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Body dysmorphia: Worry worry and more worry.

Permanent Linkby margharris on Fri May 29, 2015 4:09 am

People often don’t really know what BDD is. They know they have BDD but they believe the symptoms listed in the diagnosis is the problem. This makes BDD very hard to treat.

We all know that someone falling down with epilepsy doesn’t need a straight-jacket. We know that it is the brain misfiring that is the cause and the agitation state is the symptom.

BDD is very much like this. The obsessional worry starts interfering with everyday life. But you have to get the right treatment by understanding really what is wrong. You have to be clear what the problem is or else you will be going to buy straight jackets. BDD hijacks your logic and makes you think the problem is something else. You don’t think the problem is in your brain.

It is very similar to OCD. If you become a washer, your problem isn’t dirt. If you check, the problem isn’t uncertainty. The problem is always the worry. The person with the illness worries so much because they care so much about getting it right. They are just conscientious, so try hard to solve the problem of worry. They try to deal with the worry about slight risks in ways which are counter-productive and damaging. They increase and exaggerate their perception of the risk. The fears trigger the sufferer to try too hard to be clean or to be sure. They want to be in control.

BDD is just the same. The person seems unable to ignore their own thoughts and doubts because they seem protective and the risks too great. So the paradox is that the more sensitive and caring types are more at risk of BDD. The person who values looks because they have been told they are goodlooking is tortured by the idea that they might not be. And the more they try to deal with these obsessional thoughts the more distressed they become. So obsessional thinking and behaving becomes the solution to the first worry. Then this solution becomes the problem.

How can the solution be the problem? It happened gradually. “If only I can do a little more it will help me relax.” I can do this and it helps me stop worrying…..I will camouflage.I will avoid. The promise is the worry will stop. The liar’s lair, the trap is playing you. You haven’t a clue.

But the thoughts keep coming, progressively more demanding, taking more from you, leaving you feeling more worthless. More out of control. You have to obey. The risk you think is too great. Whatever the risk was has now taken on the size of a Behemyth.

So you buy the straight jacket from the plastic surgeon multiple times. You tell everyone who will listen that they need to fear everyone because of put downs. You complain that you are ugly and others are lying.

But all of it is worry. Worry that someone might find you ugly. Worry that you might not be as beautiful as they said. Worry that someone might not like your looks. Worry about a nose, skin or hair that is not perfect. Unnecessary worry.

I call that worry, FUD. That is what enters your brain. The fear, uncertainty and doubt is felt as worry. It wears you out with its persistence. It is hard to tame once you have given it so much value over your life. The fear that something is wrong, creates the thought of uncertainty. Something needs fixing. The emotion of doubt enters trying to force you to own the FUD and translate it into something tangible you can focus on. Is it your body? Is something wrong there? Is it the people walking past...will they ridicule you? So you worry....

My son's worry is his hair. It is the worry of... that is the problem. That is his BDD. His hair is normal. But his stories he repeats daily. This worry has no logical path to resolve. He just has to accept the uncertainty at the moment. Perhaps that uncertainty will recede a bit with the meds but ultimately we all have to live with a mind that can filter out the trivia so we can concentrate on living well.

Another doc visit this afternoon. Meds have made not much difference at this stage. He has to try and live at his optimal best. Marg

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