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- July 2018
An update on recovery
   Fri Jul 27, 2018 10:03 pm

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An update on recovery

Permanent Linkby margharris on Fri Jul 27, 2018 10:03 pm

Well a few years have past by now. We did have some set backs that almost propelled life over the cliff but we did learn a lot in that process.
My son did recover from his BDD. He still has some residual concerns but they don't bother him as much as they do me.
His life did fall over though. The girl of his dreams turned out not to be. In fact she had vastly more problems than he. With a child in the mix he had to head for the law courts. No sane person should ever go there. What takes place there would kill off the most sane of us given enough exposure. The experience of the legal system brought us to our knees. Medications were increased to help him cope but ultimately no one could cope. We had to turn back and let the child go. The mother could accomplish her desired international child abduction with the robust approval of the judiciary.
This situation is not a light load to have to carry.
I had learnt the importance of emotional guidance by this stage. So I was practicing changing thoughts to others more wanted and writing them on the white board I had placed on the fridge. When he was crying, I asked him what the thought was, he was just now thinking. He would tell me and together we would try and create a make peace thought to counter it. He had to come to the place where he was free to start over with improved understanding of how he needed to be actively managing his thinking.
I can't say he has reached that place. Learning to bring awareness to thought and how it feels is a new skill most of us have never learnt. We never understood the need. The rollercoaster of emotions that is typically the lot of all BDDers is still present. I just have to try and sell him the message that he does have full control over them. It takes recognizing that he does have thought choice and can direct his thinking to what truly feels best to think. Guidance is always coming in the form of emotion. You just have to care more about how you feel. If you feel bad stop..it is that thought now that has to be tweeked. Find relief by tuning into your own wisdom. Hopefully we can get off this bus at this stop. We can learn this skill of letting emotions guide our thinking. If it doesn't feel good it isn't good. Wish you well. Marg

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How my son recovered.

Permanent Linkby margharris on Fri Nov 27, 2015 10:14 pm

It is about 9 months since starting this blog. A lot has changed over these months. My son has gone from a bedridden psychotic to a competent young man. He is now employed, living with his girlfriend and is only required to see his psychiatrist once a month. The crisis has been resolved.
By his own account he is 95% recovered and is in the best head-space he can ever remember. So why do I think this occurred?

What I now realize is that my son was ready for a cure. His ego was in fragments. He had no energy invested to fight for his own beliefs. He wanted to find someone to give him hope. BDD thinking didn’t work and he wanted to think differently. So he being in such a bad way inadvertently worked in his favour. He had no defences that wanted to dismiss help. He was no longer ego invested to prove he was right to anyone.

We meet the best professor in the field we could have ever hoped for. He had done research work with Katherine Phillips. He had many patients he had treated. He could appreciate my son’s fears and was warm and compassionate. My son knew that the professor knew and in that exchange a bond was formed. The professor’s beliefs were firmly based in reality. My son was able to hear and incorporate the views of the professor without a fight. This had never happened with any other therapist. My son was able to understand reality through his connection to someone he admired and trusted. It is as though he actually got for the first time that the professor was invested in telling him the truth. We all had been but he never understood that.

The medication altered my son’s brain chemistry. Prozac was increased over a month until a therapeutic result was obtained. 60mg worked at around 9 to 10 weeks. The dose was later pulled back to 40mg after a big improvement was already well underway. Had there been no improvement a dose of up to 100mg might have been required. Initially Lyrica was used as an adjunct to manage an intolerable level of anxiety. We moved from 150mg to 300 mg as needed. Some sexual issues and insomnia are side effects needing medication still but they are manageable.

No CBT has ever been offered. As BDD is primarily a thought disorder, originating in the brain chemistry, it was consistent that treating the biochemistry would resolve the thinking. Any residual behaviours would be challenged as thoughts became realistic. That is exactly what happened. He can now tell me no one cares because he doesn’t any more. So almost all his compulsions fell away as his thinking became real.

ACT therapy was the type of approach the case worker who came to the house used. Acting according to what you valued, meant that my son was to keep very busy doing stuff that mattered. He took up cooking with a passion that filled the whole day. He reconnected to all his friends and made regular meetups with them. His enthusiasm for life reignited. So a super effort in time management was required to beat the addiction to intrusive thought attacks.

I can’t underestimate my own contribution as well. I wrote the blogs as we went and he read them. He knew he had to resist compulsions. He still does. Over time it got easier.

So that is our recipe for recovery. Not easy but doable. Keep trying to find your personal recipe. A word of caution. Surgery is not an option to consider, that is the truth.

Hope we have been able to help. Marg

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Body dysmorphia: update. Ideas are left

Permanent Linkby margharris on Sat Aug 29, 2015 11:31 pm

It is a little over 4 months since starting with the professor. The professor’s approach is to medicate the biology that underpins the disorder. The amygdala in the brain has been hijacked by anxiety. The amygdala usually has two functional circuits to create alarm. A fast circuit tells us that alarm exists and we should run. The second circuit goes to higher areas of the brain and is aimed to provide feedback about what is actually wrong. This second circuit allows the alarm system to subside once the danger passes. These circuits are not functioning correctly in BDD. Medication attempts to reset this alarm system.

My son has been on a cocktail of meds to manage a very severe, stage 4, bed rescue of his BDD. After being house bound and psychotic for most of the year, the health professionals thought he would never recover. There had been talk of him going to community housing as few people thought I could manage him long term. That was before we met the professor. That was also before we realised the psychosis had been brought on by the use of Seroquel. The off label use of antipsychotics for BDD now seems questionable. Any exacerbation of symptoms on such meds needs to prompt an immediate review. In our case the more psychotic he became the more antipsychotics he was prescribed. I doggedly approached a higher echelon of medicos after exhausting the lower ranks. Ultimately, I reached the research professor who lives and breathes this. He could live in his rooms. He is that dedicated. He even returns emails about meds on Sunday. After 4 months my son’s life has returned.

I asked my son how much he has improved and he answered 90%. Now that isn’t a miracle but it seems near enough for us to state that meds work. My son’s regime is now: Lyrica 75mg twice daily for GAD. Prozac 50mg in the morning. Minipress 1mg for sleep ( used in PTSD). The doc has been quite adamant that he is not to reduce the dose as he might bring on a return of symptoms.

At the same time, an outreach worker has come to the house. Her approach is to help him reconnect to life. This treats the behaviours of BDD as an addiction. My son must remain active throughout the day. He now cooks most days. This gives him something to do in the house. Reading the recipes and getting ingredients helps keep him in active focus. He has to plan concerts and do catch up with friends. He now has a novel he is reading and a new membership of the local library. An old pinball obsession has also been revived. He has had a new girlfriend for about 4 months who is keen to have him move in full time.

It was only last session with the professor that hair was really mentioned. The BDD seems to be falling away without doing anything directed towards it. His self care of hair remains atrocious as he still has ideas that hair is like candy floss. He doesn’t wash but cuts it to barely pinchable length. I don’t know when he does this but he knows he shouldn’t be doing it in response to stress. If one does start talking about anything BDD, he does start to become noticeably more anxious as he defends it still. So I can see that at this stage CBT might be counterproductive. The professor talked about him being in the consolidation stage of his recovery. He is to have medical clearance from work for another three months.

So there is no touching, checking, online browsing, talking it up and comparing going on. Most of the behaviours from his compulsion list have gone. But there is still the ideas. My son now recalls times past when someone mentioned hair and a celeb losing his looks and he would feel that pang of anxiety. He felt the anxiety even when it related to someone else. The notion of genetics made him connect his future to his own father and he then pronounced by prediction a future calamity. He was doomed by his own mind. These ideas that he values have formed circuitry around the amygdala in his brain. Whether he can be ever free of these ideas, I am not sure. We all age an...

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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....

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Body dysmorphia: Compulsion S##t.

Permanent Linkby margharris on Tue Aug 04, 2015 12:14 am

Overcoming compulsions:
You absolutely have to want to stop to be able to stop. If you say you can’t then you never will. The person with BDD is not seeing that their compulsion is part of an illness. Unless you know your thinking is wrong, you will not have the inner reserves to fight against what your brain tells you.
The reality check is that we can all curse God for something wrong with our appearance. I can curse God that I was given freckles but there is no point to that perspective. I have to get on with life in the body I was born with. If I thought I had to fix it, where would I stop. I would merely find something else to think was not the best about my look. I think I would settle on my chin. And so it goes. I am not picture perfect. Woohoo! Do you really give a toss if I am not? You wouldn’t be bothered to look twice at my arms or chin. But when it comes to your own look your brain sends you fear.
What makes me different than a person with BDD is not appearance but the level of worry triggered by the amygdala. My amygdala is not connected to give me an emotional response to the look of my freckles. They are just freckles and nothing more. I don’t link the look of them to any story of disgust. My rational brain stays in control of my responses. I may not like the look of my skin but there is nothing abnormal or hideous or fearful about having freckles. No one cares about my freckles. I don’t have to check them or cover them up. People engage with me through my personality. I am in touch with me as an entity through my own soul. I am a reflection of my soul and not my skin. So I know if I feared my own look, I would not be thinking rationally.
That mindset of reality checking and recognizing your urges are driven by emotion of anxiety and are not rational is the area needing continuous work in BDD. If you wouldn’t teach what you do to your friend, then it is not right for you to do. You need to develop your own new circuitry that says NO regardless of how distressed that makes you feel in the moment. That anxiety feeling will pass when you are doing right.
The pain of your compulsions will first be felt by family members. They have no positive link to any reason for the compulsions existence. To them they are a constant reminder of the pain and torment that you and they live under. Their personal motivation to have them cease will be much much stronger than yours. Hence you are likely to hear the complaints that you need to stop, the anger when you don’t and the family fracture over their continuation. They are merely trying to save you all from more pain.
What can family do to help you stop? Positive and negative consequences such as bribes and arguments are common. Ignoring doesn’t work either. We can only look to organizations like AA for a role model to follow and treat your compulsions like an addiction.
You can create distance between the compulsive act and the person. You might need to take down the mirrors or cover them up. You might need to wear gloves to stop giving into the sensations of touch. You might need to ban yourself on the computer and restrict the sites you surf.
Getting in control of your compulsions takes you to actively do the work to stop the things you do to feel safe and stop the things you avoid doing to feel safe. You will feel safe when you truly know it is just your brain sending you all this information. It just keeps funneling it down a shoot that says this is your BDD needs. But BDD is a lying disorder.
Lets go to the plane disaster. Every bit of rubbish on the beach is from the MH370. That might be an initial thought when you pick up the litter. Your emotions want it to be so. But then your rational brain takes over and you think twice. You gain perspective of all it could be. You think…what are the chances? You override your emotional brain and need some confirmation. You check in with the scientists. That is logic at work. Now the scientists tell you it is rubbish. A rational pers...

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