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BDD, a family perspective – by Ruth’s partner

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.

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”

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 she be so dramatically concerned about her appearance. How can she think he looks disgusting? She 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 her opinion of herself, it is equally important not to be drawn into conversations about her appearance. What I have found invaluable in these situations is to widen the context of the conversation, to focus on why his view of herself is so distorted? On an ongoing basis, it is important to remind her that she is dealing with an anxiety disorder, disguised on the surface by his symptoms and safety behaviours, and especially disguised by what she sees in the mirror.

“Try to be patient and encourage her not to over-indulge in her symptoms”

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 her behalf, and equally that she not be coerced into to sharing her 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.

“BDD desperately wants to keep itself in place”

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.

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BDD, a family perspective – Claire’s story

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.

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 Dysmorphic 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.

“It’s hard to imagine that someone so apparently outgoing could be suffering from such a condition”

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.’

“At this point none of us could understand how he could have done something so awful over something we felt to be insignificant and non-existent”

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 non-existent. 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 counselling, 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.

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BDD, a family perspective – Sergio’s story

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 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.

“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.”

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.

“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.”

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.

“With David on your side, you really felt like anything was possible”

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.

“BDD sufferers know they need you; let them know how much you need them too.”

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.

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Marie’s Story

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.

My first memory of BDD symptoms was when I was out shopping with my Mum and I noticed people looking at me as they walked past. I remember telling my Mum constantly that, “Everyone is staring at me” and I wanted to leave. This happened every time I was in large social settings and it became a huge effort to go out. My Mum would always tell me that it was possible they were admiring me or my outfit and that everyone who meets me tells her how beautiful I am. These were comments I constantly brushed off as classic ‘Mum talk’.

I don’t remember a time when I ever felt content or happy about my body and appearance. During my High School years, I was bullied about my weight, my appearance and, later, my intellect. Comments were made like: “No amount of makeup will fix your ugly face”; “It’s actually disgusting how fat she is”; “She’s so dumb she actually doesn’t deserve to be here” and jokes about me doing further Maths. These were, unfortunately, things I heard daily. Those comments, on top of the pressures every normal teenager faces, were enough to cause me to enter a very damaging spiral.

“I would go home and try to find ways that I could look more like them because, in my mind, they looked so much better than me.”

My focus completely shifted to my physical appearance because that seemed to be everyone else’s focus on me. I began purging. I thought if I lost heaps of weight, I wouldn’t get bullied anymore and I would be happy and skinny like everyone else. That was my mentality and I stuck to it for a very long time. One of my best traits is that I’m extremely self-motivated and one of the my worst is that I can be extremely stubborn – if I want to do something, I’ll do it and I’ll do it until I’ve pushed myself to my absolute limit. I lasted about a month or two of skipping lunches at school and heading to the bathroom after dinner before I realised that nothing had changed; I was physically and emotionally wrecked. I then looked for the next fix and began to spend hours every single night Googling ways to lose weight fast including diets, pills, surgeries… anything I could find. I would spend hours looking at myself in the mirror thinking of things I could get done and changes I could make from head to toe. At school, I was constantly jealous of other girls and friends of mine, which caused me to become incredibly introverted. I would go home and try to find ways that I could look more like them because, in my mind, they looked so much better than me.

University came around and that brought on a slew of more insecurities. These insecurities were in the form of dating, boys and social gatherings. Social situations were always very difficult for me. I was very good at putting on a front and saving face (a bit too good) and going from the dancefloor, into a taxi, then into bed and crying myself to sleep; this became an all-too-familiar weekend routine. Pool parties, beach days, and beach houses were a no-go zone for me and even the clothes I wore became incredibly limited. This was all so I didn’t risk friends looking at me and thinking I was fat.

“My preparation was extreme dieting and exercising and a mirror analysis most nights”

When beach days or pool parties came around I would always go into a panic. I hated events that weren’t planned weeks in advance because I needed time to prepare. My preparation was extreme dieting and exercising and a mirror analysis most nights. One of the biggest turning points for me was a friend’s birthday party in Cape Schanck. It was a Hawaiian themed party and everyone was going, including the guy I liked. I got the invite weeks in advance and started preparing my diet and exercise routine. I exercised for 1-2 hours a day and ate very few calories every day, often causing me to feel faint or to pass out mid-workout. For the first time ever, I felt like I could go to the event, be in a bikini and look somewhat okay next to everyone else. It was a huge deal for me to reach that point and I worked myself to the bone those two weeks for it. The night before I had my best friend’s 21st birthday and we were all leaving in the morning, so I had my bags pre-packed. I was doing my makeup when I got hit with the comment, “Exercises every day and still looks that fat”. After weeks of putting myself through hell, that broke me. I wiped away my tears, finished my makeup and went to the 21st with a happy face on and pretended that work had called me in to cover shifts and I couldn’t come to the weekend away anymore. The reality was that I spent that whole weekend in bed crying. I was looking at photos of my friends having fun, becoming extremely jealous of their mentality, pretending I was at work and then crying. I never knew what it felt like to just be able to go to someone’s beach house on a whim and to have fun and I had come so close to experiencing that. I think I out-cried myself that weekend. Two days later I promised myself I would never allow myself to feel like that ever again.

Dating was a whole other situation. I always went in pretty confident with dating until it got to the intimate point and I would freak out. I thought that once they saw my body they would think, ‘Woah, she’s actually so fat and ugly’, which caused me to often try to leave my clothes on during sex. I wanted so badly to be confident and to express myself but I had been scared into not exposing my body and I couldn’t shake it off with anyone. Add one extremely toxic situation with a guy for five-six years into the mix and the spiral just got deeper. I started studying and comparing other girls he liked as though it was my job. Every single girl was a supermodel in my eyes and I got uglier and uglier with each comparison of each girl. I didn’t realise how bad it had become until mid-argument when this ex had to tell me to, “Stand up for yourself”. Things took an interesting turn when I began to get consistently slut-shamed. I had one ‘friend’ tell me that I “get around a lot” quite recently and that I “have nothing important to say” while another made a tree of people in our group who had hooked up and placed me in the centre, accompanied with judgmental comments and gossiping. Being slut-shamed by people I thought were my friends made me see myself as an object. I believe you are treated the way you allow others to treat you and I began to allow a lot of people to treat me like an object; I went along with a lot that I wasn’t okay with at the time.

“I had days when I really liked the way I looked but when you hear something enough you start to believe it.”

Although I always thought I was uglier than the average person and felt incredibly damaged from other people’s perceptions of me, I never wanted to change my physical appearance. I had days when I really liked the way I looked but when you hear something enough you start to believe it. I began to see everything I saw in the mirror in a negative light and assumed the role of someone that had zero self-esteem. That was the biggest mind twist for me. My mind shifted into being unhappy with myself because of other people, when in reality I feel like I’m the strongest and most confident person I know. Confidence to me has never been about being loud or being the centre of attention; it’s about being sure of who you are, your intentions, believing in yourself and backing that. I always knew deep down that I had something to offer and was going to get through the bullying and BDD and come out of it much stronger.

I haven’t got over BDD. I don’t think it never really goes away. I go through phases when I’m booking surgical consultations and cancelling them the next day and phases when I’m over-exercising and being too hard on myself. But then I go through phases when I’m wearing clothing that I never had the guts to wear before and feeling myself. Just the other day I was shopping with friends and as we were discussing what sizes we would be. The sales assistant came up to me and said, “You’re definitely an extra small, you’re tiny”. While many people might find that complimentary, I was about to reach for the medium size and was very taken aback that she looked at me and saw me as an extra small and labelled me as tiny. I became extremely nervous about trying the clothing on because I knew it wouldn’t fit me in the slightest. In actual fact, it was probably a bit too big and I had a moment in which I had to shift my mindset to be a bit kinder to myself.

I feel extremely proud of where I’m at today but it wasn’t easy and has taken me years of self-work and a shifting of priorities to get to the more relaxed mindset about physical appearance I have now. I skipped a lot of social events that made me uncomfortable. I don’t subscribe to influencers or brands that flaunt unrealistic bikini bodies on social media. I completely cut negative people who evaluate success as having an amazing job, boyfriend and being skinny from my circle. I have come to just focus on being single and finding my own limits and happiness without being influenced. The biggest thing I’ve learnt is just to be kind. You never know what people are going through; some people are just more vocal than others. Still, to this day, there are friends and people I’ve dated that would read this and have no idea I even remotely felt this way about myself or was going through BDD. I’ve also learned a hard lesson that – you are who you surround yourself with. The way you feel about life, yourself, your future is completely influenced by your conversations and experiences and, therefore, it’s so important to be around people who push the good sides of you. I’m extremely lucky to have a strong and supportive family and friendship base but I never take that for granted and I work to maintain those bond constantly.

Today, I live a very healthy lifestyle but I do that because I grew up in a healthy and active household. I have two doctor parents and was raised to take care of myself; not in order to look skinnier, but in order to live a stress-free life. I can genuinely say that I feel really grateful for my appearance and body. I feel more confident in myself than I ever have and I don’t let BDD dictate what I do or don’t do anymore. At the risk of sounding cliché, life really is too short to watch everyone else enjoy themselves. Oh and I also swam in that Cape Schanck pool for the first time a few months ago with no worries and it felt damn good!

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Holly’s Story

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.

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’.

“You glance in the mirror as you pass it, and immediately freeze”

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”

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’”

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.

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Felipe’s Story

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.

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.

“My parents thought it was just their teenage kid going through an undefined crisis”

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.

Thank you.

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Erin’s Story

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.

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.

“My best friend came up to my face and peered closely. ‘What bumps?’”

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.

“She kept telling me all she could see was a little scratch”

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 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”

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.

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Nicole’s Story

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.

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.

“On school picture days I would come home bawling because I knew that my nose would be posted everywhere”

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!

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Val’s Story

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.

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.

“Eventually my mother and stepfather kicked me out of the house because of my ‘attitude problem’”

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.

“I had stopped eating and was surviving on an apple and two pieces of bread a week”

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.

“I absolutely loathed myself, everything about myself”

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.

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Sue’s Story

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.

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.

“I felt repulsive and hideous and didn’t feel that I looked human or deserved to live.”

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.

“I visited the beauty salon and spent over £300 on the treatment”

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.£8,500 for another face-lift, chin tuck, eye-brow lift and laser treatment.

“I returned home feeling that the end had come.”

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.

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The Body Dysmorphic Disorder Foundation. Charity no. 1153753.