Living with Body Dysmorphia

Its three in the morning and my newborn baby is demanding another feed. I’m tired, achy and feeling, well, content. It wasn’t that long ago that I couldn’t contemplate feeling this way in the middle of the night much less attending antenatal visits, baby showers or parent and baby classes. The thought of making eye contact was crippling, never mind the invasive nature of starting a family.

But first, I’d like to rewind a little to the beginning of my mental health story for those who may not have heard of BDD (body dysmorphic disorder). I was diagnosed two years ago, and in all honesty, I felt relieved to have a name for this. It had been called various things over the previous few years, depression, general anxiety, social anxiety and so on. All I knew was that it felt awful, a dirty little secret that was too shameful to let most people really know. Like many others with BDD, it can be difficult to seek help due to worries that people will judge you or think you are vain. Heartbreakingly, this often means that people with BDD are likely to experience it for long periods of time before seeking support. For me, the excessive, obsessive behaviours around my appearance (particularly related to my skin) started to seriously affect my daily life, including work, social life and relationships. The mirror checking, the avoidance of social situations, the mirror checking, the comparisons to others, the mirror checking, hours spent looking for a fix’, the mirror checking, the need for reassurance, the mirror…well you get the idea. It was exhausting, and I was done.

When I finally broke down to a kind, supportive line manager at my work and eventually (despite my original reluctance) became signed off work for 2 months, I was referred to a Cognitive Behavioural Therapist (CBT) by my GP. Here was someone (a CBT counsellor) who finally saw through it all. They saw the real issue, not the cheerful girl who pretended she was fine, not the person who just needed a couple of weeks off to get her act together. No there it all was, the pain, the frustration and the confusion. And I am not alone, according to NICE guidelines, it’s estimated that approximately 0.5 – 0.7% of the UK population are experiencing BDD (with the much higher likelihood) and on average take 15 years to access help. Suicide is higher in people who are experiencing body dysmorphia, and studies have shown that if BDD is not recognised, it can become chronic until treated appropriately. This makes me incredibly sad that there are several million versions of me out there with all the pain and loneliness that it brings.

Yet, there is no definitive cause of BDD despite various proposed explanations such as bullying which may lead to an emphasis on low self-esteem and contribute to the disorder. Although I was fortunate never to experience this is my younger years, and my BDD became much worse in my twenties, I feel this proves the real complexity of this disorder. Recent research suggests that there may be several different risk factors such as perfectionism, genetics, depression, anxiety or OCD. Although the causes of BDD may be unknown, it is important to recognise that it is treatable.

In a world where social media is king (or queen) the very thing that is meant to be bringing us together actually isolates us more. Several correlational studies have made links between increased social media use and being unhappy with body image. Although, not all social media should be tarnished with a negative view, for some people (myself most definitely included) it may well maintain psychological distress. However, despite all of this, I am hopeful. This hope grows with the recent surge of social media linked to the body positivity movement, which includes blogs and posts from the men and women who promote this positivity, as well as those in the public eye who are starting to speak out against those unrealistic ideals.

So, in keeping with this theme, I’d like to bring some awareness to the positives in my mental health struggles. Yes, you read that right, the positives! Previous surveys have identified that people with BDD have a much greater tendency to have education or occupation in art and design as they may be able to hone in on visual details and appreciate unperceivable aspects of art. I certainly found this for myself, whilst my BDD has worsened over the last few years, I have found great distraction in drawing and photography. By no means am I the next Van Gogh or David Bailey but by taking part in some small local exhibitions, I found something that made me proud of me.

Not only that, by experiencing the devastating lows that the human mind can construct, I feel that it has helped me gain the tools to empathise and recognise some of those signs in others. I have developed many new skills from mindfulness to Yoga with all the abilities my body has developed in this. Finally, but most importantly, it has provided me with numerous opportunities to meet a variety of wonderful people who genuinely care about what happens to me, from my husband (who is my greatest advocate), family and friends to the doctors and therapists who helped me find my way back from the darkness (a work in progress).

For me, this ‘work in progress’ included a mix of CBT, self-care, support groups and SSRIs (antidepressants) to help manage the symptoms. CBT aims to improve attitude to body image, concerns around perceived flaws and reducing unhelpful behaviours through the use of methods such as trigger diaries as well as slowly facing situations that would normally make you think obsessive, anxious thoughts. For those at the beginning of your journey, this may sound scary and, believe me; I remember that feeling well but your therapist, like mine, will help you through this so over time you may begin to feel less self-conscious. Accessing self-support groups had a hugely beneficial impact as I found hearing about how others coped with similar feelings and experiences useful and certainly helped with the feelings of isolation this cruel disorder can create.

So, whilst I finish feeding my baby and watch her go back to sleep, I enjoy this wonderful moment knowing that, although BDD is part of who I am, that it’s okay and even though sometimes it makes me feel anxious, that’s okay too. I was once given a beautiful piece of advice from a therapist, ‘you do not need to be fixed because you are not broken’. And they were right, some parts of me need more work than others, but I’m certainly not broken, and neither are you. For those who have or are experiencing difficulties, your journey to recovery may look a little different to mine, but that’s what makes us so unique. And that’s what I hope to leave you with you today. Some awareness to look through the mental health struggles, look through the labels to find the positives and the person underneath.

So please access help, whatever that might look like to you, so you can achieve the contentment you deserve and all the future wonderful moments that might bring.

by Rachel Guy

Resources and references

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