When the mirror is: Understanding the body's deformity

Teen examines acne in the mirrorDysmorphic Body Disorder (BDD) or physical malformation is a condition in which a person thinks his body is a serious defect. The flaw is either fictitious or real, but small. For example, a person may have a small skin irritation that others almost do not notice, but develop a worry and an over-perception of the defect.

Usually, a person's focus is on the face, head or body shape. Excessive mirror control, care or exercise can be BDD indications. The condition is closely related to obsessive compulsive disorder (OCD).

BDD usually begins to develop in puberty. The average age is 17 years and the studies showed that prevalence began to decline after age 44. Body malformation is more common than can be thought of, accounting for about 2% of the population.

Symptoms of body malformation

The following are common signs of physical malformation:

  1. Excellent concern with a natural defect that is de minimis or can not be observed by other people.
  2. A strong belief that this defect makes you ugly or unattractive, no matter what it looks on your resting body.
  3. A belief that others are aware of the defect or defects in your appearance.
  4. Always compare your appearance with others.
  5. Avoiding social situations due to shame for your appearance.
  6. Always seeking reassurance for your appearance.

We live in a society that places great emphasis on beauty and youth, so it is normal to worry about our appearance. However, if your concern about what you see becomes obsessive, it starts to interfere with your daily operation and / or causes considerable anxiety, you may have BDD.

What Causes Body Dyspnea?

A survey of people with a physical malformation disorder found a significant correlation with child abuse. In particular, 78.7% of individuals diagnosed with BDD reported early life misuse, including:

A child born of a neglected parent is unlikely to have the opportunity to develop good coping abilities. For some people with BDD, it appears that as a result of abuse, it can internalize sadness and pain. Over time, the person comes to believe that there is a problem with them or their body.

Researchers have found that people with BDD have abnormal organization of the brain. The greater the severity of the symptom, the greater the impairment of function and organization compared to individuals without BDD. Researchers also found signs of abnormal connectivity in the visual areas and emotional processing, suggesting a lack of information processing in these areas of the brain.

Treatment and effects on physical deformity

Body malformation is a serious issue and should not be treated as mere vanity. Individuals experiencing BDD have a higher risk of suicide as well as hampering social and professional development. BDD is often not removed without treatment. If left untreated, physical malformation can lead to depression, anxiety and extensive medical expenses.

Body malformation is a serious issue and should not be treated as mere vanity. Given the long-term course of BDD and the significant impact on quality of life, it is important that people who are affected seek treatment. While there are neurological differences in patients with BDD, it is possible to make changes in neurological function. The brain is plastic and retains the ability to change throughout its life.

The most common forms of treatment for BDD are cognitive behavioral therapy (CBT) and pharmacotherapy. In a recent study, the drug of choice was a selective serotonin reuptake inhibitor (SSRI). Studies investigating the use of both pharmacotherapy and CBT combined have shown that combination therapy is effective.

BDD may require long-term treatment and many patient populations do not wish or can not receive SSRIs, such as pregnant women. However, CBT has proven to be very effective and is often a preferred treatment course. CBT has been shown to improve the results both when it is the only treatment and when combined with medication.

If you or a loved one are experiencing physical distress, you can find a therapist here.

Bibliographical references:

  1. Arienzo, D., Leow, A., Brown, J.A., Zhan, L., GadElkarim, J., Hovav, S. & Feusner, J.D. (2013). Abnormal organization of the cerebral network in physical malformation. Neuropsychopharmacology, 38(6), 1130-1139. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629399
  2. Bjornsson, A.S., Didie, E.R. & Phillips, K.A. (2010). Body distraction. Dialogues in Clinical Neuroscience, 12(2), 221-232. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/20623926
  3. Buhlmann, U., Marques, L. M., & Wilhelm, S. (2012). Traumatic experiences in people with physical malformation disorder. The Journal of Nervous and Mental Disease, 200(1), 95-98. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/22210370
  4. DeVos, K. (2017, September 5). Examining the relationship between physical deformity and PTSD. Retrieved from https://www.eatingdisorderhope.com/blog/examining-body-dysmorphia-ptsd
  5. Hong, K., Nezgovorova, V., and Hollander, E. (2018). New perspectives in the treatment of physical malformation disorder. F1000Research, 7. Retrieved from https://f1000research.com/articles/7-361/v1
  6. Koran, L.M., Abujaoude, E., Large, M.D., & Serpe, R.T. (2008). The prevalence of physical malformation in the adult population of the United States. CNS spectra, 13(4), 316-322. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/18408651
  7. Vitiello, B. (2009). Combined therapy for cognitive behavior and drug therapy for teenage depression. CNS Drugs, 23(4), 271-280. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2671638

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