The Ugly Truth About Body Dysmorphic Disorder (Plastic Surgery Matter)

Idk if this should be under children but plastic surgery's related to bioethics anyway haha

Excerpt From:
The Ugly Truth About Body Dysmorphic Disorder. Sally Williams. December 10, 2012.
(http://www.telegraph.co.uk/health/9693178/The-ugly-truth-about-body-dysmorphic-disorder.html)

Title says all....

Samantha Davies was 13 when she began to develop the deformities that would transform her into what she described as ‘the most ugly person in the world’. Her nose began to spread into a formless lump across her face, her cheeks inflated to three times their normal size and her head became square and masculine.

First, she tried hiding behind make-up. She would use so much foundation that ‘her face was just orange, like a mask’, her mother says. She would apply six or seven layers of mascara. She would straighten her hair (to cover her face) with hair irons to the point of singeing it.

After three months she decided she was too monstrous to be seen. She confined herself to her bedroom and refused to go to school. She would agree to be taught at home only if the tutor couldn’t see her face. ‘She would sit on the bed with a quilt over her head. The woman would teach her through the quilt,’ her mother remembers. Finally, aged 13 and a half, Samantha had had enough. She took an overdose. And if this weren’t evidence enough of her state of mind at that point, her reaction when she came to in hospital underlined it. ‘My first thought was, “What do I look like?”’ And the feelings of self-revulsion returned.

The strange thing is that Samantha looks perfectly normal. It was all in her head. In October 2009, after months of anguish and three suicide attempts, she was finally treated for severe body dysmorphic disorder.

Body dysmorphic disorder (BDD) is driven by intense anxiety about appearance, and its exceptional force lies in its delusional quality. The focus can be any body part, but typically it is the head – hair, nose, ears, skin, the size and shape of the jaw – which sufferers see as ugly, ‘not right’.

BDD is relatively common – it affects about one in 100 people (significantly more than schizophrenia; slightly more than anorexia). It typically starts in early teens and affects boys as frequently as girls.

The causes of BDD are still unknown. ‘We know it runs in families and that there is a strong genetic component, but that doesn’t explain the whole picture,’ Dr Mataix-Cols says, listing such factors as ‘appearance-related teasing’ and bullying. ‘It’s not clear if they simply trigger a pre-existing vulnerability or whether they have a proper causal effect,’ he adds.

It’s possible that the rate of BDD is increasing as women get bombarded with media images of perfection. Lots of studies have shown that the more you see images of perfection around you, and the more you compare yourself with those images, the worse you tend to feel about yourself.

The point on which experts agree is its seriousness. Sufferers are compelled to take steps to mitigate the disaster they see in the mirror. Samantha was fixated on hair extensions and make-up. She used to put a lot of make-up on, wipe it off, start again, for hours and hours.

Obsessive exercising is another compulsion. Photographing themselves on mobile phones and digital cameras is another. Sufferers repeatedly ask if they look fat/disgusting/ugly; overfocus on the appearance of other people and pick at their skin. At her worst Samantha was checking her face in the mirror 80 times a day, sometimes for up to two hours at a time.

People with BDD seek cosmetic surgery – about a quarter of BDD sufferers have actually had it – and avoid other people. Sometimes children drop out of school. Being around other people is extremely painful and anxiety-provoking, and in severe cases they can become housebound. BDD also raises the spectre of suicide with a rate approximately 45 times higher than in the general population.

And yet, despite it being such a serious problem, BDD is under-reported and undertreated. People with BDD are afraid they will be considered superficial or vain. It is hard to go to your doctor and say, I think my nose is too big. So what often happens is they report an associated problem such as low mood or anxiety, but they won’t say what the reason for that is.

The result is that the only a ‘handful’ of new cases are treated a year, with patients ranging in age from 12 to 18, typically the more extreme cases. Less severe cases tend to be treated at local Child and Adolescent Mental Health Services (CAMHS) – if they’re lucky. If you live outside a big city or a developed country like Britain, your chances of getting access to good psychological treatment are a lot less.