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Body dysmorphia: Another psych visit.

Permanent Linkby margharris on Tue May 12, 2015 12:35 am

Yesterday we checked in with the psych again. He thought my son was more present than at the previous session. We are to take the Lyrica slowly to 300mg and increase the Prozac to 60mg as tolerated. He wanted to go to 50mg of Prozac this morning after increasing the dose of Lyrica last night. But he hadn't slept well. Was up from about 2am. It wasnt such a good idea in hindsight. The akathisia hit hard only half an hour after taking the stuff. He couldnt stop the shakes and has returned to lying down to cope.
My son was also given a timetable sheet as the doc mentioned that the illness has taken away his functional routine and he has no confidence in his ability to resume life. Baby steps is his approach. He is to fill in the timetable with one half hour activity a day. This is to be an anchor activity. Something he practices as a discipline. I don't know if he will even fill in a sheet. His usual effort is to totally dismiss it all. I was told not to police him. I don't know how many days i can go letting this slide. It will be a test of my endurance. I feel like a mum still doing his homework.
We also talked yesterday about thinking about three core tasks to do in a day, write them down and then do at least one. The harder the task you set yourself, the more rewarding it will be to your confidence to complete it.
The TMS is still going ahead. This will be targeted and must rely on the functional MRIs obtained from the research project completed at the end of May. I took my son's art along also to show how the fine detail was a bit savant like. This might indicate that the visual processing in the brain has been too finely tuned and could be a target for the therapy.
So From my own interpretation of BDD so far, I see a brain malfunction. The brain creates this FUD, fear uncertainty and doubt. The brain is in worry mode and doesn't really know what to fear. The uncertainty is felt like a constant need to scratch. It must be relieved by doing something. A check or avoid usually works but then the doubt returns and the process continues to repeat.
What is feared relies on the individual person's experience of life. If someone was bullied then they are more likely to become paranoid that people are looking at them and are making judgements that should be feared. If you live in a society that prides itself on conforming then being mixed race might be enough of an issue to cause fear of negative judgement. If a person has more of an aesthetic bent then anything that is visually variant with perfection might cause alarm and provide the context for the fear.
So in my son's case, his brain created FUD. He gave it context and settled on hair because he valued hair and also valued visual perfection. This might have been fine if his life had remained in balance. But it didn't. The worry took over, the obsession stole his functional life. The fear breed.
The odd thing about this illness is that although my son knows his only option now is to medicate his brain. He still misattributes his illness to his hairdo. He does believe that if his hair was fine his brain would no longer be in fear mode. But that is really not possible if FUD comes first and all his own brain is doing is providing context to explain the FUD. It is the FUD that really explains why you feel that pervasive sense of being ugly. You go to the mirror to check or you touch to check or you ask to check. But you never can be certain. The answer is never stored. So you don't learn from anything you do. You repeat tomorrow all the same stories you hear in your head today.
You have an overvalued idea that you need a certain look to be happy or to even date. You tell yourself it all depends on that one thing that is not perfect. The "If only" thinking impairs your judgement so you don't step away from this shadow. You have defined too narrow a focus to value yourself. You fail to see all your own potential.
This is why often the forum becomes a sharing of poor perceptions and misjudgement. If you all have the same disorder it is hard to recognize where your thinking is wrong when others are thinking the same way. You need that independent third party to give you perspective. Even though I know a lot about this illness, we still need outside help.
Hope for a better day. Wish you all well. Marg

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