Dr Asha Pemberton
teenhealth.tt@gmail.com
Body dysmorphic disorder (BDD) is a common condition, although many young people remain undiagnosed. It occurs in approximately two per cent in young people worldwide, and left untreated can be extremely disruptive and damaging to the life of a teen. But with proper treatment young people can live a completely normal life of productivity. The first step in that direction is recognising the signs of this disorder.
The disorder is characterised by preoccupation with perceived flaws in one's appearance and lead them to engage in repetitive behaviours to try to hide or fix them. The distress caused by these false perceptions can be devastating. Affected youth find it hard to stop thinking about the parts of their looks they dislike. They focus on specific things - like acne or scars on their skin, or the shape or looks of their nose, eyes, lips, ears, or hands and are unable to see anything else or even focus on any positive attributes. They define themselves by their imagined flaws and their entire self-esteem and self-worth is eroded. The emotional symptoms of BDD go beyond simply 'disliking' and those affected begin to feel stressed, anxious, sad and depressed constantly.
Some of the features of BDD include:
Extreme and constant focus on appearance and in particular the feature that they perceive to be unacceptable.
A false or negative image of their looks, with emphasis on 'flaws' that often do not exist. They see themselves in a manner completely different to the impressions of others.
Constant checking and attempting to fix, hide or cover the area, where possible.
Avoiding social contact, including school due to the incorrect idea that everyone is staring at them or judging them.
Covering themselves with large clothing, hats, gloves, masks or other garments constantly, even when inappropriate or impractical.
Engaging in unhealthy behaviours, cosmetic procedures or other actions to attempt to 'fix' these perceived flaws. It is to be noted that cosmetic procedures rarely lead to recovery without proper therapy, as the individual them directs their thoughts to another body feature which takes over the distress.
Perhaps the most devastating aspect of body dysmorphic disorder is the time and energy consumed by the negative thoughts and worries produced. They literally take over the lives of affected people. In adolescence, this leads to a significant impairment on social functioning, peer relationships, school performance and overall development. In severe cases it can lead to the development of depression, self-harming behaviours, eating disorders and general dysfunction.
Causes of body dysmorphic disorder
The cause of the disorder is not fully known. However, there are risk factors that largely explain why a given individual may struggle with body dysmorphic disorder. These include experiences of trauma including bullying that were focused on a specific physical feature. Genetic factors also play a role, with affected youth often having a
