Did you read our post on facts about body dysmorphia a few weeks ago? It has been so popular that we’ve been asked to do a post on facial dysmorphia, which is a specific variant of body dysmoprhia. We’ve tracked down experts on this condition, and these are the essential facts that everyone should know about facial dysmorphia.
Body Dysmorphic Disorder, or BDD, is an anxiety disorder which causes a person to have a distorted view of how they look. They spend a lot of time worrying about their appearance because of this. Facial Dysmorphia, or FDD, is a specific variant of BDD, where the sufferer fixates on a perceived flaw on their face or neck. For example, they might be convinced that a barely visible scar is a major flaw that everyone is looking at.
Most people have something that they’d change about their face, so what makes FDD different? The intensity of their dislike is one thing. Individuals with FDD tend to spend between three and eight hours a day obsessing over their flaw, which could be relating to acne, ear size, nose, teeth, hair or overall appearance. FDD sufferers genuinely and wholeheartedly believe that others stare at their hideous defects, and that they are judged because of this. It also impairs sufferers, because of their intense thoughts. FDD patients tend to avoid social activities, school, work…anywhere that they might see other people.
The preoccupation with perceived imperfections can be so consuming that everyday activities become a monumental struggle. This often results in significant emotional distress, anxiety, and depression. For some, the overwhelming anxiety and fear of judgment can lead to severe isolation and even an unwillingness to appear in photographs or look in mirrors. Relationships are frequently strained as loved ones struggle to understand the depth of the preoccupation, leading to further withdrawal and loneliness. Moreover, the disorder can also drive individuals toward extreme behaviors, like seeking numerous cosmetic procedures, which rarely provide the relief they seek.
Individuals with FDD may try to alleviate their condition in a variety of ways. These include seeking reassurance from other people, or bringing the topic up a lot, in an effort to share the discomfort and be reassured. They may also use camouflage to cover up their perceived flaws, such as wearing very heavy make-up, or using clothing or accessories such as sunglasses or hats. Some sufferers might also have cosmetic surgery. FDD patients often reach out to cosmetic surgeons and dermatologists to try and fix their problems. One study found that 77% of sufferers had attempted cosmetic surgery, and 50% sought dermalogical treatments. Some patients even try DIY cosmetic surgery, which never ends well.
For those grappling with the distress, professional psychological support is crucial. Cognitive-behavioral therapy (CBT), which challenges irrational thoughts and changes behavior patterns, shows promise in managing symptoms. Medication, like selective serotonin reuptake inhibitors (SSRIs), may also help by addressing underlying anxiety and depression. A critical step is fostering a supportive community – whether through support groups or online forums, where individuals can connect with others experiencing similar struggles. Self-care practices, such as mindfulness and regular exercise, can be supplemental tools in building resilience against overwhelming anxiety.
Similarly to BDD, sufferers of FDD might engage in obsessive exercising, check their reflection frequently, try to tan to an excessive level, pick at their skin or self-harm. These behaviours can appear strange, especially if they do not affect the face. They are documented ways to reduce anxiety and pressure, and are common for FDD sufferers. One study suggested that 94% of sufferers felt that their condition stopped them from socializing, 85% felt held back in education or at work, and 18% dropped out of school completely.
FDD can also cause sufferers to engage in compulsive make-up application or excessive grooming to conceal perceived flaws, which may consume several hours per day and impair daily functioning. These repetitive acts are sometimes attempts to attain an unattainable level of perfection. Relationships may strain as loved ones struggle to understand the severity of the sufferer's distress, leading to further withdrawal and isolation. The intense preoccupation with appearance can overshadow other aspects of life, contributing to a lack of fulfillment and joy in activities that once were pleasurable.
FDD isn’t a common condition, but it is also believed to be very underdiagnosed. Some sufferers are too embarrassed about their flaw to be able to seek help, even from a doctor.
The prevalence of FDD is not fully known due to the challenges in identification and diagnosis. Many individuals may not recognize that their distress has a medical basis, mistaking it for simply a lack of self-esteem or a personal preoccupation. Additionally, healthcare providers might not always be sufficiently trained to detect the subtle signs of FDD, especially when conversations about cosmetic concerns are normalized in society. Open and empathetic communication about body image issues can pave the way for better understanding and support for those struggling silently.
It is possible for someone of any age to get BDD. It is very rare in children, however, and it usually develops during adolescence. It is not unusual for it to be mistaken for normal teen angst during this period, so diagnosis is most common in older teens, or adults.
Although typically diagnosed in older teens and adults, BDD can afflict individuals at any point in their lives. It’s been observed that women might be particularly vulnerable due to societal pressures regarding appearance. Men, of course, are not immune and can also experience BDD, but the emphasis on physical attractiveness in women’s socialization can contribute to a higher number of cases reported. It's important to recognize that BDD is not vanity; it is a serious mental health condition that can lead to severe anxiety and depression if left untreated.
The first thing that you can do to help someone with facial dysmorphia is to accept how they feel. While you might not understand their concerns, resist the urge to judge them as vain or self-obsessed. Next, encourage them to seek help and support. Doctors can help, as can psychiatrists, and therapy groups of other sufferers. You could offer to go to a session with them, or help with childcare or household chores so that they can go. Accessing help is really important. Next, try to be understanding if he/she doesn’t want to see you in person. It might be hurtful, but try to keep up text or email contact instead. Finally, remember to get help for yourself if you need it. FDD can be distressing to witness.
Remember that facial dysmorphia is an illness, like any other. The sufferer can’t snap out of it, and they need your support and help. If you think you have facial dysmorphia, get an appointment with your doctor. They really can help you, and refer you to help that you’ll be happy to access. Give it a try. At the very worst, you might be able to get a referral to someone who can help you physically. Do you have any thoughts about facial dysmorphia, or requests for other health articles? Let me know!