Unmasking the Invisible Scars and Unseen Consequences on Mental Well-Being
Introduction
Connor lives in a world where technology consumes his day-to-day activities. He scrolls through Instagram or TikTok endlessly looking at other people’s lives. Many of these so-called social media influencers talk about body image and advise on how to achieve a “perfect” body, like having proper nutrition and working out consistently. Consequently, on one end of the spectrum, this fuels some people to achieve this goal. On the other end, others, like Connor, may feel insecure about their bodies and pressured to conform to societal standards. Body image concerns can be a stressful experience: it can reduce individuals’ confidence and self-esteem, and they may constantly compare themselves to other people.
Every day, Connor starts with a ritualistic examination of his perceived flaws in the bathroom mirror. He obsesses over every detail of his eyes, nose, mouth, and hair to the point that he is often late for school and work because he always tries to fix his appearance. He also obsesses over the clothes he wears to hide his perceived large body and prevent criticism from other people. Connor used to enjoy parties, but he now avoids them because he believes that everyone will judge his physical appearance. What was once a source of joy has become a source of dread. What can explain this underlying difficulty Connor is experiencing and how can we help him overcome this situation?
Amid the widespread concern for body image, there exists a subset of people facing an even more formidable battle — a condition known as Body Dysmorphic Disorder (BDD). This goes beyond the common fluctuations in self-esteem and ventures into the realm of a distorted self-perception that can have profound negative consequences. Let us shine a light on the often-overlooked difficulties of those, like Connor, battling the complexities of BDD.
What is BDD?
BDD is a psychological disorder in which individuals see themselves as ugly, and they get significant distress by obsessing over their perceived defective appearance flaws for at least an hour a day (Gorbis & Jamero, 2019). Consequently, they experience significant impairments in social, cognitive and/or occupational functioning. For instance, they may avoid social interactions or going to work because they think that other people will judge them for their physical defects. In turn, this causes a lot of mental distress and may lead to more overthinking, which ultimately can lead to a vicious cycle of negative thoughts about themselves. To relieve themselves from their high anxiety, individuals diagnosed with BDD will engage in compulsive and repetitive behaviours and/or mental acts. For example, people with BDD will check themselves in the mirror consistently, ask people for reassurance that they look “okay”, and compare their appearance to other people. Individuals with BDD tend to misinterpret ambiguous social information in a more negative and threatening way. This causes them to maintain their BDD symptoms and psychosocial impairments by reinforcing their distorted self-perception and ideas of social undesirability.

Prevalence of BDD
Research has shown that the prevalence of BDD ranges from 0.7% to 2.4% in the general population. It is more common in females than males and females with BDD are more likely to also have an eating disorder. In addition, BDD symptoms tend to appear before the age of 18 years old. There are two subtypes of BDD: muscle dysmorphia (MD) and BDD by Proxy (BDDBP).

What is muscle dysmorphia (MD)?
People with BDD can have perceived defective flaws in different parts of the body, such as their skin, hair, nose, and other parts. MD is more common in males than females. People with MD show significant distress by obsessing that their body or muscle is too small and not lean enough. They exercise compulsively to regulate their emotions, avoid distress, and attain their desired body shape by burning more calories.

What is BDDBP?
Rather than the belief of having perceived flaws, people with BDDBP are concerned with perceived defects in another person’s appearance, like their spouse or partner, or even a stranger. They believe that other people will see the defects of their person of concern and judge them. This causes individuals with BDDBP significant distress and impairment in daily functioning.

Interesting fact about video conference (Zoom) dysmorphia?
The COVID-19 situation shifted a lot of meetings to online platforms instead of in person. Even though it is not an official diagnosis, Zoom dysmorphia describes how video calls can affect how people see themselves on screen. These applications let you change how you look with things like better lighting and filters. This can lead to individuals experiencing significant distress, often fixating on their physical appearance and engaging in compulsive behaviors to fix their perceived flaws. For instance, they might use more makeup, wear fancier clothes or jewellery, or mess with camera settings to hide what they do not like. Individuals with symptoms of Zoom dysmorphia may also be vulnerable to developing BDD.

Mental Effects of BDD
It is no surprise that BDD has debilitating effects on one’s mental health. Individuals with BDD experience high levels of anxiety and distress related to their perceived physical defects, which can be overwhelming and persistent and cause an impairment in daily life functioning. The constant thoughts about their perceived flaws make it hard to concentrate and stay focused, affecting things like work, school, and just getting through the day. People with BDD tend to be depressed, and it can contribute to feelings of hopelessness, sadness, and dissatisfaction with one’s life. In severe cases, they can experience suicidal thoughts or behaviours. That is why it is crucial for professionals to recognize the signs of BDD early on and step in to offer interventions and support.

Conclusion
It is essential to cast a spotlight on the impact of BDD on mental health. Its negative impacts intrude through the corridors of the mind, leaving individuals trapped in a web of relentless self-criticism. The mental toll of BDD is not merely a battle with the mirror but a relentless struggle against one’s own thoughts, where every flaw is magnified, and self-worth becomes a casualty. Hence, it is important to reach out to professionals if you are experiencing body image difficulties and body dysmorphia in order to receive proper and individualised treatment to restore your perception of reality.
Stay tuned for Part 2 of this blog where we discuss various strategies to recover from BDD. In the meantime, if you identify with any of the information above, please know that professionals at Sööma can assist you in gaining a better understanding and overcoming this debilitating preoccupation. Contact us today to learn about how we can help at info@sooma.ca or 514-437-4260.
By: Paul Vincent Marasigan, McGill Student
Sööma est une entreprise bilingue qui fonctionne en anglais et en français. Nous fournissons des articles de blogue, des recettes et des articles de diverses sources qui sont parfois écrits en anglais et parfois en français. Si vous vous sentez incapable d’accéder à un article ou à un sujet spécifique en raison d’une barrière linguistique, veuillez nous contacter à info@sooma.ca et nous serons heureux de traduire le contenu pour vous.
Sööma is a bilingual company that operates in both English and in French. We will provide blog posts, recipes and articles from various sources that are sometimes written in English and sometimes in French. If you feel unable to access a specific article or topic due to a language barrier, please reach out to us at info@sooma.ca and we will be happy to translate the content for you.
References
Björnsson, A. S., Didie, E. R., & Phillips, K. A. (2010). Body dysmorphic disorder. Dialogues in Clinical Neuroscience, 12(2), 221–232. https://doi.org/10.31887/dcns.2010.12.2/abjornsson
Gorbis, E. & Jamero, J. (2019). Comparing and contrasting body dysmorphic disorder and eating disorders. Journal of Aesthetic Nursing, 8(3), 123-127.
Martenstyn, J. A., Aouad, P., Touyz, S., & Maguire, S. (2022). Treatment of compulsive exercise in eating disorders and muscle dysmorphia: A systematic review and meta-analysis. Clinical Psychology-science and Practice, 29(2), 143–161. https://doi.org/10.1037/cps0000064
Sarangi, A. K., Yadav, S., Gude, J., & Amor, W. (2022). Video Conferencing Dysmorphia: Assessment of Pandemic-Related Body Dysmorphia and implications for the Post-Lockdown era. Cureus. https://doi.org/10.7759/cureus.22965
Subtypes of BDD – BDD. (2023, April 21). BDD. https://bdd.iocdf.org/about-bdd/subtypes-of-bdd/