Two-time Academy Award-winning actress Jane Fonda made headlines in May when she revealed in People Magazine that she has suffered from body dysmorphic disorder (BDD) for most of her life. The same month, Hollywood beauty Megan Fox made a similar confession during an interview reported in the Washington Post.
What exactly is BDD? Ironically, in the cases of Fonda and Fox, it is a condition characterized by a preoccupation with one or more perceived defects or flaws in appearance, which are unnoticeable to others.
Occasionally a perceived flaw is actual and noticeable, but it’s usually a normal variation in appearance and not nearly as prominent as the sufferer believes.
Media reports sometimes refer to BDD as “Imagined Ugliness Syndrome,” but the ugliness is very real to the individual concerned, causing severe mental and emotional distress.
Dr. Susana Marikle, a clinical psychologist with a practice in Vero Beach, said we all have a little bit of BDD. “It is the intensity and severity that make it a diagnosable mental health disorder.”
The number of people who suffer from BDD may surprise you. According to the National Institutes of Health, it appears to be relatively common, seen in up to 2.4 percent of the general population, making it more common than schizophrenia or anorexia nervosa.
“We frequently find depression and anxiety to be concurrent diagnoses,” Dr. Marikle says.
She said that if your preoccupation with your appearance gets in the way of your normal ability to function, it’s a red flag. “Does it interfere with work, family time, hobbies? Are you unable to leave your home?”
Johns Hopkins Medical School reports that patients may find that negative thoughts about their bodies are hard to control and they may spend hours each day worrying about how they look.
Thoughts can become so negative and persistent that some consider suicide.
To be diagnosed with BDD, you must be abnormally concerned about a small or nonexistent body flaw. Your thoughts about your body flaw must be severe enough that they interfere with your ability to live normally.
And other mental health disorders must be ruled out as a cause of your symptoms.
“Many people are rewarded, praised and given validation by their family from a young age for their good looks,” said Dr. Marikle. You learn early that being attractive gets you attention and you don’t forget that, even in your 60s, 70s and 80s.
Nobody knows the cause of BDD but it usually begins in adolescence, with males and females equally affected.
Contributing factors may include:
• A family history of BDD or a similar mental disorder.
• Abnormal levels of certain brain chemicals.
• Personality type.
• Life experiences.
The most common areas of obsession for people suffering from BDD are face, hair, skin, chest and stomach.
There are many symptoms of the disorder, including:
• Constantly checking yourself in the mirror or avoiding mirrors.
• Trying to hide your body part under a hat, scarf or makeup.
• Constantly exercising or grooming.
• Constantly comparing yourself with others.
• Always asking other people whether you look OK.
• Not believing other people when they say you look fine.
• Avoiding social activities.
• Not going out of the house, especially in the daytime.
• Seeing multiple healthcare providers about your appearance.
• Having unnecessary plastic surgeries.
• Picking at your skin with fingers or tweezers.
• Feeling anxious, depressed and ashamed.
• Thinking of suicide.
Being in treatment early with a provider who is experienced with BDD can bring positive results. “Early intervention is critically important,” says Dr. Marikle. “It’s easier to get successful results if a patient starts at 16 rather 60.”
Treatment may include talk therapy or medicines. Cognitive behavioral therapy (CBT) is the most effective talk therapy and it is what Dr. Marikle uses. In CBT, a mental health professional helps patients replace negative thoughts and thought patterns with positive thoughts, teaching the patient to think in a healthier more realistic way.
BetterHelp, the world’s largest therapy platform, states that there is no known way to prevent body dysmorphic disorder, and it’s important that people understand that body dysmorphia symptoms are not their fault. Although this life-altering disorder can be treated, proper diagnosis is essential.
Dr. Marikle adds, “People often suffer with body dysmorphic disease far too long before seeking treatment. Why put up with something this painful when there’s so much that can be done? There’s always something we can do to make ourselves better.”
Dr. Susana Marikle is a clinical psychologist, licensed in Florida. She earned her doctorate from Nova Southeastern University in Fort Lauderdale and completed her pre-doctoral internship at Jackson Memorial Hospital in Miami. Dr. Marikle’s postdoctoral fellowship was at the Center for Eating Disorders at the Sheppard and Enoch Pratt Hospital in Baltimore. She has helped individuals with body dysmorphic disorder, anorexia, bulimia and binge eating disorder and behaviors such as overeating, emotional eating and obsessive habits. Dr. Marikle’s practice is located at 847 20th Place, Vero Beach. The phone number is 772-663-2929. She is accepting new virtual or in-person patients.
