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How To Treat Body Dismorphic Disorder

 
By Nidhi Nangia. Updated: June 3, 2018
How To Treat Body Dismorphic Disorder

Body dismorphic disorder, also known as body dismorphia, is a kind of mental illness in which the patient feels obsessed with a minor or imaginary flaw in their appearance. The person may spend all of their focus on fixing a perceived flaw, even going to the extent of cosmetic surgery. You will frequently find such people spending hours in front of the mirror and comparing their looks with others. The issue is that what someone with body dismorphia sees will often not correlate with their actual appearance. The condition may lead to excessive stress, anxiety and depression, even provoking suicidal attempts. In this oneHOWTO article, we will discuss about how to treat body dismorphic disorder, as well as provide some necessary background information on this condition.

You may also be interested in: How to Diagnose Schizoaffective Disorder

Symptoms of Body Dismorphia

While it is common for people to focus on improving their appearance, the aim of a person suffering from body dismorphic disorder (BDD) is to at least normalize his or her looks as compared to others. The patients may focus on any area of their body, including the face, skin, hips, thighs, belly, hair or arms. Some of its symptoms are:

  • Attempting self-treatment, such as skin picking, which further create lesions which make the area even more unsightly.
  • Obsessive compulsions, also linked with depression and anxiety.
  • Constantly thinking about appearances of others, paying particular attention to their flaws and making fun of them.
  • Ruminating several hours a day about their perceived body defects and avoiding social interaction.
  • Trying to camouflage flaws with apparel and cosmetics, and repetitively checking their appearance and comparing it with others.
  • Seeking verbal reassurance from others.
  • Sometimes avoiding mirrors altogether and repetitively chaging outfits.
  • Excessive focus on their appearance often leading to deteriorated occupational and academic performance.
  • Seeking cosmetic treatment or surgery, but not feeling satisfied even afterwards.

One review of the disorder compares BDD with obsessive compulsive disorder stating that as 'with OCD, the behaviors are not pleasurable'[1]. This means that the repetitive actions which are thought to make the individual feel better can even cause pain and even physical damage.

Causes of body dismorphic disorder

There can be several genetic, psychological, developmental, cultural and social factors that can lead to body dismorphic disoreder. Early adolescents are the most common victims of BDD, often triggered by trauma, neglect, abuse, bullying and teasing. Heredity is another factor that can cause BDD in an otherwise healthy person. However, it is not exclusive to those who have had traumatic upbringings. It is still difficult to work out why some people develop the condition. Body dismorphic disorder can also be caused by introversion, perfectionism, negative body imaging, excessive aesthetic expectations or general childhood neglect.

Treatment of body dismorphic disorder

The goal of body dismorphic disorder treatment is to improve the quality of life and decrease distress associated with appearance and compulsive issues. This means that management is more likely than curing the disorder completely. Some Basically, there are two treatment approaches for managing BDD:

  1. CBT or Cognitive behavioral therapy: It is a psychological approach towards treatment of BDD
  2. Medication: Serotonin reuptake inhibitors or SRIs can be administered to treat body dismorphia

Patients with BDD can have additional problems, due to which they may show different responses to the treatment approach. That is why, it is necessary to seek professional assessment first. Let’s talk about the different treatment procedures in detail.

What happens in Cognitive Behavioral Therapy (CBT)

Scientific researches and clinical studies have found that patients with BDD tend to over-focus on minor details of their body instead of looking at the bigger picture[2]. They give more significance to being physically attractive, rather than on self-worth. CBT is applied both for individuals and groups to provide psychological treatment. It focuses on their thoughts, cognitions and behaviors triggered by body dismorphia. Essentially (but not exactly), improvements are made by changing the thought processes which lead to unhealthy behavior.

During CBT, the patient and therapist work together to determine the behavior and thought patterns involved in the patient’s symptoms. Basically, it aims at identifying the patient’s compulsive thoughts related to their appearance, and developing flexible beliefs to help change everyday behavior. Patients are encouraged to participate in challenging situations which decrease their anxiety over time. In this way, their brain responds to changes gradually and they can have more control over their emotions.

Patients learn strategies to control their compulsive and avoidance behaviors, thereby decreasing distress and anxiety which lead to BDD. Over time, patients learn how to face people with confidence and gradually overcome body dismorphia. Apart from this, CBT patients also learn to see the bigger picture of things rather than just focusing on their looks. They ideally start looking at their body in the mirror with a positive frame of mind, without focusing on the flaws. Or at the very least, not letting their perceived flaws rule their thoughts.

Several homework assignments and therapy sessions are involved to help an individual learn new skills of handling different situations. Some therapies also involve family members who can help them address and confront their negative thoughts.

How To Treat Body Dismorphic Disorder - What happens in Cognitive Behavioral Therapy (CBT)

Medication treatment for body dismorphic disorder

Serotonin reuptake inhibitors or SRIs are first-line medicines used for treating body dismorphia. These are antidepressants, but they are also helpful in reducing compulsive behaviors and obsessive thoughts of patients with body dismorphia. In addition to BDD, they are also helpful in treating major depression, anxiety, OCD and other such conditions.

SRIs are effective and safe for most patients with BDD. After taking SRIs, patients tend to spend less time in front of the mirror and thinking about their appearance. They gain better control over their obsessive thoughts and compulsive behaviors. They also see significant improvement in their anger, distress, daily functioning and suicidal thoughts. Because medication is not enough to resolve BDD completely, it is usually coupled with cognitive behavioral therapy.

How to Support BDD Treatment

Although a mental health specialist will make the best treatment plan for an individual, there are certain things they can do to get the optimal benefits. Some of them are:

  • Strictly follow treatment plans and never skipping therapy sessions. Many people tend to skip their medicines if they feel better. But you should never do this without speaking to your therapist or doctor first. Symptoms can quickly come back if you stop your medical treatment. Withdrawal-like symptoms may also arise if one stops your medicines suddenly.
  • Accepting the fact that they have a disorder and needing to make efforts to overcome it. Meeting people, talking to others, browsing through the Internet and trying to gain maximum knowledge about BDD. Knowledge will empower and help people with body dismorphia understand their situation better. Once educated, they can feel motivated to stick to therapy sessions with a positive frame of mind (be careful when researching on the internet as some sites might have unhelpful information about BDD).
  • Identifying warning signs and learning about the factors that trigger BDD symptoms. Once triggers are identified, trying to avoid them and planning responses when symptoms return. Contacting a therapist whenever they notice changes in symptoms and body self-perception.
  • Practicing the strategies and skills learned during therapy sessions when at home. Gradually, they will become stronger habits and will better help individuals deal with their symptoms.
  • Avoiding use of alcohol and drugs during treatment. They may worsen symptoms, or at least interact with medication.
  • Staying active, doing some physical activity, aided by an exercise plan. Being physically active will be helpful in managing symptoms, including anxiety, stress and depression. One may consider activities like jogging, walking, gardening, swimming and others that they enjoy. However, do not exercise excessively with an aim to fix a perceived flaw[3].
  • Writing a journal of the situation and improvement can help you identify thoughts, behaviors and emotions.
  • Not making themselves isolated and aloof from the world. Engaging in regular activities that they enjoy with family and friends. Trying to be with people who make them feel better and provide support.
  • Eating healthy food, resting well, staying physically active and general focus on positivity.
  • Reading literature, joining support groups with people going through the same thing and developing useful relaxation techniques. These need to be catered to the individual, but can include practices such as yoga, tai chi or meditation.

This article is merely informative, oneHOWTO does not have the authority to prescribe any medical treatments or create a diagnosis. We invite you to visit your doctor if you have any type of condition or pain.

If you want to read similar articles to How To Treat Body Dismorphic Disorder, we recommend you visit our Mental health category.

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