Beauty obsession

by Rosie Kaloki

Gripping the sink, the young woman stares at herself in the bathroom mirror.

Reflected back she sees a monster; large protruding lips and yellow teeth so thin they are about to fall out.

A single tear rolls down her cheek.

Meet 22-year-old student Emily Jane.

Does she have a facial disfigurement?

The answer is no, for in reality Emily Jane is an incredibly beautiful young woman with nothing wrong at all.

In fact, the only problem she has is suffering from Body Dysmorphic Disorder (BDD).

For sufferers of BDD, self-love is as alien as food is to an anorexic.

It is a serious psychological illness that affects one per cent of women and men equally in the UK today.

But many are still in the dark about its existence. Emily Jane is not alone in her way of thinking.

Everyone has concerns about certain aspects of their appearance.

Who hasn’t queried at one time or another if their bum looks big in an outfit?

Vowed to get rid of their pot belly for that summer bikini or fretted about their love handles?

I think it’s safe to say most of us.

But imagine being so consumed with these thoughts that you refuse to leave the house or to look in the mirror – or you even quit your job.

It sounds extreme but this is the daily reality for many BDD sufferers.

Obsessive illness

The illness sees the victim gradually become obsessed with the perceived flaws in their appearance – whether it actually exists or not.

It takes on such exaggerated proportions in their minds they develop obsessive ritual-like patterns of behaviour, to try and ‘fix’ or cover up the feature with make-up, clothing or their hand.

Emily Jane fears all mirrors and reflective surfaces: “Every moment of every day is spent covering my mouth. I avoid mirrors because then I can try and pretend I don’t exist.

Seeing my reflection sends me into a downward spiral of depression. Suicide is never far from my mind.”

According to Dr Katherine A. Phillips, author of The Broken Mirror: Understanding and treating BDD, the top three most affected areas are the skin, hair and nose.

But the official list is extensive.

With gyms, hairdressers and nail bars on practically every street, personal appearance is big business.

For most of us, caring about our looks is normal, but when does self-grooming step over the line of normal physical concern?

When does worrying about our looks cross that fine line from healthy to psychological illness?

“When self maintenance begins to take up all of someone’s day in thoughts as well as actions, it’s getting serious,” explains Dr David Veale, specialist in BDD and consultant psychiatrist at London’s The Priory hospital,

“If the patient displays signs of incessant worrying about a slight or non-existent defect, on an average of three to eight hours a day, BDD is usually diagnosed.

Self-harm

Many sufferers develop depression or anxiety disorders. Some even turn to substance abuse as a means of coping.”

Emma Collier, founder of bddhelp.com, said: “From the people who contact us, just over 50 per cent of them are frequently drinking and using drugs.”

Emily Jane is part of that statistic: “I need to drink to face people and get through the day.

At first it made me forget all my BDD worries for a few hours. But now when I drink I don’t get that high anymore,

it has long since worn off. I just feel numb or even more despair, but I can’t stop. Reality is far worse.”

There are many theories about what causes BDD, such as the media or psychological factors, for example being

teased at school or having low self esteem.

Cultural factors such as society’s perception of image and what is the ideal also have an effect.

Even genetics are thought to perhaps play a part.

Emily Jane only noticed her teeth were different when she reached secondary school.

“From then on my life became awful – practically non-existent,” she states.

“Between the ages of 12 and 17, when teens are exploring their personalities, I was lost in an isolated wilderness.

I shut down and consequently never let anyone get close. I still find it hard.

My family have to deal with my severe mood swings and drinking. I hate what I am doing to them but I can’t help it.”

Still a taboo

Unlike anorexia, where the effects are visible, BDD is very much a silent illness, for varying reasons.

Society’s image obsession means people displaying the symptoms are often dismissed as vain.

But as Dr David Veale says: “People with BDD believe themselves to be ugly or defective, they tend to be very secretive, and this is why BDD receives less media coverage than eating disorders. Reluctant to get help, sufferers are more likely to seek out a cosmetic surgeon.”

This, for many, is indeed the case; BDD sufferers believe that the only way they can be ‘cured’ and live contented and normal lives is if their ‘defect’ is put right.

This, in their minds, can only be achieved through cosmetic surgery.

But surgery is most definitely not the answer, because the root cause of their illness is their perception of the flaw and not the flaw itself distorting their image.

Sufferers who take the cosmetic surgery route are largely never satisfied with the outcome.

Some merely end up shifting their attention to a new flaw.

More worryingly still, ‘DIY surgery’ is sometimes attempted by those sufferers for whom surgery is not a viable option, for financial or other reasons – with potentially disastrous consequences.

This extreme action just goes to show the tight grip BDD has on a person.

Although BDD has dated back over a century and thousands are in its grip, it is still a relatively ‘new’ illness; consequently many people have been misdiagnosed by their doctors who don’t have sufficient subject knowledge.

Diagnosing depression or social phobia often means sufferers sink further into confusion, despair and isolation.

Case studies show BDD has been recorded way before media and advertising became the phenomenon it is today.

Dr Katherine A. Phillips wrote of African tribes who had no prior experience of western culture but were found to suffer from BDD. 

Are we perhaps too quick to point the finger of blame at the media?

Or are they really guilty?

Emma Collier, from bddhelp.com, says: “The media sends messages every day which try to lower our self esteem so we feel the need to buy their products.

Devices such as Photoshop now produce completely unrealistic images of men and women which nobody can ever live up to, not even the model.“

That is not to say they are to blame for the illness entirely, as BDD really comes down to the individual’s way of thinking.”

As with any psychological illness, the path to recovery is a tough journey, with the average patient seeking professional help after suffering with BDD for around 15 years.

But the good news is it can be beaten.

Cognitive Behavioural Therapy (CBT) is a well- received form of treatment because it identifies negative thought patterns about your appearance and changes them.

Medication also helps in balancing out the affected chemicals in the brain.

Putting BDD in the limelight will further help awareness and, in effect, treatment, according to Dr Veale.

Emma Collier also shares this belief, stating: “I believe sufferers and their loved ones need to speak out and explain just how serious of an illness this is. Magazine articles, documentaries, websites, TV and radio interviews should continue bringing the disorder into the public eye.

“I hope to see more sufferers speaking out at mental health conventions and even bringing awareness and information into schools and to all the mental health professionals out there.”

But the good news is it can be beaten and sufferers such as Emily Jane will hopefully one day break free from the prison that is BDD and start living a full life once again.

(Emily Jane is a fictitious name).