better from simple compliments, and criticism always hurts. Once I met a young man, and on the first date he gave me a "compliment": he said that I had a nice smile, despite my ugly face. It was a low blow, especially since it was said at the moment when I almost stopped considering myself a freak. After this incident, I began to have reactive depression (formed as a response to the experienced situation. — Approx. ed. ). Then there were thoughts about suicide as the only way out. And at that moment I decided never to have children, so as not to spread "ugly genes."
Now it is much easier for me, because I have a beloved man. He never made me remarks about my appearance. He always says that I am beautiful. It is very important for me. I continue to carefully monitor myself: it would be easier to score, but I can't. I also stopped being afraid to have children, and if I have a child, I will do everything to make him feel in the first place. I realized on my own - only love heals.
In modern terms, body dysmorphic disorder is an excessive preoccupation with one or more subtle physical defects. The disorder is usually accompanied by stereotypical behavior (actions that are regularly repeated regardless of the context. - Approx. ed. ): people look at themselves in the mirror, take care of themselves excessively, pay close attention to certain parts of the body, compulsively compare themselves with those around them, constantly looking for confirmation that they have a flaw. A person suffering from dysmorphophobia is always sure that he has some kind of defect.
According to epidemiological studies, the prevalence of the disease in society ranges from 1.7 to 2.4%. Obvious symptoms usually appear at the age of 13–20 years and are observed with the same frequency in men and women.
If men are characterized by concern about insufficient muscle mass, then women are more likely to pay increased attention to minor skin defects and certain parts of the body (the shape of the lips, eyebrows, nose, anatomical features of the hips, abdomen, legs, and so on).
Adolescents are primarily at risk, since it is at this age that an active process of self-identification begins. Through appearance, a teenager becomes aware of himself, answers the question "What am I", identifies with a social group that is significant for him. And it is appearance that becomes the basis for painful fixation and increased sensitivity to oneself and one's experiences. Also at risk are people for whom appearance is professionally significant: for example, photo models, TV presenters and all those for whom problems with appearance can become a serious obstacle to achieving professional and personal self-realization.
It is important to understand that the identified defects or shortcomings are imaginary, imperceptible to others. According to one of the hypotheses, the appearance of the disease is associated with a violation of the global perception mechanism - in other words, a person perceives only individual details, since the ability to see objects as a whole suffers.
There is a big difference between the usual complexes, psychological trauma, obsessions and body dysmorphic disorder. Preoccupation with acne, overweight, or obvious physical handicaps during adolescence are common pubertal problems that are not manifestations of a disease state. Sometimes people who lack attention behave the same way. This feature refers to personality traits and is not a manifestation of pathology.
We can speak of a disorder when a defect becomes so problematic for a person that it changes his whole life. Behavior, everyday habits, thoughts begin to revolve around this topic. That is, there is a painful fixation, a “stuck”, from which it is no longer possible to get out on your own.
The traditional answer to the question "When is it time to see a doctor?" - the earlier the better. However, in reality, this principle is difficult to implement. If something similar happens to one of your relatives, you need to draw his attention to the situation, advise him to consult a psychotherapist or psychiatrist. We can definitely say that if the symptoms of dysmorphophobia distort everyday life (for example, a person stops leaving the house, withdraws into himself, and so on), this is a serious sign that suggests that you need to contact a specialist as soon as possible.
Treatment for body dysmorphic disorder is usually lengthy and can take months. It includes both medication and psychotherapeutic methods of correction. The first line of therapy, regardless of the severity of disorders, are antidepressants from the group of selective serotonin reuptake inhibitors. Of the psychotherapeutic methods, the methods of cognitive-behavioral and existential-analytical psychotherapy are most widely used.
Dysmorphophobia, that is, the fear of the unattractiveness of one's body, is arranged as follows: a person sees some part of his body as ugly, deformed and strives to correct the defect. The lack may not exist at all, but all thoughts are focused around it. The problem develops more often when two circumstances coincide: external and internal.
External circumstances include widely advertised standards of beauty, and internal circumstances are associated with the emergence of an obsession in a person: a person sees some kind of defect in himself, starts thinking about it, thereby supporting him. He is no longer able to distract himself from this shortcoming, so it becomes obvious not only to the sufferer himself, but also to those around him. For example, a girl who believed that she had an ugly eye shape wore glasses with dark lenses both in sunny and bad weather, thereby drawing attention to her eyes.
Dysmorphophobia can be part of anorexia, when a person seems to have some part of his body fat - for example, cheeks or thighs. A person begins to limit himself in food, but this does not help to lose weight exactly where you want. Then it begins to seem to a person that he is not losing weight well enough, so he begins to restrict himself in food even more. In this case, the disorder can even lead to death.
The line between a critical attitude towards oneself and dysmorphophobia is easy to understand.