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08-07 More than skin deep: Body dysmorphic disorder in adolescents

More than skin deep: Body dysmorphic disorder in adolescents

Body dysmorphic disorder (BDD) is a mental health disorder characterized by an individual’s obsessions over perceived flaws that are minimal or nonexistent. The Anxiety and Depression Association of America (ADAA) reports that approximately 1 percent of the U.S. population struggles with BDD. However, a 2006 study by Dr. Jennifer Dyl found that approximately 4.8 percent of adolescents struggle with the disorder. While many children and teens are self-conscious about their appearances or struggle with low self-esteem, this behavior is not necessarily indicative of BDD. Similarly, BDD is not a form of extreme vanity or superficiality, and these beliefs contribute to the stigma that keeps many from seeking treatment. Rather, BDD is a disorder diagnosed when intrusive thoughts and obsessions over appearance, body image and perceived flaws cause extreme emotional distress that interferes with an individual’s daily life.

Individuals struggling with BDD — a condition equally likely to occur in males and females — often obsess about their perceived flaws for hours each day, sometimes unable to focus on anything else. For this reason, those with BDD often find short-term solace in compulsive behaviors, such as looking at mirrors and reflective surfaces, skin picking and excessive grooming. Since these obsessions and repetitive behaviors are often indicative of obsessive-compulsive disorder (OCD), BDD is often misdiagnosed as OCD. The embarrassment and shame that many who struggle with BDD feel often keeps them from reporting their debilitating preoccupation with appearance or body image, also contributing to misdiagnoses. As is the case with OCD, the compulsive behaviors associated with BDD only provide temporary relief.

BDD can co-occur with other mental health disorders and substance abuse issues. The ADAA reports the most common disorders that go hand-in-hand with BDD include OCD, depression, social anxiety disorder and certain eating disorders. In addition, individuals with the disorder are more likely than the general population to develop substance abuse issues as methods of coping with the symptoms. Of the subjects involved in a 2005 study entitled, “Substance Use Disorders in Individuals with Body Dysmorphic Disorder,” 68 percent who struggled concurrently with BDD and substance abuse reported that the former contributed heavily to the latter.

The flaws over which an individual struggling with BDD obsesses can be related to any part of the body. The most commonly reported obsessions are over the skin, hair and nose. Individuals use these compulsive behaviors to reduce their feelings of anxiety surrounding the perceived flaws. However, these habits can actually exacerbate the aesthetic issue, sometimes causing bleeding and scarring from picking skin. The average person struggling with BDD typically experiences an obsession with five to seven different body parts throughout his or her lifetime.

According to a 2005 study led by Dr. Katharine Phillips, the average age of onset for BDD is 16 years old. Adolescents struggling with BDD face numerous obstacles regarding academic and social development. BDD interferes with school performance to varying degrees, including inability to focus in class and missing entire school days to avoid social interaction. Approximately 18 percent of children and teenagers struggling with BDD drop out of school as a result of their debilitating symptoms, according to the International OCD Foundation. Symptoms of BDD, which can be triggered by changes in an individual’s routine or environment, include fear and avoidance of social situations. This leads to isolation in an attempt to avoid rejection or bullying about perceived flaws, contributing to the suicidal ideation experienced by many adolescents who struggle with BDD, according to Phillips’ research.

It is difficult for many individuals struggling with BDD to seek help, but many of the disorder’s symptoms are treatable. Cognitive behavioral therapy (CBT) is often used to help those with BDD recognize irrational thoughts and harmful behaviors and change his or her patterns of thinking and responses to triggers. Selective serotonin reuptake inhibitors (SSRIs) are anti-depressants often prescribed in tandem with CBT to reduce the obsessive-compulsive symptoms of the disorder. According to the Body Dysmorphic Disorder Foundation, 40 to 50 percent of individuals struggling with BDD experience a reduction in symptoms with the use of SSRIs.

A 2005 study entitled, “The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder,” found that children as young as 5 years old can exhibit symptoms of BDD. If you or your child is exhibiting these symptoms, help is available. Sovereign Health Rancho San Diego is a facility that specializes in treating adolescents and teenagers struggling with mental health disorders, substance abuse and dual diagnosis. Call 866-615-7266 to speak with a professional today.

Written by Courtney Howard, Sovereign Health Group writer

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