It can be dangerous, debilitating and all-consuming. So why have so many of us never heard of body dysmorphia?
Here, Lysn psychologist Nancy Sokarno takes us through everything to know about the mental health condition currently affecting around 2 per cent of the population.
What is body dysmorphic disorder?
Individuals with body dysmorphic disorder (formerly known as dysmorphophobia) are preoccupied with one or more perceived defects or flaws in their physical appearance, which they believe look ugly, unattractive, abnormal, or deformed. The perceived flaws are not observable or appear only slight to other individuals. Concerns range from looking "unattractive" or "not right" to looking "hideous" or "like a monster." Preoccupations can focus on one or many body areas.
There are two variations of Body Dysmorphia – one where the sufferer is delusional and the flaw is an imagined thing, the other where the flaw is a real thing however the importance of this is severely exaggerated.
What’s the difference between body dysmorphia and poor body image?
The difference is that body dysmorphia can be quite obsessive and imagined, and poor body image is a person’s perception of one’s self which they see in a negative light. Whilst a person’s body image might not always be positive, it is not imagined or overly exaggerated and doesn’t tend to preoccupy a person’s time too much. Most people tend to have a view that they have physical imperfections, however, with body image, these imperfections aren’t something a person will constantly focus on, merely that they are aware of it.
What are the tell-tale symptoms of body dysmorphia?
One of the biggest tell-tale symptoms is the tendency to focus and obsess about perceived flaws, as well as thinking flaws exist when they don’t. A person with body dysmorphia will also often seek excessive reassurance from others, engage in repetitive compulsive behaviours in order to check, camouflage, hide, or fix the perceived defect. Examples include excessive mirror checking, repetitive efforts to hide their perceived flaws, and avoiding activities that might display flaws (such as swimming).
Are there any more subtle signs to look out for?
Yes, there certainly are some more subtle signs however most of these happen internally, that is, to the sufferer. These can include constantly comparing yourself to others and feeling inadequate, constantly focussing on your flaws and ways that you might be able to fix them, or obsessive habits that are related back to your appearance. From an outsiders perspective, things to look out for can be when sufferers constantly seeking reassurance and validation about their appearance, or on the other end of the spectrum avoid talking about their appearance at all and become withdrawn not wanting to socialise or hiding behind articles of clothing such as wearing large jumpers, glasses etc.
Who is most likely to experience body dysmorphia?
Most people have something about themselves that they don’t like however that doesn’t mean that they have body dysmorphia, rather a view of themselves which is related to their own body image. Body dysmorphia usually develops at adolescence and teenage years. Research shows that it affects women and men almost equally.
How is it diagnosed - is there a test you can take?
There are diagnostic criteria in the DSM-5 used by mental health professionals which can ascertain whether someone is suffering from body dysmorphia. The criteria normally looks at repetitive and obsessive behaviours related to a preoccupation with appearance and how this affects the person’s life (for example, does it impair their social or occupational functioning?). Unfortunately, body dysmorphia is often misdiagnosed as a disorder such as generalised anxiety disorder or eating disorders. Body dysmorphia symptoms can also appear in conjunction with or cause other disorders such as anxiety and depression.
What is the treatment/management like?
Treatment for body dysmorphia is focused a lot around Cognitive Behavioural Therapy which focuses on helping the patient to change their maladaptive thought patterns and behaviours. This is a type of therapy that usually involves the psychologist asking the patient to try to challenge the thoughts and engaging in social situations without focusing on covering up their perceived flaw. Other strategies include getting the patient to remove things like mirrors from their house, or getting them to start showing their ‘flaws’ (for example avoiding using makeup to cover) exposing them to the identified triggers and tracking the intensity of symptoms. Treatment for body dysmorphia can take time – it’s certainly an ongoing journey of working towards changing the patient’s entire mindset.
What should you do if you or a loved one are struggling with body dysmorphia?
Definitely seek help from a professional right away– please don’t suffer alone. Unfortunately, sufferers of body dysmorphia can often keep it to themselves and the condition can slowly deteriorate a person’s mental health. Seek out a psychologist who specialises in the area and they can arm you with strategies to help manage this disorder. For someone you know suffering, suggest options for help. The first step is talking to a professional and sufferers can chat to Beyond Blue or Lifeline for free over the phone service. Otherwise, places like Lysn offer psychology services that can be done via video from the comfort of a person’s home. If you or anyone you know are feeling suicidal please call 000 immediately.
For information, support and guidance from qualified Australian psychologists, contact LYSN.