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This obsessive disorder distorts one's perception of one's own body and must be treated with psychotherapy, which can be combined with medication and psychiatric help.
“They have always told me that I am very pretty. From hearing it so much, she had beauty stuck in her head, so much so that she always thought in those terms and rated people as to whether they seemed pretty or ugly to me. If she thought someone was handsome, she thought they would do very well in life, have a partner, be successful. I began to become obsessed with my legs, I saw them as horrible, deformed. I constantly looked at myself in all the mirrors, I self-harmed because I didn't like my body. In the end, I had to ask for help.”
María (not her real name) is 20 years old and has spent more than two years in psychological therapy for a case of body dysmorphia, an obsessive disorder that causes a unusual concern about some defect, whether real or imagined, perceived in physical characteristics own. In her case, when her body developed, around age 9, she concluded that her legs were disproportionately large and thick, and since she also did not grow much in height, the size of her lower extremities She obsessed him even more.
But beauty standards are not always enough to eat, although many teenagers today are guided by television programs in which a group of more or less attractive young people earn money and succeed without doing anything. “And that perception, added to the constant dependence on social media, It makes them lose their references and constantly compare themselves with what they see en Internet", Explain Helga González Medina, psychologist at the San Francisco Pediatric Center, in Zaragoza. She has worked closely with María so that she could overcome the anxiety caused by her physical appearance, increase her self-esteem and perceive her body as she really is. “She abused Internet filters so much that one day, when I saw a photo of her, I asked her if she saw herself or a puppet,” the specialist recalls. And Maria's perceptions were so altered that she was unable to recognize herself.
The causes of body dysmorphic disorder differ from person to person and symptoms develop especially in adolescence, which is when personal criticism related to body image begins. And although both men and women can suffer from it, it is true that when hormonal changes occur after leaving childhood behind, they may stop accepting themselves if they see that their body is getting bigger and developing more than they would like. “Society demands beauty standards that are impossible to meet.", warns González Medina. And, daily, we are surrounded by advertising messages full of images that express the duty of having a perfect body. Furthermore, success in life, social skills or a person's own goodness is associated with their degree of beauty, "and that is not always the case." In fact, when she started treatment, María began to realize that among her friends, with whom she got along very well, There were pretty girls who were not “good people.”
A long and very hard healing process
There is still not much talk about this disorder, although, in the psychologist's opinion, more and more cases will be seen. “They are camouflaged behind low self-esteem, eating disorders, anxiety or panic attacks., but you have to know how to distinguish it to be able to work on it,” he explains. And the tools to leave it behind are learning to control anxiety and patience, facing a mirror and little by little beginning to be rational about the image it returns, working on distorted thoughts and false beliefs about oneself, or to stop obsessing about social networks and 'likes'. It is, yes, a long and very hard process.
María began, guided by Helga, to try to look at herself less in mirrors, to wear baggy pants or very tight socks to reduce the risk of looking ugly and harming herself, to take walks when she thought she was going to panic in order to distract herself from her obsessions. … Now she feels better and accepts her body, but she is also aware that you have to be alert all your life to prevent bad thoughts from returning to your mind.
Pharmacological treatment with antipsychotics or antidepressants
In his case, he did not need psychiatric help, although pharmacological treatment can perfectly be an adjuvant to psychotherapy. A patient with dysmorphia may be treated with antipsychotics such as those prescribed for schizophrenia, because they also have a perceptual delusion. And if your disorder causes you a lot of anxiety, you can also receive antidepressants to help keep serotonin levels in your blood stable. Yes indeed, Isabel Martínez, nurse in the eating disorders unit of the Provincial Hospital, remember that this therapy must be followed for at least six months and should not be abandoned without medical supervision to avoid the risk of relapse. “There are medications that take between two and four weeks to take effect, and a patient with a lot of anxiety, if they see that they do not improve in a couple of days, can stop taking it, or double the dose, with the contraindications that this entails,” warn.
Martínez indicates that many patients with problems generated by high exposure to social networks go through psychiatry consultations, as the psychologist considers, but she also warns that cases have skyrocketed due to the pandemic. And it is that, With so many video conferences, we have been more confronted than normal with our image. "In general terms, a person is not constantly looking at their image. But with so many meetings through 'Zoom' or 'Teams', many people have ended up being affected and with a distortion of their appearance," says the nurse.
These patients are concerned about a specific part of their body, which may be the face, hair, skin, genitals, breast size (especially women), or muscle size or tone (especially men). . They go to great lengths to hide perceived flaws and believe that other people judge them or make fun of their appearance, so they tend to avoid social situations. "They never look good, so they often resort to cosmetic surgery, over and over again.. But the problem is deeper, it is emotional, and reflects a loss of control in other areas of their life, which leads them to become obsessed with trying to control something, in this case their own body.
