Stories by relatives
I was at primary school when I first started thinking that I was too skinny and awkward-looking. Somebody teased me in the playground, someone else insisted that I needed feeding or tidying up… But I was already an insecure little girl. Life at home was unstable. I needed reassurance and security. I wanted so much to feel loved and accepted. I had a quirky mother, to whom I never felt as close as I wanted. I lacked a father figure but had an older brother who was adored and preferred over me. I spent my childhood years feeling depressed, and started to believe that the key to happiness lay in my looking a certain way.
I would fan out my hair on the pillow at night, hoping my mother would pop her head around the corner and think what a beautiful daughter she had. In fact I felt anything but. I was angry inside. I wet the bed, and had terrible nightmares. I suffered from panic attacks. I felt like a disappointment. I felt weird. As I got older school became a struggle. I was stuck in a rut of negative thinking about myself, and consequently my development suffered. Despite positive attention, friends, aptitude for some subjects, I became entrenched in my conclusion that I was not good enough. I was allowing myself to be ruled by an ideal of unattainable perfection.
I looked to the mirror to help me cope with my difficult feelings. If I could only make myself appear a certain way then I would be okay. So my thinking went. I wore thermals underneath my clothes to bulk me out; I hid behind layers of make-up. I wore my hair a particular way to disguise all that I saw wrong with me. The mirror was my best friend and my worst enemy. I gazed in it secretly, because the monster was always gazing back; keeping me locked in a cycle of preening and face pulling. I couldn’t look in it in front of anybody. I would become quietly hysterical at the sight of a photograph of me.
I believed I was a monster. I had to conceal my true identity from the world, at any cost. So, at the age of fifteen, when life should have been exciting and full of a sense of beginnings, of character-building experiences, I dropped out of school and, for an entire year, became a recluse. I lost touch with the world and life grew cold and lonely. All my time was spent gazing into the mirror, wondering what was wrong with me and why I couldn’t look and be normal like everyone else.
At sixteen I finally met someone, moved to London, and started working. People would offer up compliments and even tell me that I should be modelling. But, although I thrived on positive attention when I was with others, later, alone at home, my hellish reality would dawn on me again. I felt like a fraud. I’d spend hours naked, just looking at myself, poking and prodding bits, preening, exercising, worrying that every additive in the food I ate was conspiring to make my skin uglier. I’d check my reflection from every angle, under every kind of light, always ending up back with my self-loathing and tears. My life was not so much about living as surviving. I didn’t feel worthy of happiness. So many times I ran away, only to find that, funnily enough, I couldn’t get away from myself. With each new home, new area, new job, I’d vow that things would be different. I’d be different. But nothing changed.
I remember the day I first heard about Body Dysmorphic Disorder. Flicking through a magazine I came across an article with the heading, ‘I Feel Too Ugly to Live.’ It spoke directly to me. As I started to read I had a sense of revelation, because I saw myself in this horrendous illness. Suddenly I wasn’t alone, I wasn’t crazy. I know some people struggle to believe they have this disorder but for me there was no mistaking it. I went to get a professional opinion at the Priory in North London and walked away determined that I’d kick arse with this disorder.
I tried various medications, eventually some counselling; I even visited a spiritual healer and tried prayer. I read up on the illness, I talked with others who were suffering, I created a website, ‘BDD Help’, to raise awareness and reach out to other sufferers. Yes, some days I struggle and cry and get frustrated because I don’t feel good enough or presentable. It’s to be expected; you pick yourself up and brush yourself down. I have found ways to keep my BDD demons under control, and to get enjoyment out of things I never could before. What I most want to say to you is this: there is light at the end of the tunnel. It’s a slow process reprogramming your brain to think differently so you eventually feel differently, but it’s worth it! And it can even be fun getting to discover who you really are from the inside too, to see yourself changing for the better by developing new ways of thinking and being. Life is an adventure and that is the only way to look at it.
So where am I now? Well you know what, with my hand on my heart I could look back on my life so far and either feel regret and sadness, or take out of it valuable insights to carry me forward. I choose the latter. As I get older I realize that it’s the world I live in that is messed up, not me. I see through the media and the beauty industry, all the ignorant and shallow grand illusions that we’re sold. I appreciate that beauty lies in imperfections and uniqueness. Yes, really! But I also see how sensitive and vulnerable we are as children, and how important it is to nourish and nurture every spirit.
I would like to end by saying a big Thank You to all of you that have contacted me since BDDHELP was created. For me it has been wonderful getting to know other sufferers, and to get back support and encouragement from you.
Onwards and upwards with love,
My first memories of BDD symptoms are from when I was younger than 7 years’ old and at primary school. I had a fantasy that I would run again and again in my head that involved me playing in the playground at school and then suddenly dying. The other kids and the dinner-ladies would notice without being upset or bothered, as I was too ugly to care about. However, when they moved my body, the mask of ugliness that I had been secretly wearing all that time would slip off to reveal a pretty little girl underneath. At this point, the children and dinner ladies would become very upset and mourn my death, realising that all the time they had shunned me for being ugly, they had been wrong, and all the time I had been pretty underneath.
Other specific memories from that young age are rare, but the feeling that I was repulsive compared to the other children was always there. Playing kiss-chase with the other girls was never an option as it would put the poor boys in an embarrassing quandary where they were forced to either kiss some monster or humiliate me by not chasing me at all. I can remember being very young – I still had curly hair which I lost when I was 6 so I must’ve been 5 or less – and somebody in a shop commented to my mum that I had beautiful hair. I was eaten up with embarrassment and anger at the woman for saying something so obviously untrue and stupid. I couldn’t understand why she would be so cruel.
At that point my BDD was vague and undefined; I just knew that I was ‘very ugly’ and had horrid hair. Then, when I was about 11 years old, I started to get spots, and the BDD had something to really get hold of. By the time I was 14 I was spending an average of 4-5 hours getting ready to leave the house, with all my energy going into plastering on foundation and concealer and re-constructing my face as much as I could, using blusher and other makeup. I was getting though a concealer stick each week. If I heard anyone coming towards my bedroom during this process I would have to lock the door and pretend I was getting undressed to make them go away. I just couldn’t allow anyone, including family, to see me without full makeup, so it was always a stressful rush to get it all on before anyone caught me with a naked face!
People would make comments within earshot about wearing too much foundation, but I would much rather that than reveal the true horror of my face! High School was difficult, as my friends and I grew into young adults. They were all pretty, and would peer into mirrors to check their skin and have a moan about the odd black head. I would hang back; I couldn’t go anywhere near the mirror as I knew they would’ve been secretly watching me to see how I coped with looking at myself and my ugliness. In my head, my hideousness was recognised by all my friends but they were kind enough to never mention it, and to play along with the farce that I was normal. I could never figure out why they hung around with me, but I was fairly sure it was because they would look prettier to the boys if they stood next to me!
Of course, it was a different story with mirrors when I got home. I had one in my bedroom that I spent most of my time in front of, putting on makeup, staring unbelievingly at my gargoyle features, crying, asking why me, hitting and scratching and clawing at my face for hours on end. The only day of the year I looked forward to was Halloween, when I could wear a mask and blend in with the other people, and experience for one night what it was like to be normal. Every waking moment and everything I did was shadowed by an intense self-consciousness and awareness of my looks. I was so repulsive that I wanted to hide away forever, and not put others in the embarrassing position of having to look at me. I felt sorry for anyone that came into contact with me. When I was out I had an overwhelming urge to walk up to passers-by and apologise for my face, and let them know that I was fully aware of what I looked like but there was nothing I could do. I wanted to beg them to forgive me for being so ugly. Every fibre of my body just yearned to disappear.
The only thing I can liken it to is being forced to walk down a street and go about your business completely naked, feeling vulnerable and exposed and knowing that it is unacceptable and wrong for you to be naked, that everyone is staring at you but is too shocked or polite to say anything. So there is this overriding belief in every social interaction that the person you are speaking to knows you are naked and they know that you know they know, and they are horribly embarrassed about it and so are you, but neither one of you is going to mention it. The worst thing was that it could never be talked about. In my head, everyone knew how hideous I was, but it was never mentioned and I could certainly never bring it up as I was so excruciatingly embarrassed by the whole situation. Unfortunately in the ‘real’ world, this meant nobody would’ve known the reasons I was behaving oddly. I avoided leaving my bedroom, as it was the only place where I didn’t feel like I was about to explode with the stress of it all.
During my later teenage years the darkness of night and the dim lights of nightclubs provided a certain amount of disguise, where I thought my skin and layers of makeup were less obvious. So I was able to participate in a basic social life with my friends, especially as getting drunk dampened the feelings of self-hate a little bit. I would know, down to the last minute, what time it got dark during the summer, and only then would I leave my bedroom. It meant missing out on all the summer day activities and early-evening fun, but there was absolutely no choice. I would start getting ready at about 5pm, but still not be ready by the time the pubs were closing at 11. My friends grew increasingly annoyed with my lack of reliability. It wasn’t just a case of not ‘being ready’ to go out – it was more a case of not having done a good-enough job to conceal the terrible secret that was my face. There was no way I could leave the house and let people find out the true extent of my grotesqueness. That would mean disaster.
Obviously I didn’t have boyfriends. Now and again I would drunkenly snog someone in a club, but I knew they were only doing it because they were drunk and that they would wake up the next day ashamed, with their mates taking the piss out of them. Now and again someone would say they fancied me, and my world would spin with anger at their cruelty. I wanted to push them up against a wall and scream in their face that I knew what I was, I wasn’t stupid, and that I knew they were taking the piss out of me, and how could they be so spiteful? All of this was accompanied by the huge amount of other neuroses that you would expect someone under great psychological and emotional strain to display. The OCD symptoms, general anxieties, phobias, depression, self-harm and thoughts of suicide all kept my BDD great company.
But there is hope, and good news. I am now 30 years old, and have considered myself ‘recovered’ for about 5 years. I only realised there was something to ‘recover from’ at the age of 22, when I stumbled across Katharine Phillips’ book The Broken Mirror, in the course of my psychology degree. If I had been as ill as I was during the rougher years, I think I could have read that book from cover to cover and never realised that it was describing something I might have, so convinced was I that I looked like a 100% genuine freak.
BDD caused me to drop out of my A-Levels (in the end I couldn’t face leaving the house). It cost me a ‘normal’ childhood and adolescence, and left me with a persistent underlying suspicion of anyone who compliments me or wants to hang out with me. I still fail to comprehend that someone might fancy me or fall in love with me, but I hope this will change as time goes by, and at least I can be rational about these things now, and recognise that it’s probably the BDD whispering doubts in my ear, rather than the way things really are. Life is liveable and I can function. I can look at myself in a mirror with other people present. and I can walk down the street without wanting to apologise. I feel very positive about the fact that I can now recognise I had a disorder. In my mind that is the definitive sign that you are on the road to recovery, because then you can start to see and accept the outside world’s perspective. Things get a lot easier from that point onwards!
I never felt pretty, even when people told me I was, or when a boy said he liked me. I always felt ugly. When I was younger I had no self-confidence. I remember my childhood friend telling me, when I was about 13, that I should straighten my hair and wear makeup, but I just couldn’t do it. It wasn’t until I started to gain more confidence in myself and see myself differently that others did too. But that came later. I remember one of my close male friends telling me I was pretty and I was devastated, because I thought he was poking fun at me. I don’t have a straight nose or full lips; the only thing I liked about my body was my eyes. When I got a little older I started to wear makeup and straighten my hair. I tried my hardest to look better, to wear nice clothes and smile, but it never made me feel good.
I’m better now than I was back then. I still go through phases where I feel disgusted by my face and body. I look in the mirror and notice all my flaws and punish myself for them. Whenever a guy comes up to me in a club I honestly think it’s because he’s picked me out as the ugly one, and therefore easy and desperate, and whenever I hear the word “ugly” in public I think the person must be talking about me. Of course, I know that there are worse things in the world than being unattractive, and I thank my lucky stars that I have good health and an amazing family and wonderful friends, but I still can’t help it. My mind goes back and picks out the people who may have said I’m ugly or who have looked at me oddly.
And the weird thing is that I wouldn’t change the way I look. I don’t think I’d like to be one of the gorgeous girls that all the guys like. What I really want is to stop caring. To just see myself in a consistent light, and not as ugly and worthless or as beautiful and superior, but as a human being just like everyone else. Body Dysmorphia is terrible and soul-destroying. Perhaps if we lived in a society that was not so focused on looks, that valued people’s hearts more, then there wouldn’t be such a disorder. Perhaps we need to rethink our values and stop making our lives miserable by thinking that we are not pretty enough.
I have never had a proper boyfriend. I never like the boys who like me, although I always give them a chance, and I have never felt good enough for the boys I do like. I spent my whole teenage life pining after this one guy but never actually made a move on him because I thought he would be repulsed by me. It turned out that he did like me but he was also shy. So I missed out on something that could have been really special, just because I saw myself as inferior.
I believe we need to raise awareness of Body Dysmorphia, otherwise people will spend their whole lives thinking they are something they’re not: ugly and unloveable. I have never met anyone truly ugly, so why do I see myself as such? I don’t care about appearance; never have and never will. It doesn’t matter to me whether someone is amazingly beautiful or disfigured, who cares? At the end of the day beauty is deeper than people’s skin. It’s about personality.
I would like to share my experience. Forgive me if I give advice or offend; I’m quite passionate about my recovery and want to share with you my sense of hope.
I did not realise that my Body Dysmorphic Disorder had gradually changed me into someone that I didn’t want to be. A person who was at odds with himself and his fellow man. I picked my skin until I gave myself scars, then I stayed in my room to pick at the scars rather than go outside the house with family or friends. One of the things I used to do was to keep looking at my scars in the mirror until they became out of focus, as my eyes grew tired. Gazing from different angles and not wanting to blink, I was drawn to the things that I hated and it caused me a lot of distress. It felt as if the mirror would drag me towards it and scream ugly names at me. Later I tried to remove the scars with unnecessary surgery, which only caused larger and redder scars.
I had painful steroid injections into the scar tissue to try to soften them. I had laser surgeries to try to reduce their redness. I filed my own teeth with a razor to try to make them even. I dreamt incessantly of nose surgery. I thought my arm and leg hair was ugly and dirty and tried to cover it up. I saw uneven ears, uneven nostrils, over-developed muscles on one side of my forehead, to name just a few of my ‘flaws’. And that’s not even going into the rituals and tricks that took up hours of my day in an effort to camouflage.
For many years I tried to keep people from knowing about my pain and my negative thoughts. I isolated myself, and lived in a prison of my own making. I avoided intimate relationships for fear of rejection because of my defects. If I felt rejected I put it down to the way I looked. I thought I didn’t deserve love, but punishment. I told myself no one would love me because of these ugly, grotesque parts of my appearance. In my head I went over every conversation, every social interaction, trying to account for my feelings of rejection. I was trying to use my insight, not realising that my insight was distorted. Later I came to realise that, unknowingly, I was using my ‘insight’ to keep myself stuck.
My BDD was a destructive force in my life. My best efforts resulted in ever-greater destruction and despair. At some point I realised that I needed the help of professionals. With therapy I came to realise that holding on to these rituals, tricks, safety behaviours and obsessions would eventually sicken me and stop me from taking part in a new way of life. I realised that if I kept entertaining these obsessive thoughts it would lead me to a worse state. I have learnt that if I let an obsessive thought surge, it maintains its own momentum, until it boggles my mind and alters my mood. It is the old, unhealthy mindset that BDD is preserving.
How sincerely I worked at each Cognitive Behavioural Exposure exercise (or what I term a recovery step). My effort was proportionate to my desire for change. And this next part was an important one for me: for a long time it didn’t seem safe to embrace what I now knew, and to let go of the familiar for the unknown. Many of us with BDD cling to our fears, doubts, self-loathing or hatred because there is a certain security in our pain. But I started to liken my behaviour to that of an addict, and I realised that each ritual starts the deadly cycle all over again. Drug addicts try to control their addictions, to ‘use in moderation’ or to use just ‘certain drugs’. None of these control methods work. I too had to admit my powerlessness over my rituals. I couldn’t substitute one ritual for another. I couldn’t take the view that I could do my rituals in moderation. My therapist gave me a great example: if you have an infected wound and you wipe 90% of the infection away, the infection spreads again.
My therapist told me to view any current or new behaviour in that way. If it was even partly BDD-related, e.g. 20% BDD, and 80% a ‘normal’ appearance concern, then I had to stop doing it because substituting one trick for another was releasing my compulsions all over again. BDD is great for manipulating the truth. BDD is always a step ahead. I said to my therapist: yes, I need help, yes, I am willing to do whatever it takes to stop my rituals/tricks, but in the back of my mind I was like an addict, telling myself that ‘when’ I get my life together, then I can handle my drug habits. Or, ‘when’ I get out of rehab, I can handle the occasional drug. Such ways of thinking and acting lead us back to what Narcotics Anonymous call ‘active addiction’.
I came to realise that I had no choice except to completely change my old ways of thinking. From that point forward I began to see that every ritual-free day is a successful day, no matter what happens. Surrender means not having to fight anymore. We accept life the way it is. We become willing to do whatever it takes to stay ritual-free, even things we don’t like doing. I had to learn, and did learn, that I was growing when I made new mistakes instead of repeating old ones. I came to know myself through therapy. I found myself growing into a mature consciousness. I began to feel better, as willingness grew into hope. For the first time I could see my new life. With this in sight, I put my willingness into action, and that brought results. I examined my actions during the day. Writing them down helped. I could ask myself whether I was being drawn into old BDD patterns of fear. That way I could see if I was setting myself up for trouble.
I have come to realise that when someone points out a shortcoming in me, my first reaction doesn’t have to be defensive. I have had to realise, and do realise through recovery, that it is okay to have some not-so-great things about you. In appearance or otherwise, it is okay! Some parts of yourself might be a work in progress; other parts have to be lived with. But constantly thinking about changing a defect keeps the crazy thoughts going.
My recovery from BDD involved much more than simple abstinence from BDD tricks. If we had problems in the past, it is unlikely that simple abstinence will solve our problems. The recovery process involves an active change in our ideas and attitudes; attacking our ‘cognitive distortions’ such as catastrophising, mind-reading, disqualifying the positive, etc. We need to face up to our problems in order to stop the preoccupations which lie at the core of our disorder. If we allow ourselves to plateau and cling to ‘fatal’ safety behaviours, we are giving into the symptoms of our disorder. Continually ask yourself: would I be doing this if I didn’t have BDD?
Moreover, don’t let BDD dictate what you do or don’t do. I had to learn new ways to live, to replace old BDD habits with new ways of living. I have learnt from experience that a wave of peacefulness washes over me after I have successfully reduced or eliminated a ritual. Of course, at first it was hard and anxiety-provoking. But when I really kicked the trick, my internal fires died out. That which opposed me was less troubling, maybe even gone. I no longer feel the need to struggle today. Trusting that relief awaits me insures its arrival. Amelia Earhart said, ‘Courage is the price that life exacts for granting peace’. I am starting to be spirit-filled and I get the feeling my greatest contributions will be discovered now that my BDD has taken a rest. Our creativity awaits our discovery; we just have to release it from the clutches of our BDD.
How do you feel when you look in the mirror? Happy? Not fussed? Whenever I saw my face in the mirror, I felt so sick I wanted to smash the glass. I thought I looked like a monster. It all started my first term of secondary school. A bunch of girls and boys in my class began bullying me about my acne, calling me ‘Spotty’. I tried to ignore them, but the insults made me feel really self-conscious. They started taking the mick out of my forehead, saying it was ‘massive’, and that I had a voice like a man just ’cause it was deeper than some of the other girls in the class.
As the months passed I got more and more upset. When you’re told over and over again that you’re ugly, you start to believe it. I began studying my face in the mirror, worrying about the way I looked. I decided I hated my nose: it was too big. My eyes squinted when I laughed, and my hair was too thin. And I was fat. I’d try holding my stomach in and pulling the skin taut, wondering if I’d be prettier if I was skinny. By the time I was 13 the way I looked was all I thought about.
I tried to talk to my school friends about how I felt. ‘Don’t be silly, Cari,’ they’d say. ‘We all feel like that.’ But I knew they didn’t. It wasn’t like I was having an ‘off day’; I felt like this constantly. If I was going out with mates I’d spend the entire day getting ready, changing my outfit and make-up about 20 times. Each time I’d hate the way I looked, take off my make-up and start again, only to hate what I saw and end up in floods of tears. In the end I’d refuse to go out at all. Gradually my friends stopped including me in their plans, which made me feel even more isolated.
When I was 14 I started self harming, cutting my wrists and neck with knives from the kitchen, or razor blades. I wanted to punish myself for being so ugly and worthless. Nothing made me feel better about myself. If someone paid me a compliment I wouldn’t believe it. If a boy glanced at me I’d imagine he was looking at me in disgust. As I got older I started finding other ways to hide. I had a fringe cut to hide my forehead and began getting tattoos and piercings. I felt that if I had something beautiful on my body, I wouldn’t be quite so revolting. Plus, if people were looking at my body art they wouldn’t be looking at me.
I knew my family were worried about how withdrawn I’d become, yet when they tried to talk to me I’d just snap at them. But as time passed I found it harder to keep my feelings to myself. Finally, one New Year’s Eve (as usual I was at home instead of out partying), I found myself blurting out everything I felt to Mum. How ugly I was. How I’d cut myself. Mum was shocked. ‘You silly girl,’ she told me as she hugged me, ‘there’s nothing wrong with you.’ She didn’t understand that her words couldn’t make me feel better. I wasn’t just feeling insecure; I hated myself.
Mum was convinced I had depression, so she took me to the doctor who put me on anti-depressants. They made me feel a bit better, but I still couldn’t shake the repulsion I felt about my own appearance. Months passed. Then one day, when I was 17, I sat down in front of the TV and started watching a documentary called Too Ugly for Love. It was about people who couldn’t have relationships because they felt they were so ugly. None of the people in the show were ugly, but their behaviour was like mine: they’d look at themselves for ages and hate what they saw. They all had something called Body Dysmorphic Disorder, or BDD: a condition that meant they couldn’t see themselves the way other people saw them; their self-image was so distorted they thought they were hideously ugly, when they were perfectly normal.
It was like a light bulb going on in my head. I knew this was what I had, too. Weirdly, just knowing what was wrong with me helped me to feel better. I found a counsellor, which meant I had someone to talk to, and having an actual diagnosis made it easier for my family to understand what I was going through. I still struggled to accept my body, but gradually I recognised that I didn’t see it the way other people did, and that it was possible for me to live a normal life. I even said yes when an old friend, Mike, asked me out. I’m working on the way I feel. I hope that one day I’ll feel truly confident in myself.
Looking back, I think I have had BDD all my life. There has always been something to worry about. I remember a year of obsessively looking at my fringe in shop mirrors, thinking I was going bald, and an obsession about brown marks on my teeth for a whole summer. My obsessions moved around my body until, four years ago, they took over my life. I noticed I had facial hair that was quite long, and got very upset. I was travelling at the time, and started to check it in different mirrors, from different angles, at regular intervals during the day. When I returned from travelling I tried different treatments to remove the hair. I felt very self-conscious sitting in certain lights. This carried on even though my Mum said she couldn’t see it. The treatments only worked temporarily, and I became convinced they were making the hair worse and worse and worse until one day I decided I wouldn’t look any more and would only think positive thoughts about my facial hair whenever it came up in my mind.
Amazingly I managed to avoid looking at my facial hair for about two years, and if I ever did see it I would look away. I felt like I was lying to myself, but it meant I could get on with my life. This seemed to work until my Mum bought me a magnetising mirror, and I noticed that the skin on my cheeks had got looser and more wrinkly, and felt very upset that one of the treatments might have ‘damaged my skin’. I remember sitting in a meeting at work for two hours with my jumper pulled up around my face!
I became more and more upset about it until I started looking for a treatment to fix it and discovered microdermabrasion. This magic treatment promised to smooth out my skin and get rid of wrinkles and the first treatment did seem to make my skin look smoother. But each treatment after that seemed to make it worse, even though I followed the instructions on how often to do it and how to look after my skin. I became more and more worried that I had now damaged my skin more, and this is when my BDD got really bad.
I visited a dermatologist who said my skin was fine and completely undamaged by the microdermabrasion and previous hair removal treatment. He even said my skin was quite good for my age and another dermatologist has since said the same – and that I should see a psychiatrist! But although I felt better for a few hours I found his words of reassurance very hard to believe. Subsequent reassurance from family and my boyfriend did nothing to make me feel any better, as there was no way my skin looked okay to me. I thought they must have low standards, or that they were being nice or just not looking close enough. The more I looked at my skin the worse it looked, and I became transfixed and increasingly horrified by how bad it was and how it was getting worse and worse.
I started piling on expensive anti-aging creams, and when I saw some new lines by my eyes I started to worry that the positions I was sleeping in was making it worse. I tried lots of different pillows and positions – some of them very uncomfortable! It got to the point I would look in the mirror over and over again, sometimes for hours on end, and not be able to go out because I was so self-conscious and panicked. Instead I would hide under a pillow and cry. It became difficult to see friends who had ‘good skin’. I looked at numerous magazines to see if I could find anyone with skin like mine. Sometimes I could, but I would only feel better for a short times. Nothing could make me feel better for more than a few minutes. It felt like being in a nightmare I couldn’t wake up from. Sleep was my best escape, although I would often dream about it. My poor parents caught the brunt of it, as I would phone them regularly, completely distraught and inconsolable. Out of work I had too much time to look in the mirror, but when I did eventually go back to work part-time it was stressful and I found it very difficult to concentrate whilst sitting under a strip light. My output was pretty low!
This went on for quite a few months. Every day it took a huge effort just to get up and out of the house with people looking at me. Tubes were a nightmare and the mirrors in plane toilets caused massive upsets. I spent hours upset or worrying about or looking at my skin, to the point where it became what I thought about most of the time. I found it very difficult to think how I would live with looking so bad, and with it getting worse the older I got. Although I was in a relationship, that in some ways made it harder, as someone was looking at me close up and seeing how awful my skin was.
I started CBT at the end of last year and have had 5 sessions. It is the most difficult thing I have ever done, as I am having to give up habits that seem impossible to resist. I have done better at some than others, and sometimes I have to start all over again when I slip into my old habits. But overall I am better able to concentrate on other things. It’s difficult to imagine fully recovering, but my CBT therapist, who specialises in BDD, has a very high recovery rate. I know that, one day at a time, I will get there.
At the age of 18 here I was, the survivor of a huge overdose. I lay in the hospital bed with my family around me, their faces stricken, pale and afraid, asking, ‘Why?’ I had my reasons. Every second was a struggle, and with every waking breath I thought about one thing: my monstrous ugliness.
I don’t remember when I started to believe that my skin had begun to thin, to redden and to grow pimples. But one morning as I got ready for school I just couldn’t bear the thought of being exposed and u, so I raided my mother’s make-up box. I covered my face with her foundation and caught the bus as normal. No one seemed to notice. The taunts of ‘ugly’ and the sarcastic comments of ‘nice hair’ continued unabated, but they were not accompanied by jibes about the fact that I was a man in make-up. I thought about my face all day, worrying that I still looked ugly and worrying that I stuck out like a sore thumb, but no one said anything, and it was better than having no cover for my skin. I was so pleased to get home but I knew it would be the same the next day. From that day on I had to wear make-up.
When I left school and got a job as a hospital porter I thought things would change, but they didn’t. Every morning was a battle with the mirror. I would put on make-up, pick at my skin and try to make myself look normal. I didn’t have to be outstandingly handsome; I wasn’t vain. I was a deformed monster and I just wanted to look acceptable. I would be late most days and I was so miserable being on display to the public that I couldn’t do my job. I would hide in the toilets and stare into the mirrors and just wish that I was back home in my dark bedroom where no one could see me. I lost my job, and when I seemed to lose everything else I tried to end my life.
I didn’t tell anyone about my fears relating to my skin; I was too embarrassed by it. And I didn’t think that there was anything anyone could do. I started to see a counsellor and went on prozac. I felt a little better but the problems were still there, my dark secret: that I felt like the phantom of the opera hiding behind my mask. I had to avoid getting wet, so I never went swimming and tried not to leave the house in the rain. I dreaded sweating and losing my make-up. Everyone has thoughts about their appearance, about wanting to look their best, but I was disabled by it. I was in mental anguish every day. All I wanted was to look normal.
When my long-term relationship ended it was at its worst. I was living alone, lonely and at the mercy of my mind. I had a job again, but it was getting harder and harder to make it in each day. I began to set my alarm earlier and earlier so that I had time to sort out my face before facing the guys at work. It went from one hour to three, and I was still late most days, if I made it in at all. I would look from the mirror to my watch, going from room to room to look at myself in different mirrors where the light was different, and might make my reflection more favourable. I would pick at my skin with tweezers and finger nails. I would put the make-up on, smooth it in, and then wash it all off again. I just couldn’t make it go right. I was never happy with how I looked. And when I glanced at my watch and saw that it was already time to be at work and my face still looked awful I would panic, and try to sort it one last time with my heart racing and my breath coming too quick. Then it would seem impossible for me to go to work at all, and I would fall to the bathroom floor and cry pitifully.
I told my boss that I was depressed and that some days it was too hard for me to be at work. That was only half of the story. I was depressed but it wasn’t as simple as that. I couldn’t tell him that even on the days I made it to work I was thinking about how bad I looked and comparing my skin to everyone else wishing I looked human. How could I tell anyone the embarrassing truth? No one would understand, and if I told them I had a problem with my face they would all notice my ugliness even more. I despaired, and before long the pressure and the pain had got too much for me and I tried to slit my wrists.
Despite the help I received from the mental health system it wasn’t long before I was back in hospital, having overdosed on my antidepressant pills. I was getting deeper and deeper into misery and couldn’t cope with even the smallest problem. I was cutting my arms regularly and isolating myself from former friends, even shutting out my family. I would ignore the phone and hide if there was a knock at the door, afraid to let anyone see me without first sorting out my make up.
I didn’t tell the doctors about the main problem because I didn’t want to admit that my face was my main problem. I understood my feelings of depression but I couldn’t justify my appearance worries, they just seemed too trivial. I didn’t tell anyone because I thought the problem was physical, not mental. I really was ugly. I researched online the possibility of having a chemical peel but it was too expensive. I stole tablets from my sister’s house and took a massive overdose that put me in a coma for a day and two nights. I survived, and it made sense that I should now tell my new doctor everything.
That was the best thing I could ever have done. He prescribed me a new antidepressant called Clomipramine that he thought might help with my other worries. I could not have imagined the dramatic effect it would have. Within a few weeks of taking it my skin seemed to improve. The redness of my nose dulled and the pimples seemed less intrusive. I still put on make-up but I did it more from habit than any actual need. I stopped taking the make-up to work with me, stopped thinking about my face for twenty-four hours a day. I would never be completely free from my thoughts but they were not so strong or so all-encompassing as they used to be.
I could begin to live normally, to go out of the house without hours of trauma. My doctor had truly helped me and the reason was a simple one: there had never been anything wrong with my skin. I had a mental condition called Body Dysmorphic Disorder, and the pills were easing the symptoms. My silence had been my enemy: an enemy that had ostracised me from the waking world for fifteen years.
I am now happily married. I still have occasional attacks of BDD but I have had the strength to write about my problems and turn my darkest thoughts into literature. My autobiographical work Suicide Junkie, which goes into detail about my battle with mental health, has now been published by the mental health publisher www.chipmunkapublishing.co.uk.
I now realise that I experienced symptoms of BDD from a very early age. I was always sensitive and self-conscious and felt that I was different from the other girls. My confidence increased slightly when I reached my mid-teens and I was able to camouflage my appearance with make-up, and straighten and control my hair. With the arrival of a few boyfriends and my marriage at 18 I felt a little more ‘normal’, but by this time the obsessive behaviours had set in.
At 21 my marriage broke down and I became severely depressed. At that point BDD took over my life. I was so repulsed and disgusted by my appearance that I thought no one would ever want me again. My parents took me to the GP who treated me for depression and prescribed Valium. The BDD and depression became so unbearable that I took an overdose and was then referred to a psychiatrist. The next seven years of my life were spent in and out of hospital, trying countless different types of medication. But the symptoms persisted and I took more overdoses. I explained that I felt distressed because of the way that I looked, but I was dismissed. This increased my feelings of embarrassment and shame and I felt that I was also a ‘sinner’ for worrying so much about the way that I looked. The BDD increased and my life revolved around the level of satisfaction I could achieve with the never-ending cycle of camouflage.
When I reached 28 I met my second husband and the years that followed were much better, with the distraction of my home, children, and career. Social activities were still affected, as it was difficult to be around others who were attractive and therefore ‘adequate’, unlike myself. Then, at 45, things took a serious turn for the worse with the failure of my second marriage, and the BDD became severe. I began checking my refection in the mirror for up to four hours at a time. I felt repulsive and hideous and didn’t feel that I looked human or deserved to live. I would constantly compare myself to others and to old photographs, always focusing on what I considered to be my worst features, for several hours at a time.
I thought about my ugly appearance every moment of the day, and again became suicidal. I couldn’t talk to family and friends about my feelings because I was frightened that they would think that I was vain, or mad. I couldn’t understand how anyone could bear to look at me and not recoil in horror. I was being treated at this time by a psychiatrist who tried different medications, including anti-psychotics, and referred me to two different psychologists who didn’t help at all. I was not offered CBT, and no one seemed able to help me.
Then I saw an advertisement in the local paper for a ‘non-surgical facelift’ and I visited the beauty salon and spent over £300 on the treatment. Any positive results were short-lived but it was at this time that the owner started to talk to me about cosmetic surgery. Despite having these disturbing thoughts about my appearance I hadn’t really thought about it before. But the more I researched it the more I was convinced that it might just save my life. This seemed my last chance.
Having once made up my mind I wanted surgery immediately, and I arranged an appointment with a surgeon within days. My main appearance concern at this time was lines on my face, although over the years I had focused on my eyes and my hair. I went into hospital two weeks later and had a facelift and lower-eye surgery at a cost of £3,500. I wasn’t nervous or hesitant at all. This was an emergency, and although I was battered and bruised afterwards it didn’t matter: there was at least some hope, or so I thought. As the days passed and my face healed I could still see imperfections on my face and my anxiety soared. I scrutinised every area of my face and was convinced that I had made things worse and now it was ‘all my own fault’. How could I have been so stupid?
Within months I was back at the clinic, having injectable fillers that were very painful and expensive, and only lasted a few months. The next year I went back into hospital for more surgery: another £3,000 for tissue implants under the lines and more eye surgery. Afterwards I felt the same. Disgusted by my appearance and horrified at what I had done. Despite all this, and because my BDD was so bad, I continued with injectable fillers and spent a fortune on various products over the next two years.
This unhealthy cycle of behaviour carried on until the year 2000. I was suicidal and didn’t know where to turn. I was still seeing a psychiatrist, and a psychologist, but my BDD remained undiagnosed. The psychologist discharged me after pointing out that despite all the help I had had from mental health professionals and cosmetic surgery intervention no one could help me. I returned home feeling that the end had come. I survived another overdose around that time, but it was followed by a spell of taking tablets day and night, because I could not stand the torturous thoughts.
I decided to give cosmetic surgery another chance. After all, it may just ‘work’ this time, and if it didn’t I would end my life, which seemed inevitable anyway. Again, having made up my mind, I went to see a different surgeon and was operated on within the week, taking a cancellation slot. The surgery was more costly this time, £8,500 for another face-lift, chin tuck, eye-brow lift and laser treatment. The money didn’t matter though. I cashed in my mortgage endowment policy without a second thought.
As is usually the case (I know now) I felt worse afterwards, and whilst nothing much had improved there were now new areas of concern. It was at this time that I saw a TV programme about a girl who didn’t like the way she looked, and who had a condition called BDD. I couldn’t believe that I was not the only one who felt this way, and I phoned the helpline and got information about BDD from OCD Action. Now, nearly seven years on, after years of excellent CBT treatment from David Veale and Rob Willson, I understand that all the surgery I had was not helpful at all. It made my BDD worse and far more dangerous.
I have learnt not to make demands on myself to look or be a certain way to be accepted. It is ‘enough’ just to be me, and I am grateful for the life I am now living which could so easily have been lost.
For as long as I can remember I had self-esteem issues. My first BDD attack was when I was 12. My Grandparents sent me off to an all-girls boarding school to get me out of my mother and stepfather’s house. I was there until the age of 14. Anyway, I saw a picture of a very thin blonde girl and something snapped. I got out my secret stash of extra-strength Tylenol and locked myself into the bathroom. It was a room with only a bathtub in it; the shower cubicles, toilets and sinks were in a different room altogether. I ran a nice hot bath and swallowed the whole bottle; when I woke I was having my stomach pumped.
That was the first of several suicide attempts. I was sent home for a week to ‘recover’. By the time I was in grade 9 I was in full self-hatred self-mutilating mode. I insisted I wouldn’t go back to boarding school and told them if they tried to send me back I’d find a way to get expelled. That year I was in two different schools in different cities (my parents moved in the middle of the school year) and in each one I fell in with a group of kids that weren’t of the greatest mindset. They did drugs, drank, pulled B-n-E’s, etc. Eventually my mother and stepfather kicked me out of the house because of my ‘attitude problem’. I ended up living with people that I would deem pretty ‘seedy’ but I had no where else to go. My grandparents lived 3000 miles away and I had no family to speak of other than my dad, who was working in the camps up in the Yukon.
I never pulled any B-n-E’s but to earn my keep I had to do equally if not worse things. After another failed suicide attempt, my parents moved back to my original city and my grandparents gave them the money to enrol me in a local private school, hoping that would turn me around. I was there for my grade 10 year and absolutely refused to return the following year, again making my point by slashing my wrists. I went to the senior high school in my area for my grades 11 and 12; there I made many friends, almost all of whom were just as messed up as I was.
By this time I had stopped eating and was surviving on an apple and two pieces of bread a week, along with lots of coffee, water and cigarettes. I was working out excessively and doing any type of drug that I could get my hands on. The drugs took away the hunger pains as well as the emotional pains. I graduated with a not-so-bad GPA, considering I was in the mall across the road smoking and drinking coffee the majority of the time.
After graduation my parents moved and left me to my own devices. Not long after that my dad shot himself and that sent me into a downward spiral. I got in really deep with the coke, bingeing for days – no sleep, no food, and finally crashing. Then the cycle would begin again. I knew the coke was ageing me and I didn’t want that, I HATED that! I looked like a shrivelled-up used piece of goods at the age of 21. At the time I thought it was vanity that saved me. I went back to school and have been in the same sort of business since then.
I met my husband when I was 24 and clean. Things were definitely looking up for me. I still hated myself and my appearance, but I somehow managed to put it on the back burner – until January of 2006. It was a month before my 30th birthday and I snapped. I couldn’t sleep, I couldn’t concentrate at work, my marriage was suffering terribly and it was all because of my body and my hatred of it.
Throughout all those years I absolutely loathed myself, everything about myself, especially my body: everything about it, from the shape to the length to the width. No matter how thin I got it was never good enough for me. If my hatred wasn’t in the front of my mind it was in the back of it. I constantly compared myself to others. I went though stages of not looking in mirrors, and of being mesmerized by them for hours. All shiny surfaces were up for securitization; anywhere I could get a glimpse of myself I would. Most of the time I walked away feeling defeated, angry and sad, because nothing changed. I was constantly trying to figure out ways I could get skinnier. I was envious of every female that I saw because they were all prettier and skinnier than me. I NEVER asked for reassurance from others because I was terrified of the answer. On the rare occasion I did go out I would wear the biggest, droopiest cloths and a hat, so no one could see me.
Just before my birthday I went to one of my many ‘quest-for-perfection’ appointments and the nutritionist asked if I had ever heard of BDD. She had asked how many inches I wanted to loose and I guess to her my answer seemed unreasonable. That night I went home and started surfing. I was glued for hours. I was in tears for hours. I had no idea there were others out there like me. I thought I was the most vain, selfish, narcissistic person ever, but reading about BDD, and in particular the personal stories of other sufferers, I knew I had found my answer! I finally knew what was wrong with me, and for me that was half the battle. I had spent years in and out of therapy without being properly diagnosed.
I made an appointment with my doctor the next day and told him my story, and about my recent ‘breakdown’. He started me on medication and referred me to a psychiatrist who specializes in CBT. It took several months of being on a waiting list, but I tell you, it was well worth the wait. My psychiatrist has diagnosed me with BDD, along with several other disorders, and we’re actually gaining on them, slowly but surely. I still have my rituals; I still compare and get envious, but it is diminishing as I catch myself, and correct myself. The therapy is very hard work, but I think in the end it will be well worth the effort.
My name is Nicole and I am 20 years old. I was diagnosed with BDD a little over a year ago and have spent my time since then trying to learn about this disorder. When I was first told I had it I felt relieved that there was a name for what was wrong with me, but I also felt sad because there was definitely something wrong with me. I remember when I was only nine years old I thought about cutting off my nose because it was too big. I was already tired of the snide remarks from friends and even strangers about how big it was.
When I was in junior high, my self-esteem issues went far beyond the average teenager angst. I couldn’t bear to look in a mirror or have my picture taken. On school picture days I would come home bawling, because I knew that my nose would be posted everywhere. I wore a windbreaker with long sleeves so I could use the sleeve to cover up my face. It made me feel better. In high school I discovered my knack for humour. I made fun of myself before anyone else could get to me first. Deep inside the demon was ready to come bursting out. I suffered from anorexia for years, as well as addiction to painkillers.
After I was diagnosed with BDD, along with panic disorder, I was put on an anti-depressant that has saved me. No, it doesn’t take away the thoughts about my nose or body; no, it doesn’t give me hallucinations that I am a supermodel. It helps me to think clearly, and not dwell on my ‘physical problems’. I know that no matter how many times people might tell someone with BDD that you are beautiful, you still won’t believe it. And what if you were absolutely the most gorgeous woman on the inside? Doesn’t that matter too? That’s what I try to tell myself each and every day. It’s sort of my mantra now. I’ve noticed that, once I stopped openly complaining about the way I looked, I began to receive more positive vibes from people. I am still not ready to be photographed, but hopefully with time and my therapy I will make that giant step!
I have suffered from BDD for 10 years; it started when I was 18. I was convinced that there was a patch of bumpy, scarred skin on my face and became obsessed with it. I only liked to go out at night as I thought that way people couldn’t see my hideous flaw. I had a boyfriend but was sure he thought I was disgusting and just didn’t say so. I couldn’t look people in the eyes, and had really low self-esteem. I tried various creams, would sleep with scar pads on the area, and spend hours a day in front of the mirror inspecting it. When I went out, I would cover the patch with makeup, wash it off and reapply it 4 or 5 times. I was convinced I was disfigured. I was living less than a life, unable to enjoy anything.
Things came to a head in 2005. I was breaking up with my boyfriend – totally mutual and friendly, I wasn’t really upset about it, but I started panicking because I was convinced I would never find anyone who would overlook my flaw. Finally I broke down and told my best friend about the bumps. I had never told anyone, I was too embarrassed and I thought everyone knew I was very ugly but felt pity for me. It was also that I didn’t want to hear ‘but you’re a great person’ or ‘it’s not so bad’. My best friend came up to my face and peered closely. ‘What bumps?’ She said she didn’t see what I was talking about. I thought she was just being nice.
I felt angry, and in a fit of BDD picked at the bumps I saw, which left what I thought was a huge gaping scar. For weeks, it was all I could talk about. I was no longer hiding my flaw but instead obsessing about it – on the phone to my sister, to my friends, who couldn’t understand what I was talking about. They listened patiently though. I was spending about 6 hours a day in front of the mirror. I would feel tears start up while at my desk at work, and go into the bathroom to sit in front of the mirror, hating my scarring. I hid in my house for weeks, drinking a lot and making excuses to friends so I didn’t have to go out.
Finally, one night, I broke down. I couldn’t stand it anymore. I was becoming increasingly paranoid that people on the street were talking about my skin. I had mirrors all over the house in order to look at my face from different angles and in different lighting, and it always looked horrible. I had a crush on a guy but ‘knew’ I could never get him because he’d only seen me in a dark pub and if I actually went on a date with him he would see how scarred I was. I called my parents in tears. My dad answered; he’d never heard me like this. He knew something was wrong and he told me my mom would fly out the next day to spend some time with me. I cried and told him about the big scar I had and how my skin was ruined, destroyed, and I couldn’t stand being so ugly anymore.
My mom came out the next day. She hugged me and I felt a bit better, and took the next two days off work sick. She kept telling me all she could see was a little scratch, but I didn’t believe her. We went to A&E and I was given medication, but I just told the nurse I was feeling suicidal, and didn’t get into the skin ‘problem’. My mom tried to help cheer me up at home, but I felt worse and worse. She forced me to go to casualty with her again, and this time, the psychiatrist came in. I broke down and told him my suicidal thoughts were because of my awful skin problems. He got me to point out what I meant, and then said, ‘We would like to admit you.’ My mind raced: I hadn’t thought that would happen. Still, I had no idea about BDD; I thought they were admitting me solely because of my suicide risk.
I spent the next three days in the common area waiting for a bed in the psych ward. Thank God for my mom, she came every day to visit. That time is very hazy, I was on a lot of medication and it wasn’t very comfortable. I moved up to the psych ward where I stayed for seven days. I was assigned a nurse and a psychiatrist, who I talked to every day. Despite my extreme embarrassment about my skin, I showed the doctor my problems, including this new scar, and the other bumps and scars I thought I had. But at this point the doctors and nurses just listened to me, and didn’t offer any advice.
My mom and I met with the psychiatrist on the 3rd or 4th day, and he said he had a diagnosis. Body Dysmorphic Disorder: I’d heard of it but didn’t know a lot about it. He said it was severe, to the point where it was paranoid and delusional. I was shocked. I asked him if he was sure, if maybe it wasn’t just the lighting in the room or something. He said yes, we’re sure. Back on the ward I asked the nurse, ‘But can’t you see the bumps and redness?’ She said, almost sadly, ‘No, I really can’t.’ It was like a light bulb went on: there was nothing there.
It was good to have a name for what I was suffering from, and in a way I felt like I had a new chance at life. For 10 years, I had hid my face in shame, thinking that I was scarred, avoiding social situations and opportunities. But it wasn’t really there – I was attractive after all! I felt so happy that I wasn’t disfigured, but sad that I had wasted so much time thinking that I was. It was difficult because I still saw the scarring but had to come to terms with the fact it wasn’t there.
It’s been a year and a half since that time. I’m slowly weaning off my medication. I have also been able to stop the compulsive mirror checking and reapplying of makeup. I am happy in my job, and was married last year to a great guy. I’m not saying everything about my BDD is gone; I still suffer from symptoms if I catch myself in a brightly lit department store, or if someone is close to my face, especially in the daytime. It’s as though most of the time I realize it’s not real, but sometimes my mind is powerful enough to convince myself that perhaps it is, even though deep down I know it’s not. But all in all, I feel good, and I’m glad for my journey. Although I had to hit rock bottom and struggle for a while, it made me stronger, and I got my life back.
Hi, my name is Felipe and I used to suffer from BDD and Depression. I don’t know how it started but I think it was at some point when I was between 13 and 15 years old. In my case I felt I had a problem with my speech. I couldn’t explain it to doctors; I knew I didn’t have a stutter or anything and there were times when I spoke normally – mainly when I was with my family. So my problem must be psychological.
I struggled on my own for about 6 years, and during this time I got low grades, had almost no social life, lacked the will to do anything, and didn’t attend school very often. In fact the only positive thing I can say about this period is that, while I stayed home, almost all my free time I spent reading, which is a good habit I still have. My parents thought it was just their teenage kid going through an undefined crisis or something, but didn’t think it was very important. Not even when their son remained in the car when they went out, remained in the hotel when they went travelling abroad, and had no social life.
One thing that helped me was Buddhism, and meditation. When I started doing meditation it hit me like a rock that life was very short, and I had to live it no matter what. So, still under the effects of BDD I started making the effort to go out, use the bus and underground, even though I still thought everyone was looking at me for being so utterly hideous and different from other people. Eventually I sought psychiatric help, and went on to have regular therapy. It’s helped me a lot. I’m taking an antidepressant, and it helps too. Knowing that there is an illness with the very symptoms you have is the first step to recovery, I think.
A day in the life of a BDD sufferer
Imagine you are at a conference and as you look around you notice the room is packed full of gorgeous people that you admire and want to impress or perhaps even date (let’s say for the sake of argument, Barack Obama, Richard Branson, famous supermodels, Angelina Jolie, Brad Pitt and more). Imagine the organiser suddenly dims the lights, puts an extremely bright spotlight on you and asks you to deliver a speech on why you are all gathered there; you are unprepared and the topic is on something they all know more about than you (I don’t know, maybe ‘Why America is the best’… but you are British and have never been across the pond, while clearly the above attendees have).
You start to mumble and blag your way through, knowing that all the attendees know more about that topic than you and will immediately spot all the mistakes you are making. In fact, one by one, you start seeing each of them rolling their eyes, smirking with distain and even whispering conspiratorially to the person next to them as they turn to stare at you. You feel yourself going red, you start to visibly sweat and your shaky voice is giving you away even more and causing a scene. The organiser takes pity and interrupts you to say “thank you for your… contribution” and proceeds to deliver the finest, most eloquent, witty and intelligent speech you have ever heard on the topic. The crowd love him and give him a standing ovation, as some glance over uncomfortably because they clearly feel sorry for you, considering how awkward the situation is and the obvious ‘elephant in the room’.
Afterwards, you head home. On your way to the kitchen to make dinner and take care of important ‘life admin’, you glance in the mirror as you pass it, and immediately freeze. Oh no. Your hair must have gotten caught in the rain before the conference and has done that unique frizzy thing that only your hair can do, which makes the bowl haircut disaster that the hairdresser created the other day even worse. You also appear to have the largest, pusiest, ugliest, angriest, reddest spot known to man that has set up home right on the tip of your nose! You have large bits of black food from breakfast stuck between most of your teeth, your skirt is visibly tucked into your granny pants and you have a large stream of toilet roll stuck to your shoe. You also have mascara stains down your cheeks from a panic attack you had that morning just before you went into the conference, so it must have been obvious to everyone that you were not confident and knew you didn’t deserve to be there. In fact, your whole appearance most likely accounts for at least some of the looks you received that day.
When your partner arrives home, you tell them all about the scandal that happened that day, waiting for them to be as outraged as you at the unfairness of what you’ve had to go through; but instead, they tell you “you look beautiful today” and “in fact, this is the best I have ever seen you look”. You feel shocked and betrayed that they are mocking you by telling you such a lie or, more scarily, that they think this is actually what you normally look like and is the best you could ever look. You withdraw from them and make a note to store up that resentment for later. You go to bed feeling humiliated and ashamed, hoping tomorrow will be better. When morning comes, you get up and make your way to the second day of the conference, determined that today will be the day you will prove your worth to these amazing people. But wait – you get home that day, look in the mirror and you have somehow managed to make all the same mistakes again!! How is this possible?! As you fall asleep that day, you start to lose confidence that tomorrow will be different.
The following day, remembering how you must have been appearing to others the last couple of days and the growing likelihood that today is no different, you are quiet at the conference. You do not speak unless you must, you avoid eye contact, and you pull your hair forward to cover some of the likely abominations on your face (such as the spot and possible food between your teeth). In fact, whenever someone starts to talk to you, you make an excuse as soon as possible and go hide in the bathroom before they notice any such deficiencies. You see someone else observing this and through their eyes and body language they communicate an unspoken message that they understand why you are doing this, having witnessed your aesthetic disasters the last couple of days, and would indeed be taking the same action if god forbid they were in your position. At the end of the day, you rush home as quickly as possible, head down when passing people in the street. When you get in, you let out a sigh of relief that you are now in a safe place and spend the rest of the evening focusing on what you can do to avoid such future disasters, whilst crying tears of frustration and sadness.
This is the reality of a BDD sufferer – they go through the exact same scenario, except that the ‘abominations’ they see are skin-deep and cannot be washed away or covered. They also go through this humiliation EVERY SINGLE DAY, without any break in-between to build themselves up again; in other words, the conference never ends. BDD afflicts 1 in every 50 of us, which is rather common – this means there are people in your school or workplace going through this battle right now. The private shame of sufferers and misdiagnosis (for example, of anxiety or depression) mean that this horrific illness is often not well known about or given appropriate treatment. The unrelenting pervasive pain experienced can lead to devastating consequences – BDD sufferers are 45 times more likely to commit suicide than the general population and suicidal thoughts are more common than in ANY other mental health condition including major depression. Thus, in many ways, it must be handled with the upmost respect and viewed as a potentially fatal illness if left untreated.
BDD is NOT about wanting to look good, it is about wanting to look ‘normal’ or even ‘below average’ but without being a walking freak show (hoping to be considered ‘attractive’ would be too high an aim). It is about being able to see the beauty and worth of EVERYONE you come across, except yourself. It is a medically-recognised illness, much like diabetes, that anyone is susceptible to given the right combination of genetics and environmental factors. It is NOT what defines someone or their personality, in fact given the right treatment it can largely be successfully ‘removed’ and the person, not ill or in pain anymore, shines bright and can be who they were before this insidious illness attached itself to them.
Stories by relatives
It was Thursday morning, 12 March 2015, when my father told me that David wasn’t breathing on his own. Half-asleep, I assumed the staff at the hospital had placed him onto some sort of life-support machine. In a way, I was actually relieved. David had been in a psychiatric ward after being rescued from the edge of Beachy Head by the Chaplaincy Team that patrols the area. Since being admitted into the hospital, he’d been talking about how much he regretted not jumping, and how he’d find a way to end his life there instead. My immediate reaction to my father’s news was that that would be impossible (even for him) if he was on some sort of machine, and so despite the seriousness of the situation, and how terrible it was that it had come to this, I was relieved – almost glad. I thought this would be both the lowest point and a turning point. It couldn’t get any more extreme than this; he’d be shocked into taking positive steps to get better. It would force him to.
A few minutes later, my father came back to tell me that he was dead. I remember asking him a stupid question about whether they’d phoned us or he’d phoned them. It seemed important to find out, since there must’ve been a miscommunication: my brother wasn’t dead. And in those first few seconds of denial, there was a sudden realisation too, as if all my feelings towards him had crystallised, and were finally clear to me, only now at the exact moment when it was too late to tell him.
Looking back at his life, my brother had undiagnosed autism and Asperger syndrome for as long as I can remember, but the first time David showed signs of BDD was when he faxed home drawings of himself while he was studying in Rome as part of his degree. At school he’d been bullied about how he looked (he’d been bullied about a lot of things) but this was the first time he began to publicly obsess over and express shame about aspects of his appearance. He went on to finish his studies at Cambridge (Medieval and Modern Languages, and Philosophy) and graduated with a scholarship, but he was already battling severe depression. There were many occasions over the years when he’d tell me he wished he’d never left academia – not because of the social side of university life (he actually said he regretted trying to focus on that side of things) – but because studying was one of the few things – perhaps the only thing – that he truly wanted to dedicate his life to, that he could feel a real sense of achievement with. For people like David, whose minds are ever restless, always inquisitive, I think academics is one of the few things that brings them a semblance of peace.
He left university, but after a couple of jobs that didn’t work out, David’s mental health issues prevented him from working and having any kind of career. He had ongoing depression, but the next time BDD surfaced again was probably about ten years ago when he started to fixate on what he considered to be unacceptable hair loss. He had a successful hair transplant – but not long afterwards he began to talk continually about other perceived flaws: his nose, his jawline, his forehead, the asymmetry (as he saw it) of his face . . . in all likelihood the seeds of being bullied as a child had finally started to take root; certainly the crippling insecurities had been pushed to the forefront of his mind. Combined with his autism, Asperger syndrome and depression, David’s BDD would eat away at him for the rest of his life. It would consume him; eventually it was nearly all he could think or talk about.
It’s a testament however to his character and generosity of spirit that in spite of the scale of his suffering, David was dedicated to helping others through his work as a trustee of the Body Dysmorphic Disorder Foundation. A jack of all trades and master of them all, he was at home helping out on the IT side of things as he was drafting eloquent introductions to how BDD shaped Kafka’s writing. David was passionately committed to advancing understanding of the disorder and raising the level of support available to sufferers. He was immensely proud of how much the Foundation has accomplished in such a short space of time. If only he could be here as it continues to grow and thrive.
Those lucky enough to have got close to David will never forget him. He lives on in our memories, and in the inspiration and determination he continues to give us. His friends and family lost a unique intellect and an extraordinary person – with David on your side, you really felt like anything was possible, that any problems could be overcome, that any goals could be achieved.
I can only guess at the level of suffering those affected by BDD go through, but I wish those who take their own lives because of it could see the effect that suicide has on their families and all those who care about them. I wonder if they could see how much it tears lives apart, then despite all their pain, maybe they wouldn’t go through with it. If you have BDD, please, please do all you can to keep fighting, to make use of the network of support that charities like the Body Dysmorphic Disorder Foundation are doing so much to promote and develop. And if you’re close to someone who has BDD, keep doing all you can to help. And always let them know how much you care about them. BDD sufferers know they need you; let them know how much you need them too. Along with how much I loved him, I think that was what I realised at that moment my father told me David was gone.
My brother Martin Joseph McAnulty was 22 when he committed suicide on the 24th November 2010. At the time he passed, neither Martin nor his family had heard of the debilitating condition called Body Dysmorphia Disorder. But those of us who loved him sought an explanation for his suicide, and the note he left us, from a psychiatrist. And so my experience of this condition comes not from living with someone diagnosed with it, but from grieving and trying to understand my brother after he had passed.
Martin was an intelligent, normal ‘lad’ who participated in activities typical of any boy his age, such as going out with his mates, playing football, supporting a football team (Tottenham) and spending time with his family. He studied Creative Writing and Journalism at St Mary’s University, and was involved with the university newspaper. It’s hard to imagine that someone so apparently outgoing could be suffering from such a condition. But after he passed we realised that he had been suffering alone, and in secret.
On the night he died Martin came home to see my mum, dad and sister. I was living at university, so missed seeing him that final time. They thought it was unexpected that he had come home from university. But he explained that he was going to visit a friend, and so thought he would pop in and say hello. Martin spent time with my mum, dad and sister separately. Looking back they can see that he acted in a way that was unlike him. He declined the radiator key my dad had offered him for his uni house, despite needing it, and asked our mum if she was proud of him. Then, instead of visiting a friend like he said, Martin went to a nearby field and sadly killed himself. It was a passerby that noticed Martin and called the police.
Once he was identified the police came to our house and informed my mum that Martin had died. His family was called home, where we were told what had happened. The police gave us a letter written on Martin’s laptop that they had printed off for us to read.
‘The reasons for doing this are because I cannot live with my scarred nose anymore. I have tried oils, creams and anything else I can put on it. The condition of my nose is progressively worse at time of writing; skin is peeling off and it hurts when I move it the slightest bit. I cannot shower properly as my nose ends up in excruciating pain and whenever water or sweat goes on my nose, more skin peels off.
‘When I was looking in the mirror all the time it was not because I was vain, but scared. I was worried and petrified at the state of my nose. Whenever I asked for help I hit a brick wall. I was told “don’t be silly I can’t see anything”, or “stop being vain stop looking in the mirror”. No-one offered me real honest advice, maybe out of politeness, but it didn’t help.
‘I’ve had enough of fighting and battling my issues, instead of ‘manning up’, I’m giving up. I’m a beaten, broken man, in the words of Shawshank redemption, “Get busy living or Get busy dying.” I’ve chosen to do the latter.’
This was a portion of what Martin wrote in his final letter. He also wrote of the love he felt for his family. At this point none of us could understand how he could have done something so awful over something we felt to be insignificant and nonexistent. It was only when my auntie Elizabeth, who worked in health care for many years, did some research into the symptoms Martin describes above and other feelings he wrote of in the letter that she came up with an answer. We contacted Dr David Veale, a psychiatrist with expertise in BDD. He agreed that Martin had been suffering from the condition. In some ways my aunt gave us a gift: we might not have closure on the fact of his death, but we have an answer to the question of why he felt he had no choice but to die.
Nevertheless, the pain we feel individually and as a family is one that is difficult for me to describe. We are completely heartbroken and helpless. I sometimes try to put myself in his shoes and understand the suffering he went through alone, but it is impossible, as I can’t experience what he felt. Looking back, Martin had shown signs of body dysmorphia. But they were so intermittent, and so secretive, that it was impossible for us to see what was wrong. He did things such as shaving the top of his eyebrows when he was 14, asking me to apply makeup to his spots, and staring in the mirror for long periods of time.
It has been hard to come to terms with the fact that he died from a condition we’d never heard of, and at times my mum feels unsure he did die from it, since it was never diagnosed. But this is like saying the thousands of men who have died from undiagnosed prostate cancer didn’t really die from it. Martin went to the GP to ask for help with his nose before he passed away. He was given steroid cream, but of course this wasn’t what he needed. I don’t blame the GP for not knowing that Martin had been suffering mentally, because I don’t think he knew either.
With support from our amazing family, supportive friends and counseling, we started our journey towards understanding his death and the way in which Body Dysmorphia affected him. Martin made his choice, and none of us could have prevented what he did. I do believe that if he had got the answer he so desperately needed – a diagnosis – then maybe I wouldn’t be writing this testimonial about him now. My hope is that through raising awareness about this condition, hopefully others will find their answer. I believe that if Martin’s experience helps to save others, then his death wasn’t in vain.
As a friend or family member of someone who has BDD you are in a unique and influential position with regards to his or her recovery. However, it is sometimes easy to let yourself become overwhelmed by the stresses and strains of helping someone through what is an extremely difficult period of their lives. Remember that your own health and well-being is as important as your loved one’s. It is critical to his or her recovery that you ensure you can provide the best support that you can. There are steps you can take to aide you in this; help is out there.
The more you know about the disorder the more effective you can be in dealing with and understanding what it is your loved one is going through. Get to know this site: follow the links, get the books, and read the articles. Aside from the benefits to making your role easier and more effective, people with BDD may at times (for a whole host of reasons) be reluctant to inform themselves, and so it is imperative you do.
With your loved one’s consent, it may be appropriate to arrange a session together with their therapist. The benefits to this are manifold. Keeping the support network for your loved one as consistent and coherent as possible will benefit his or her recovery. In addition, the therapist may be able to open up avenues of support for you, advice on how best to manage the disorder, and above all reassure and help you in your role.
What follows are some personal insights and experiences I have had from living with my partner who is recovering from BDD. I hope this is a helpful tool, amongst the others (given above), to aid the recovery of your loved one.
What is most difficult and at times frustrating to comprehend when encountering this disorder, is how on earth can he be so dramatically concerned about his appearance. How can he think he looks disgusting? He is clearly not.
First of all, I have found it literally impossible to convince her otherwise; this line of reasoning is at best futile and at worst exacerbates the disorder. The simple fact that the way she looks is not causing the disorder. The way you think she looks is most certainly not the cause but most importantly, the way she thinks she looks is not the cause either. The distorted view she has of her appearance is a symptom of the disorder, not a cause. However, her perception of herself is very real to her It is important not to undermine this and the distress that it causes.
While it is important to be clear that you do not agree with his opinion of himself, it is equally important not to be drawn into conversations about his appearance. What I have found invaluable in these situations is to widen the context of the conversation, to focus on why his view of himself is so distorted? On an ongoing basis, it is important to remind him that he is dealing with an anxiety disorder, disguised on the surface by his symptoms and safety behaviours, and especially disguised by what he sees in the mirror.
You should be striving at all times to focus on dealing with the roots of the anxiety: the core beliefs. Try to be patient and encourage her not to over-indulge in her symptoms and safety behaviours. It is very beneficial and important to acknowledge and encourage the commitment and courage it takes for her to begin talking about and overcoming her BDD. When my partner began to be able to verbalise her anxiety to a wider network of friends and colleagues, much of the embarrassment and secretiveness that held the disorder in place was dispelled. People tended to be extremely understanding and supportive. This made the sometimes-claustrophobic nature of being her sole confidant, on such an overwhelming matter, lighter on both of us.
It is vital that this is not done on his behalf, and equally that he not be coerced into to sharing his problem, as this will serve only to compound the embarrassment and anxiety holding much of the disorder in place. Reflecting on the period before my partner’s diagnosis of BDD with that of the period after her diagnosis and the subsequent professional help she received, it is astounding how much she has achieved. Much of what is written above (for purposes of clarity) seems to show a smooth arc from diagnosis to recovery. I feel it necessary to assure you that the experience was nothing of the sort, and still is not. It remains an experience of struggle and confusion as to what exactly BDD is and how best to tackle it. What is, I hope, clearly outlined, is a summary of how I (and many others) have been able to support her onto the road to recovery. This recovery has proved very real and dramatic since she began receiving cognitive behavioural therapy and challenging directly what lies beneath her feelings of disgust at her appearance.
I cannot stress enough how important this first difficult step – of actively seeking help from professionals – was for her. What is important to remember is that BDD desperately wants to keep itself in place; it created in my partner a vicious circle of embarrassment, shame and secretiveness that made talking about it literally unbearable for her. It is, however, this process of communicating that has been the most successful tool in tackling the disorder, and the most effective support I have been able to provide.