Commonly Co-Occuring: Body Dysmorphic Disorder and Substance Abuse

Body Dysmorphic Disorder

In This Article

Body dysmorphic disorder often occurs with substance abuse addictions, which may serve to either self-medicate or to control weight. Also, because I am a sufferer, I would like to share personal experiences with the reader, in attempt to give a well-rounded perspective on the subject.

BDD is a mental illness, a condition in which the person becomes obsessed, preoccupied, or otherwise focused on a perceived physical flaw. This flaw may be real, objectively false, or something in between. Obsessive mental conditions such as Body dysmorphic disorder impact neurotransmitters and work on the brain in a similar way to substance addictions. They are also known as process addictions – the patient is actually addicted to the belief/thought process and behavior itself.

Body Dysmorphic Disorder Signs and Symptoms

  • Preoccupation with one more aspects of physical appearance, self-consciousness
  • Frequent mirror-checking or mirror avoidance
  • Persistent belief that a defect in appearance equates to being ugly
  • Belief that others notice this defect, judge or privately ridicule
  • Avoidance of social activities or agoraphobia (fear of public places)
  • Desire for acceptance or validation/denial of perceived defect
  • Plastic surgery addiction, often to minimal or no satisfaction
  • Excessive grooming, use of makeup, wigs, or other items to camouflage defect
  • Excessive exercise
  • Dislike/avoidance of appearing in photos

The BDD sufferer, very often, wishes they could disappear. What flaw they focus on often cannot be changed. This is partially due to genetics and nature, and partially due to the fact that the person cannot gain personal satisfaction, no matter what they do.

You see, BDD is really all about how we perceive ourselves – not just in relation to ourselves, but also society and culture. There is a direct relationship between what our culture finds attractive and what BDD sufferers fuss over. And unlike eating disorders alone, body dysmorphic disorder affects men and women in numbers which are roughly equal.

BDD is often present along with one eating disorder or another, but not always. In my case it was – a lifetime of dieting, finding acceptance, dieting again, etc. An obsession with thinness is not uncommon, but some people are focused on their nose, hair, skin, muscle tone, breasts, genitalia. It could be almost any physically presenting part of the body.

Body Dysmorphic Disorder Treatment

BDD is usually treated like other eating disorders and addictions. Comorbid conditions, such as substance abuse, depression, anxiety, and other obsessive compulsive disorders are common. These are treated in conjunction with the entire illness, and anti-depressants or anti-anxiety medications may be prescribed.

BDD often occurs with substance abuse. Men commonly abuse anabolic steroids or other body-building enhancing drugs. Both men and women alike may abuse street drugs, such as heroin and cocaine, that act as appetite suppressants in addition to being self-medicinal and mood altering. Women are more likely to use diet pills or laxatives.

Behavioral therapy may be used to alter negative thinking patterns, and promote a more realistic self/body image.

My Experience with Body Dysmorphic Disorder

For as long as I can remember, I have been very conscious of my body and my appearance. Probably not atypical for the modern woman, but some of us just take it a bit too far. I am one of those women. I am also an alcoholic. So, indeed, I do fit the profile of co-occurring disorders with BDD,

I never had therapy for BDD, although I’ve been on an SSRI anti-depressant for 12 years. This helps with depression, but it doesn’t do much to change my thinking patterns. When I had trouble with anorexia as a teen, I wish BDD would have been recognized at that time. However, it’s fairly common for one mental illness or aspect of such to be looked over in favor of another. I think cognitive behavioral therapy could have really helped me early on.

For more of my personal story, please see the second part of this series here.

If you suspect you or someone you know has a substance abuse disorder, please seek help immediately.

Just Believe Recovery is a fully licensed, Joint Commission accredited, comprehensive drug and alcohol treatment center located in Carbondale, Pennsylvania

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