Body Dysmorphic Disorder

If your teen suffers from Body Dysmorphic Disorder, it can sometimes be tough to know when the problem started.

Young children may spend no time at all thinking about how they look. In fact, some kids clamor for the right to go to school in their Superman costumes or their grubby play clothes. For kids, clothing must be endured and mirrors may be nothing more than fancy glass for make-believe play. Much of this changes during adolescence. Suddenly, that carefree behavior seems to disappear. Teens become aware of how they dress, how they look and how their looks compare to the looks of others. It can become a bit of a preoccupation, even for the most confident teens.

Teen Body Dysmorphic Disorder

A small subset of teens develop a preoccupation with looks that goes beyond basic anxiety. For these teens, one aspect of their bodies becomes so disturbing and overwhelming that it becomes the focus of their existence. These teens may have Body Dysmorphic Disorder, a mental illness that can grow stronger with time and cause a severe amount of damage.

A Matter of Degree

All teens are consumed with their appearance in one form or another. Some parents may wonder what differentiates Body Dysmorphic Disorder (BDD) from standard teen behavior. There are a few aspects of the disorder that can help make the distinction a bit clearer.

For starters, teens with Body Dysmorphic Disorder tend to focus exclusively on one or two body parts. Where a teen might complain generally about his or her appearance, worrying over acne one day and a bad haircut the next, a teen with Body Dysmorphic Disorder maintains a clear focus on one specific problem and that attention doesn’t tend to waver. While almost any body part can become the target of this attention, the Mayo Clinic reports that these areas are commonly chosen:

  • Nose
  • Skin
  • Genitalia
  • Hair
  • Muscle size
  • Breast size

Teens may be delusional about their perceived defects. They might become convinced that the body part is so ugly and overpowering that it’s the only thing that others can see. When they speak to friends, they may be sure their friends are staring at their hideous features. Reassurances don’t seem to appease these fears. Some teens may seek out comfort when insecurity strikes, and then feel better after this conversation. A teen with body dysmorphic disorder may never discuss the problem and if the topic is broached, they can’t be comforted. The delusion tends to persist.

In addition, teens with Body Dysmorphic Disorder spend a lot of time trying to cover up their supposed defect. One teen might spend a half-hour getting ready for school in the morning. A teen with body dysmorphic disorder may spend hours each day on their appearance. According to an article on Medscape, teens with Body Dysmorphic Disorder spend three hours per day on these behaviors, on average. The teen might:

Observable Signs

  • Check the body part in the mirror or avoid mirrors altogether
  • Change clothes to hide the defect
  • Brush or comb hair repeatedly
  • Pick or dig at the skin
  • Put on and take off makeup

Teens with the disorder may also refuse to be included in photographs. Many teens love to snap photos and share them on social media sites. Teens with body dysmorphic disorder may cringe at the idea of showing themselves to an audience in such a public way.

Help Is Needed

Body Dysmorphic Disorder isn’t a problem that resolves when adolescence ends. In fact, the disorder tends to grow stronger with time, and leaving the disease untreated can have serious consequences. Adults who have body dysmorphic disorder tend to face serious disruptions in their social functioning. This is due to the disorder.

A study in the American Journal of Psychiatry found that 97 percent of people with Body Dysmorphic Disorder avoided social activities (including work). And 30 percent were so impaired that they were unable to leave their houses.

These adults may spend eight hours per day, or more, on their compensatory behaviors. In addition, they may even undergo multiple surgeries and dental procedures in an attempt to make the problem disappear. As the disease grows stronger, these people may become severely disabled. They may be unable to take the necessary steps that can lead to a successful life.

Body Dysmorphic Disorder has also been closely linked to suicide. The person grows more convinced that the body part is hideous and unavoidable. All attempts to cover up the problem seem to fail. The idea of suicide seems to grow stronger. A study of 200 people with Body Dysmorphic Disorder, in the Journal of Clinical Psychiatry, found that 78 percent had contemplated suicide. Furthermore, 27.5 percent had attempted suicide. It’s a serious risk for a teen with BDD, especially if that teen has a history of depression or another mental illness.

Cause and Effect

According to the Anxiety Disorders Association of America, about one percent of the population in the United States has Body Dysmorphic Disorder. And it seems to impact men and women at equal rates. Typically, the disease begins in adolescence, but it can strike at any time during a person’s life.

It’s unclear what causes Body Dysmorphic Disorder. Many people who have BDD have another mental illness at the same time. This doesn’t mean that body dysmorphic disorder and obsessive-compulsive disorder are the same. The two conditions are quite different.

People who have a family history of mental illnesses such as obsessive-compulsive disorder or body dysmorphic disorder might be at higher risk. They might develop the disease during adolescence.

Spotting the Disorder

Teens with BDD may be secretive about the issue. In addition, they may never willingly reveal their thoughts to their family members or friends. This doesn’t mean, however, that the disease is impossible to spot. In fact, there are some specific issues that parents can watch for.

Teens with Body Dysmorphic Disorder may spend hours camouflaging the issue. They might also ask to speak with a doctor, dentist, or plastic surgeon. As the condition grows stronger, the teens may become convinced that surgery could “fix” the problem and restore them to complete health.

Parents should approach these requests with extreme caution. Surgeries rarely correct Body Dysmorphic Disorder.

They may even make the condition worse, as a failed surgery could leave the teen feeling even more hopeless and dejected. Teens who request surgeries should be directed to mental health specialists. They need to be evaluated for body dysmorphic disorder.

Furthermore, teens with body dysmorphic disorder may spend a significant amount of time exercising. They lift weights, run on a treadmill, or exercise in their rooms. Teens who are concerned with the size of their muscles may be especially prone to this behavior. Once again, this is a red flag that can prompt parents to get their teens evaluated.

Reason for Hope

There’s no question that body dysmorphic disorder is serious, and if left untreated, the condition can grow worse. But, many teens do benefit from treatment for the condition. Often, teens are asked to participate in Cognitive Behavioral Therapy (CBT) with a licensed therapist. In these sessions, they will look closely at the thoughts that are driving their destructive behaviors. CBT is effective in treating people who have circular, negative thoughts. Teens learn to identify those thoughts. They think about where they might come from, and then break those thoughts apart before they act on them. The therapy is tailored to the needs of that patient at that time. Generalizations about the therapy sessions is somewhat difficult, but in general, the sessions ask the patients to:

Therapy Sessions

  • Identify a success in the previous week.
  • Identify something stressful coming up in the next week.
  • Brainstorm activities that can be used to deal with the stressful situation.
  • Keep a written record of methods used, and how well they worked.

As this therapy moves forward, teens might also be given medications to help calm their minds. Antidepressant medications can sometimes help teens to feel less anxious and tense. This may help them to participate in their therapy sessions more fully.

According to a study in the Journal of Clinical Psychiatry, of 107 patients given this treatment for six weeks, dramatic improvement was seen in anxiety and depression scores. The treatment seems to have helped these patients emerge from the thoughts that had been so disruptive and pervasive.

At Newport Academy, we support adolescence struggling with self-image and dysmorphia. We treat the underlying causes and conditions of such disorders, to lead families to sustainable healing.