What is body dysmorphia? – also known as dysmorphobia or dysmorphic syndrome – is a somatoform disorder in which the affected person is worried or overly concerned about a perceived defect in their body. Depending on the individual case, the disease may manifest itself independently or may be associated with an eating disorder, anxiety, or depression.
The disorder always includes an excessive concern for a defect of physical appearance, real or imagined, a concern that can become difficult to control. Also, the idea may appear that others pay attention to the defect, and therefore the attempt to mask it will appear.
The patient may complain of one or more symptoms, a vague feature, or a general appearance that causes psychological stress that affects his social and professional functioning, sometimes to the point of severe depression and anxiety, the development of other anxiety disorders, social isolation. It is estimated that 1-2% of the world’s population meets all the diagnostic criteria for the dysmorphic disorder of the body.
The exact cause of the disorder differs from person to person. However, most doctors believe that it can be a combination of biological, psychological, and environmental factors from their past or present. Abuse and neglect can also be contributing factors.
The onset of symptoms usually occurs in adolescence, when personal criticism of one’s appearance usually begins. It is wrongly thought that the disease would affect only women, it affects men and women equally.
The disease causes a decrease in quality of life and can be comorbid with major depressive disorder and major phobia is known as chronic social anxiety. With a double suicide rate compared to major depression and suicidal ideation of 80%, extreme cases were considered a risk factor for suicide. However, many cases are treated with medication and counseling. A person with this disorder can be treated with psychotherapy, medication, or both. Research shows that cognitive-behavioral therapy and selective serotonin reuptake inhibitors are effective in treating the disease. The disease is chronic, and the symptoms persist or worsen if left untreated.
Many people with this disease have sought treatment from dermatologists or cosmetics with limited satisfaction before finally accepting psychiatric or psychological help. Plastic surgery in these patients can lead to psychosis manifest, suicidal tendencies or the demand for continuous surgery. Treatment can improve the prognosis of the disease in most people, some may work reasonably well for a period of time and then have relapses while others may remain chronically ill. The prognosis without therapy has not been investigated but it is believed that symptoms persist if left untreated.
What is body dysmorphic disorder?
People with dysmorphic body disorder have the impression that there is something wrong with the way they look, even if the perceived defects in their appearance are minimal or non-existent. The condition has nothing to do with the actual physical appearance, but rather with self-perception.
Dysmorphophobia has three criteria for diagnosis:
• The presence of concern about a defect in physical appearance, the defect is either imagined or if there is a minor defect, the concern about it is excessive.
• Concern causes negative effects in relationships with other people.
• Concern is not so well considered compared to other mental disorders (such as anorexia nervosa or hypochondria).
People with dysmorphic body disorders are constantly looking for reinsurance and are frustrated when other people do not notice the defect they are complaining about.
Some people may become so stressed about their physical appearance that they may stop working or socializing, becoming isolated in the home because they feel they are too hideous to be seen in public.
The exact cause of dysmorphophobia is unknown, although many theories have been suggested. This can be an inherited condition because the prevalence of the disease is four times higher in first-degree relatives of people with the bodily dysmorphic disorder.
Moreover, this condition seems to be related to obsessive-compulsive disorder. This type of disorder occurs frequently in people with obsessive-compulsive disorder and their relatives and responds to the same type of treatment.
Functional abnormalities in visual processing and in the limbic systems of the brain have also been identified as potential causes. At the same time, low levels of certain neurotransmitters may be a contributing factor to the disease.
The main component of dysmorphic disorder of the body is an excessive preoccupation with an imagined defect in the physical aspect of an exaggerated reaction regarding a slight physical defect.
It is a chronic disorder that can increase and decrease in intensity and can move from one part of the body to another.
Typical behaviors associated with the bodily dysmorphic disorder include:
• People with dysmorphic body disorder may be obsessed with their reflection in the mirror or may try to avoid them altogether;
• Concern about the physical aspect with an extreme self-awareness;
• Observation, touching, obsessive measurement of the defect;
• Excessive defect research;
• Neglecting more important aspects of life, such as work, family and personal health;
• Compulsively checking mirrors or removing them from the house;
• Using items that can hide imaginary defects, such as wigs, hats, and makeup;
People with dysmorphic body disorders report that they think about their unrealistic defects for an average of 3-8 hours a day and have only limited control over these thoughts.
Attempts to explain that the physical defect is non-existent or minor are useless because the people in question will continue to worry excessively about their imaginary defects.
Doctors often ignore the diagnosis of body dysmorphic disorder due to a lack of knowledge of the disorder, but also the reluctance of the individual to reveal their concerns caused by shame.
Dysmorphic disorder of the body is diagnosed only by clinical history and medical consultation.
The treatment of body dysmorphic disorder usually includes cognitive-behavioral therapy, drug treatment, and behavioral counseling.
Cognitive-behavioral therapy helps people suffering from this type of disorder to reduce problematic behavior and negative thinking.
Moreover, it helps individuals gain a better understanding of the disease and stop negative thoughts from occurring automatically while learning to evaluate themselves in a more realistic and positive way.
People can also learn healthy ways to cope with rituals, such as checking mirrors or touching the skin constantly.
Family therapy: A mental health professional can identify maladaptive beliefs and behaviors within the family and can find more effective approaches to treating these types of behaviors.
Dysmorphic disorder of the body is a severe psychiatric disorder that is exposed as an excessive concern with appearance and a minor or imaginary physical defect.
Because it is not given much importance, people suffering from this type of disorder are not properly diagnosed and treated and have a poor quality of life.
Moreover, due to the fact that the body’s dysmorphic disorder is a chronic condition, the people in question require long-term treatment and frequent medical consultations.
Over time, people with this type of disorder achieve the best results when psychological, pharmacological, and family interventions are combined.
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