Behavioral Treatment of Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a serious illness when a person is preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose. A person with BDD tends to have cosmetic surgery, and even if the surgeries are successful, does not think they are and is unhappy with the outcomes.

Causes

It's not known specifically what causes body dysmorphic disorder. Researchers believe that, like many other mental illnesses, body dysmorphic disorder may result from a combination of causes:

•    Biochemical. Some evidence suggests that naturally occurring brain chemicals called neurotransmitters, which are linked to mood, may play a role in causing body dysmorphic disorder. In particular, the neurotransmitter serotonin may have a causal role.

•    Genes. Some studies show that body dysmorphic disorder is more common in people whose biological family members also have the condition. This may indicate a genetic pathway behind body dysmorphic disorder.

•    Environment. Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative experiences about your body or self-image.

Symptoms

•    Being preoccupied with minor or imaginary physical flaws, usually of the skin, hair, and nose, such as acne, scarring, facial lines, marks, pale skin, thinning hair, excessive body hair, large nose, or crooked nose.

•    Having a lot of anxiety and stress about the perceived flaw and spending a lot of time focusing on it, such as frequently picking at skin, excessively checking appearance in a mirror, hiding the imperfection, comparing appearance with others, excessively grooming, seeking reassurance from others about how they look, and getting cosmetic surgery.

Getting cosmetic surgery can make BDD worse. They are often not happy with the outcome of the surgery. If they are, they may start to focus attention on another body area and become preoccupied trying to fix the new "defect." In this case, some patients with BDD become angry at the surgeon for making their appearance worse and may even become violent towards the surgeon.

Treatments

Body dysmorphic disorder causes and treatment is usually psychodynamic, which means that the mind, psyche, and personality of the person are scrutinized to try to determine what is causing the problem, since the causes are different for each case. Once the causes are determined, therapy begins to help treat the cause, thus eliminating the symptoms.

Another BDD treatment is cognitive behavioral therapy. This type of therapy, when combined with serotonin enhancing drugs or other antidepressants, does seem to be effective as treatment. CBT teaches the person to battle their negative thinking and replace it with positive, truthful thoughts.

While these treatments can help the person to deal with their disorder, BDD does tend to be a chronic problem, and can need lifelong treatment and support from loved ones. It is crucial that the person with the problem not be allowed to alienate themselves from their friends and family, as this will only make the problem worse.