Body Dysmorphic Disorder

BDD: A PLASTIC SURGEON’S FAVOURITE PSYCHOLOGICAL DISORDER
Of all the known classified disorders in the DSM IV, Body Dysmorphic disorder is probably the least researched and less prevalent than all Somatoform disorders. So much so, that a lot of psychology students have either never even heard of it, or else are unaware of it being a Somatoform disorder, until they start studying clinical psychology. If this is the case, then we cannot really blame the multitude of ignorance, which have had no experience with psychology. The first time I heard the term was roughly about 10 years ago, on The Oprah Winfrey Show( you have to admit, nothing escapes that woman), wherein she interviewed two people diagnosed as having BDD. Now, while dissatisfaction with one’s body and appearances are common with all of us, the two of them were however on a different plane of thinking all together. The first person was this dashingly handsome “rico suave” kinda guy you’d ever have seen. The kind if he was a movie star then girls would stick his posters all over their bedroom walls. And there he sat on Oprah’s couch, calling himself ugly. He went as far as to say that there were days when he never looked in the mirror for fear of killing himself stemming from pure self loathing and disgust? How was that even possible, I thought to myself? He was 6 feet tall for heaven’s sake! And then Oprah went on to explain the peculiar nature of the little known disorder called BDD.
Today, Body Dysmorphic Disorder, as it is described in the DSM IV, is diagnosed in people who are overly critical of their mirror image and physical appearances, even though there are no noticeable “flaws” or defects. They generally disagree with outside opinion, who even protest that there is any flaw at all. However the sufferers convince themselves to be unspeakably hideous and revolting, pushing themselves into depression, low self esteem, and even suicide. Suicide rates are higher by almost double for BDD then depression and bipolar disorders. Whatever the symptoms and characteristics are, fact remains that this is a psychological problem which need immediate therapeutic intervention. But the sad truth is that most BDD patients only approach a therapist after having spent a fortune on cosmetic surgery and other painful procedures in a desperate attempt to reduce their anxiety and remove their perceived “flaws”. The rate of suicides is even higher in those who seek surgery as a solution because fact remains that there are really no flaws! What’s even more unfortunate is that these patients are very often exploited by their surgeons who not only recommend expensive procedures but also push for other surgeries and options that these people do NOT need. Let us now focus our attention on Oprah’s second guest, a woman in her thirties. This woman had undergone almost all cosmetic surgeries known to the medical profession. You name it and she had gotten that surgery. When Oprah inquired of her if her doctor had ever denied or recommended not having a surgery she said no, that had never happened. Now, I personally refuse to believe that a doctor with years of expertise and experience was unaware of BDD. So can we really blame that woman for having undergone more than 10 different surgeries when her doctor told her that it was the right thing to do? And can we as society that promotes perfection through airbrushed models and implied notions of aesthetic beauty, blame her? She was suffering from a serious psychological disorder. She needed help and guidance, which she never got. The young man however was lucky to have friends and a family who intervened at the right time to provide the emotional and psychological support he needed. And while the audience watched as he quietly described the trauma that his life was, every day in and out, they also gave a huge roar and round of applause when Oprah inquired of them if he wasn’t the most handsome guys they had ever seen. And this is what BDD patients need. Not vain compliments, but help and guidance, and encouragement to seek the psychological help they need. One of the guiding ethics of medical profession is “do no harm”. But studies have shown that symptoms of BDD only worsens in those who seek cosmetic help. It’s a vicious cycle where the patient who seeks surgery perceives no marked improvement, and falls further into a myriad of despair and helplessness, saddened by the failure of what was supposed to be a sure shot solution. I’m not saying that everyone who seeks cosmetic surgery is suffering from Body Dysmorphic disorder. But the sad fact is that there is no paucity of unethical money minting surgeons who exploit patients with BDD. And that is precisely why we need to spread more psychological awareness, not just about this disorder, but a lot of others as well, so that sufferers can stop being labelled as “vain, attention seekers”, “losers” and “crazy”, and just receive the help they urgently need, especially in a country like India where as of yet there has been little known Epidemiological research undertaken to study such genuine problems and disorders.