The demon we see in ourselves - Body Dysmorphia Disorder

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Likes, shares, followers, views, all of these words have come to mean more than just social media statistics. These numbers have become directly proportional to how happy people are. The greater the likes and followers for their pages, the more satisfied they are with their social media presence. And what do these posts on social media contain? Some are informational pages, some about mental health, and some official pages of brands, but there are a few types of pages that talk about humans and humans alone. These are the lifestyle bloggers, fashion pages, and, of course, personal accounts of various people on the planet. 


While not all, but a lot of them talk about figures, clothes, skin, beauty, a happening life, and a lot more. Such discussions lead people to compare their real life with the ones portrayed on social media. “She looks so pretty!”, “I wish I lived a life as interesting as his.”, “I wish I could pull off such a dress.”. Comments of wishing to live a life like the influencers turn to hate talks for oneself. People start to obsess over having that perfect greek god body, and fitting into those size zero dresses, and flaunting perfect skins. A study conducted at the Prince Sattam bin Abdulaziz University at Al-Kharj city in Saudi Arabia with a total of 1035 participants generalized to the population found that 23.4% of the participants compared their appearance to the famous personalities on social media with more comparisons in the group with people with BDD than with those otherwise. Around 13.9% believed that others see their appearance as severely abnormal and again, this was higher in the BDD group. BDD stands for Body Dysmorphia disorder, but what exactly is it? Let’s see.


     

Body dysmorphia disorder


In simple words, it is a mental health condition characterized by an obsessive absorption with one’s physical appearances. In BDD, someone with a distorted body image, tends to focus on their physical appearance with a particular excessive focus on some perceived feature of their body - some common ones being chest, hair, genitalia, muscularity, facial features, and symmetry. It consumes their thoughts and is very overwhelming, becoming a hindrance to their general well-being and daily functioning. 

A basic concern for body image is commonly found in all individuals, which is why BDD is different from that. When one suffers from BDD, they are constantly hammered with persistent and intrusive thoughts, causing significant distress and impacting behaviour  as well as functioning. It is characterized by an obsession with a flaw or trait they perceive to be an imperfection, that is in reality, barely noticeable, sometimes non-existent to others around them. Such flaws and traits become unbearable to them and consume their very being to such an extent that they begin to hamper the quality of their life.

Some behavioural indicators for Body dysmorphia disorder are:

  • Clothing to hide certain parts of the body.

  • Excessive grooming

  • Excessive use of makeup

  • Repeatedly checking one’s appearance in the mirrors

  • Resorting to cosmetic surgeries to cover - up a perceived flaw

  • Seeking to get reassurance from others about the particular body part

  • Wearing accessories like hats, gloves, scarves, etc.


These behaviours are repetitive in nature in an attempt to get some relief from the distress that the constant thoughts and feelings of inadequacy that their BDD brings them. However, any relief is short-lived. The relief is so important because of the intensity of the distress which can reach a level where the victim finds it difficult to engage in social interactions, fulfillment of responsibilities, and in extreme cases, even the willpower to leave home.  

Along with such feelings, people with BDD also fear judgement from others on both counts, their physical appearance and being seen as vain for obsessing so much over their physical appearances. However, in order to be diagnosed with BDD, one must fulfill a list of criteria, specifically, being preoccupied with their appearance; engaging in repetitive behaviour in an effort to ‘fix’ a perceived flaw; and lastly, clinical significance of the obsession and repetitive behaviours, meaning that these behaviours must be experienced by the person to the extent that the would hamper their quality of life and daily functioning. BDD may be misdiagnosed as some other mental health issue with similar symptoms like Agoraphobia, Bulimia Nervosa, Anorexia, excoriation disorder, generalized anxiety disorder, obsessive-compulsive disorder, psychosis, social anxiety disorder, as well as Trichotillomania. In fact, the DSM - V mentions BDD under the list of OCD and related disorders. 60% of the people with BDD have a lifetime of anxiety disorder and 38% fight with social phobia. Inability to indulge in social interactions and feeling extremely fearful of judgement may also lead the people to feelings of loneliness and isolation leading inadvertently to depression. When the perceived flaws are related to the size of a body part, people develop eating disorders in an attempt to again, ‘fix’ the flaw. Studies have found that 12% of those with BDD match the criteria for bulimia - individuals here suffer from bouts of over-eating followed by using inappropriate measures to prevent weight gain such as purging, fasting, or exercising excessively (DSM-V) - and anorexia - people with Anorexia restrict intake of food leading to a low body weight due to an intense fear of gaining weight or becoming fat, even though they may be currently underweight, of which they are in denial. 

BDD affects men and women alike, however it is a little more common in women as compared to men - 2.5% vs. 2.2% - and around 5 to 7.5 million people are affected by it in the United states of America alone. Studies have indicated that in general, 2.3 to 7 percent of the entire population is impacted by BDD. Among these 7%, 80% have suicidal ideations and 44% have already attempted the same. 

While social media aggravates and contributes to the development of BDD, it isn’t what causes it. There may be multiple factors at play some of which may be a history of abuse, brain abnormalities, being bullied, a genetic predisposition (mostly a parent with OCD), and lastly, social and interpersonal interactions - social media included. 


Solving it!


Because of the nature of the issue, psychiatric treatment may seem like a trivial solution to their problem. For them, the best way to solve the issues is to use makeup, and cover up clothing etc. For them, the problem is physical, and not psychological, which is why it seems to me that the first step to get out of it, is insight. They must understand that the root of their problem lies in their mind and not their body. Their body is fine just the way it is. Cognitive behavior therapy is one of the options to go with treatment, however medications - specifically SSRIs, i.e., Selective serotonin reuptake inhibitors - are used to aid the same. It is possible that after a long time of indulging in physically destructive behaviour and trying out various cosmetic/medical treatments, victims of BDD along with their loved ones become hopeless about the scope of any improvement in the condition. It thus becomes imperative to stop chasing such treatments and discontinue ineffective medical treatments so that the willpower to fight is not lost. 

On a personal level however, an individual can start with stopping comparision to influential personalities on social media and a journey to self-acceptance. Stopping unhealthy behaviours and changing your self-talk positively can lead to better results. As it's popularly said, "change starts at home", it is important to start at an internal level to really see significant changes and results.



About the Author

Prisha Gohil

Co-Head

PsyCreative Column

Psychology Committee, SDSOS, NMIMS


Prisha Gohil, born and raised in Rajkot, Gujarat, is an 18-year-old, full of youth and quirky enthusiasm, something clearly visible in her writing. She is currently studying psychology at SDSOS, Mumbai. Her biggest achievements are her family and friends, who have always been an inspiration to her. She is full of energy when she is awake, which she rarely is. Her dream is to sleep but does some productive work in between here and there while reaching her final goal. Communication is one of the best skills she possesses, which she has nurtured over time. Confident, charismatic, hard-working, and passionate are words that would appropriately describe her.



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