Body Dysmorphic Disorder
Northeastern University sophomore Terri* spends at least a few minutes a day critiquing her body in the mirror.
“I have this extra fat on my stomach that I hate,” she said, squeezing her abdomen with both hands.
Terri is an articulate, responsible, political science major and sociology minor who looks and sounds mature beyond her years. She is well-respected by peers and authority figures alike, and she recently landed a co-op job at a prestigious law firm in Boston. This girl has got herself together.
Today, wearing a business-casual purple turtleneck, gray peacoat and glasses, this confident, capable woman points to the area under her chin.
If a slight physical abnormality or inconsistency exists in a BDD sufferer’s physicality, their concern is excessive – even to the point of experiencing social withdrawal and suicidal tendencies.
Dr. Roberto Olivardia is a clinical psychologist at the McLean Hospital in Boston and teaches psychology at Harvard Medical School. A specialist in BDD and Obsessive-Compulsive disorders, in general, he acknowledges that BDD symptoms are often mistaken as “normal” fears.
“With BDD there are many, many people walking around in the U.S. who have it that you never know have it. For a lot of people, you don’t know what it is that you have, but you know that life is not normal,” said Dr. Olivardia.
“[People with BDD] are obsessively checking mirrors, trying to hide their defect. A lot never leave their house because they think they’re so ugly and unattractive,” adds Olivardia.
Constant mirror-checking is one of the most common behavioral characteristics of someone with BDD. While most people periodically check their appearance throughout the day, the person with BDD has a highly complex, love-hate relationship with mirrors.
Britney Brimhall, a 25-year-old Arizona State University student finishing up degrees in German and business, is a BDD sufferer who runs BDDCentral, a support website for BDD sufferers. On the site, Brimhall describes the process which many BDD patients (or “BDDers”) endure when encountering mirrors.
“Any mirror will do, along with reflective surfaces such as store windows, although most BDDers will have a handful of favorite mirrors that are in places with, what they consider to be, the most appealing lighting. I’ve heard more than once that the lighting from late morning until early evening create the greatest amounts of distress … Many BDDers prefer to avoid mirrors during this time of day,” she writes.
In describing a typical BDD patient, Arie Winograd, director of Accurate Reflections, a BDD support group in Los Angeles, is quick to bring up this ritual.
“A lot get stuck in mirrors, wherever they go. Some are mirror-avoiders, but most get stuck in them,” Winograd said. “[BDDers] base their self-worth on how they look, so they are obsessed with their defects.” The obsession is ever-present, and so they experience a heightened concern with how they look at all times.
A typical person with a mild case of BDD goes to school, has relationships, goes to work, “but they can’t stop thinking about their appearance,” Winograd said. “Their brain actually locks on their defects; it can’t stop thinking about them.”
One of the most common manifestations of BDD occurs in sufferers’ reactions to public situations. BDD, especially in those with severe cases, often seriously impacts social, occupational, and relationship functioning. According to Olivardia, BDDers “sometimes won’t go to work if they think their nose looks ugly that day.”
Brimhall relates the social anxiety experienced by those with BDD to a...