But who ever looks at it when it has been in the house three days?"
George Bernard Shaw (1856-1950), Anglo-Irish playwright, critic
Man and Superman, Act 4 (1903)
Very few are pleased with what
they have - physically.
Some wish for a sharper nose, smaller feet, a slimmer waist - name it. Mostly it's a thought now and then, a passing "if only I were __________" (taller, thinner, wider, etc.). The question is when does the obsession with looks and features turn for the worse and become a psychiatric concern? When does "vanity" if you can call it that, become a sickness?
Body Dysmorphic Disorder.The Mayo Clinic defines body dysmorphic disorder (BDD) as an "excessive preoccupation with a real or imagined defect in one's own appearance." The extreme anxiety (and distress) impairs activities of work or school. One effect is that the person's social life suffers.
Causes.Researchers and psychiatrists have not pinpointed the exact cause of BDD. However, as in many mental conditions, an organic or physical cause can be unearthed. A chemical imbalance (insufficient amount) specifically of the neurotransmitter serotoninis one cause. Apparently, BDD runs in families of higher socio-economic status wherein the person is expected to look and behave (unrealistically) in a certain way. In addition, BDD can also form part of a generalized anxiety disorder, an eating disorder like anorexia nervosa or bulimia, or an obsessive-compulsive disorder.
Signs and Symptoms. It's been noted that patients with BDD are overly concerned with the following areas: imperfections of the skin - scars, blemishes, wrinkles, even acne; parts of the face, generally the nose; and hair - too little on the head or too much in the body. Sometimes the concern is over the size or shape of the penis, breasts, buttocks or muscles in general. The Cleveland Clinic lists warning signs in possible BDD patients:
* Engaging in repetitive, time-consuming behaviors - constant mirror checking, pricking the skin; touching, covering, or hiding the perceived imperfection
* Inability to stop focusing on the perceived defect
* Constantly seeking reassurance that the defect is not obvious, visible, or abnormal
* Feeling anxious around people who might notice the imperfection
* Feeling self-conscious and not wanting to be seen in public
* Always consulting dermatologists or plastic surgeons about ways to remove the "problem"
Screening and Diagnosis. It's difficult to have personal insight in this condition because we are all to a certain degree, vain. But here is where caring friends and loving relatives can help. They can schedule a visit to a psychologist or psychiatrist. The mental health professional administers a questionnaire that evaluates areas such as:
* Preoccupation with appearance
* Degree of self-consciousness
* Tendency to overvalue appearance in determining over-all self worth
* Avoidance of social situations and physical contact with others
* Excessive altering of appearance through grooming, cosmetics, or clothing
* Tendency to frequently check on appearance and seek reassurance from others.
Treatment. The goal of psychotherapy is to expose and correct the false beliefs leading to a distorted image of the patient's body. This requires a change of thinking (cognitive therapy) and an adjustment in behavior (behavioral therapy). Sometimes, medications - usually antidepressants - are prescribed. Finally, the family can be recruited to share the responsibility of treatment.
Indeed, there seems to be no bottom when it comes to mental self-torture. But for victims of body dysmorphic disorder, it's especially worse for they are trapped in superficiality and somewhat unhinged at that. No cosmetic or plastic procedure will ever be enough.