Body Dysmorphic Disorder (BDD) - Causes, Symptoms, Diagnosis and Treatment

Everything you need to know about body dysmorphic disorder
Body dysmorphic disorder (BDD) is a mental illness characterized by the obsessive focus on a perceived flaw and alleged defect in appearance and therefore warrants extraordinary measures to hide or fix one's dysmorphic part on one's figure. 
In BDD, you can feel so ashamed, embarrassed and anxious that you may avoid many social situations.
Certain biological, neurobiological, and environmental factors may contribute to the development of body dysmorphic disorder, including personality traits, genetic predisposition, serotonin dysfunction in the brain, and life experiences.
Body dysmorphic disorder
Body dysmorphic disorder is a type of mental illness in which a person is overly concerned about a defect in his body shape.

Body Dysmorphic Disorder (BDD) - Causes, Symptoms, Diagnosis, and Treatment 

Naturally, most people are worried about some of their personalities, facial features, and bodies at some point. 
But a person with a body dysmorphic disorder spends a lot of time thinking about some of the physical details that are hardly noticeable to others. 
This anxiety can turn into a pathological obsession. 
The disorder has nothing to do with a person's actual physical appearance, but about the person's self-image or the perception that the individual sees himself.

In this article, we will highlight the causes of Body Dysmorphic Disorder (BDD), its symptoms and the available treatments.

What is Body Dysmorphic Disorder (BDD)?

Body Dysmorphic Disorder (BDD), also known as dysmorphophobia, is a relatively common mental illness, in which a person is severely anxious because of a defect in their personal appearance. 

BDD varies, but for many people, it causes a severe psychological problem and can be so severe that it can severely affect work, school or social attitudes. 
It can be a concern towards any part of the body but represents the face and hair areas most often. 
For example, a person may feel a lot of anxiety as a result of having a crooked smile or an uneven smile, or some believe that acne or facial hair is more obvious than it is. Others fear that their overall appearance is unacceptable.

One study indicates that the proportion of people infected in the United States ranges from 0.7-4.0% of the population. It is spread in the 15-30 age group. Women are more susceptible to infection than men.

In many cases, anxiety levels can significantly affect social relationships and life. However, if an infected person receives an accurate diagnosis, drug therapy and cognitive-behavioral therapy (CBT), he can get rid of this disorder easily.

Causes of Body Dysmorphic Disorder 

Doctors are still unsure about the real causes of this disorder but there are some possible reasons that may include:

Obsessive-Compulsive Disorder (OCD): Those who have OCD or who are related to people with OCD often have a body dysmorphic disorder. 
One study suggests that 8-37% of OCD sufferers have a body dysmorphic disorder. People with both diseases also respond to the same treatment.

Genetic Factors: A small study suggests that genetics may play a role in this disorder. It notes that 8% of the infected people are family members who have been infected at some point.

Low Serotonin Levels: In the study, researchers have found the low levels of the neurotransmitter Serotonin in some people with body dysmorphic disorder. But it is still unknown whether these factors play a role or not. 
Researchers say the relationship between serotonin and body dysmorphic disorder may be complicated.

Visual Processing Disorder and Other Brain Issues: In a 2004 study, participants were asked to perform tasks including drawing shapes and looking at images. It is not known whether these factors are a cause or a consequence of the disease.

Childhood experiences: One study suggests that people who have suffered from bullying or negative comments about their bodies in the past are more likely to have a disfigurement. 
Increasing awareness of beauty standards also increases the risk of infection, but the study suggests that this maybe the result of the disease and not a cause.

Symptoms of Body Dysmorphic Disorder 

The main symptom of body dysmorphic disorder is the frequent attention and anxiety of the person with a slight physical defect.

Symptoms are long-term and vary in intensity, and the concentration of the person may move from one part of his body to another.
The most common areas of the body are:

The skin: For example, acne, oily skin, and wrinkles.
The face: For example, increased anxiety about facial hair.
There are some special areas in the body which are infected the most such as the nose, the mouth, the teeth, hair loss sites, breasts, and genitals.

Frequent attention to the body and anxiety can lead to the following behaviors:

Repeat touch, stare and measure the imagined defect.
Increase self-awareness of physical appearance.
Research and excessive reading about the defect.
Neglect of professional, social, family and personal health due to the high preoccupation with the defect.
Spend many hours a day thinking about this imbalance and the difficulty of thinking about something else.
Frequent consideration of mirror or doors and reflective surfaces.
Repetition of personal images (Selfie) in order to prove his belief.
Avoid mirrors and remove them from the house.
Attempts to hide the defect. For example, using wigs, clothes or make-up.
Frequent visits to the plastic surgeon.
Try to convince others that there is something wrong and frustrated when others do not see it.

If a friend or another person tries to convince him that there is no fault, the infected person will not be convinced. 
The person may also think that others are staring, talking about, or making fun of him, even though this does not exist.

Body dysmorphic disorder can affect a person's life. Some sufferers are unable to continue their professional and social life. 
Some can become anxious and depressed. Sometimes it can lead to suicide.

Diagnosis of Body Dysmorphic Disorder 

Many patients do not receive early diagnosis or treatment because they rarely turn to a specialist or psychiatrist. Instead, seek help from your orthodontist, dermatologist, the aesthetic surgeon or any other specialist who can make a change in your appearance.

Diagnostic Criteria for Body Dysmorphic Disorder
Frequent thinking of one or more formal defects that are hardly noticeable to others.
Repeating some behaviors. For example, looking in the mirror, or touching or rubbing and capturing the imaginary defect, or drawing comparisons with others.
Frequent thinking causes great sadness and anxiety for a person and affects professional social relationships and other areas of life.
Anxiety is not associated with weight in people with an eating disorder such as anorexia nervosa.

The Role of Plastic Surgeons in the Diagnosis
In a study published in 2015, it was found that 7-8% of those who wanted plastic surgery in the United States had a body dysmorphic disorder. 
However, researchers believe that the actual number is much more. They are urging plastic surgeons to be aware of the symptoms of body dysmorphic disorder. 
The patient should be encouraged to visit the psychiatrist rather than agree to the plastic surgery.

One of the methods used to identify the disorder is by using a questionnaire to diagnose body dysmorphic disorder. 
This diagnostic tool describes people who seek cosmetic surgery for no apparent reason.
For example, if a person with a body dysmorphic disorder undergoes cosmetic surgery, they notice that they are not satisfied with the results of the operation. 
Therefore, surgery does not reduce the symptoms of the disorder and may be dangerous and expensive.

If a specialist or the plastic surgeon finds any of the following symptoms, he will refer the person to a psychiatrist:

The person had frequent surgeries and did not get a satisfactory result.
A person has criteria for diagnosing a body dysmorphic disorder.
Having a simple flaw but represents the most important thing in a person's life.
Exaggerated anxiety compared to the size of the defect.

Treatment of Body Dysmorphic Disorder

Treatment is difficult, as patients refuse to visit a psychiatrist for not accepting that they have a psychiatric disorder. 
So the treatment requires many visits and the use of methods to gain the patient's confidence before being told that his physical defects are actually psychological illnesses. 

In the case of BDD, the treatment generally includes medications and cognitive-behavioral therapy (CBT).

Cognitive-Behavioral Therapy (CBT)
The goal of using CBT is to change a person's beliefs and the way they think. It also helps the patient stop negative thoughts, and encourage him to see himself in a more realistic and a positive way.

You can also learn healthy ways to resist some repetitive behaviors, such as repeating a mirror.
There are many online cognitive-behavioral therapy courses that are often less expensive than direct counseling.

According to evidence, selective serotonin reuptake inhibitors (SSRIs), a type of antidepressant medication can alleviate the symptoms of body dysmorphic disorder in half of the users. 
Examples of these drugs are fluoxetine, fluvoxamine, and citalopram.

Repetitive Transcranial Magnetic Stimulation
In a new study published in 2018, researchers found a new method of treatment, which is the repetitive transcranial magnetic stimulation (rTMS or TMS), by stimulating specific brain locations using electromagnetic fields. 
Scientists are looking at using this technique to treat depression, psychosis, and anxiety.

Body dysmorphic disorder is a severe mental illness.
BDD may cause a severe psychological problem that can severely affect work, school or social attitudes.
Genetics, OCD, VPD, low serotonin levels and childhood experiences are some possible risk factors.
Proper treatment and diagnosis can help:
Relieve symptoms and help the patient see himself in a positive way.
Solve the underlying problems causing the disease.
Prevent the infected person from unnecessary and dangerous surgical procedures.

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