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Body dysmorphia: The monster of wories

Permanent Linkby margharris on Thu Aug 06, 2015 11:52 pm

Some of us are born worriers, hypersensitive to criticism and just trying to get it right and be conscientious. Similar to a depressed brain, the worry brain is biologically driven. Our responsibility is to try and work out what is wrong. That is all a BDDer is trying to do...solve the problem and know what the worry is about.

So the brain in worry mode sends us an alarm signal. This triggers your visual responses to try and work out what is wrong. Your thinking is driven by the idea that if you know what is wrong then you can fix it and turn the alarm off. This all sounds so reasonable. So you go looking and start remembering times past when someone said something. You check yourself into a long mirror gaze. You compare with others. You look at celebs. Then you see it..A flaw. You are instantly satisfied and relieved to find it. But your opinion doesn't seem to stick. You start to doubt your own conclusion. Didn't you look OK yesterday? This is like the emerging stage of BDD.

Eventually you decide a certain body part is definitely the cause of all your distress. You just have to fix it to be fine again. You start to develop rituals to manage your anxiety level. Your BDD becomes your go to coping strategy for managing any anxiety. You do feel better when you have combed your hair just so and look prefect. You feel no worry at the moment. So you keep doing all your checking and comparing to make sure you look good and avoid feeling anxious. But this monster needs constant feeding. The worry is lurking just below the surface all the time. You maintain yourself in this stage of your BDD in a delicate balance between your compulsions taking over your life and your compulsions giving you the edge to manage your life. Stage two maintains your BDD with compulsions.

Any compulsion seems like a good idea at the start. It must give you a good feeling to want to keep doing it. At some stage this positive sum stops working. It is just the same for any addictive behaviour. The alcoholic, the binge eater, the smoker is unable to stop. They don't say to themselves." Hello, that was too much. I won't do that again." The wake up call doesn't come. Maybe you can call this just prone to excess or maybe the desire to avoid pain is just so intense. There has to be some signficant driver to allow the person caught by addiction to start to give over control of their life to a habit. This is what happens to a BDDer. Over time the monster of worries takes over your life. You spend more and more time doing things just to feel safe. You can spend hours just preparing for the idea of leaving the house. Your mind is constantly thinking about your flaws.IYou are constantly connecting with it. You have backfilled from that worry point that started your search for the answer. You now have an elaborate story to explain all your reasons for all your concerns. You can repeat the story numerous times a day. No one can convince you that you might be wrong. Your thinking is linear and rigid. You live in terror of not being able to live with the monster. It is all because of your flaws. You are just so hideous. Your BDD is now your life. You're at stage three.

You arrive at stage four when you are bedbound and screaming for relief. You think the only way out is suicide. You just can't do any more rituals to keep the monster from engulfing you. Your list of compulsions can fill a page. All you feel is worry and more worry. Bedroom rescue is the only way to manage the monster. For many with BDD, you will spend a year in that room.

For most some form of medication is needed to address the underlying biology that has first given you this worry brain. You mightn't like the idea of meds. The side effects can be nasty but bedroom rescue is so much worse. Meds do work because they do address this biology. But we cant forget all the compulsions that have been built up to address anxiety. You will still be repeating your stories any time you feel anxious. Going down the street will still be hard. You have taught yourself all this.

So you do need some CBT to manage the exposure and response prevention to help stop the compulsions. You need to be able to toss your hair around and go out the door. It is OK to have messy hair. Where really is the risk in that? The real risk is you continuing to live with a fear you taught yourself.

CBT is also needed to manage your impulse control. You don't want to be picking your face, cutting your hair or buying the grog to manage your worry. You need to develop some good habits you can do when you feel stressed. A blow up or a relapse is inevitable if you don't learn useful techniques for stress relief. Life is just too stressful and your BDD is not a good coping mechanism. But it is what you know...you have found relief in it before. That thinking opens the door to the monster. Know that you have to be ever vigilant for slip ups.

When you get well enough to do CBT, you have renewed sense of what life is truly about. You reconnect with yourself in a new way. Your brain has sent you all this worry and you have traveled all this journey to show you truly how important you are. Connect back to all life offers. You don't have any need for the ugly fear story. Why did you ever connect with it? The worry monster.

Knowing you have a worry brain might help you accept the need for medication. It is not any different than knowing you are depressive, diabetic or epileptic. It is a whole lot more satisfying than trying to convince people you are ugly.

Wish you well. Marg

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