Body Dysmorphic Disorder Clinic & Research Unit
The Body Dysmorphic Disorder (BDD) Clinic & Research Unit at the Massachusetts General Hospital/Harvard Medical School was founded in 1998 by Sabine Wilhelm, Ph.D. Currently, this is one of the few clinics in the United States, and the only clinic in Boston, specializing in the treatment and research of BDD.
Go to www.mghocd.org for more detailed information.
The Clinic consists of a treatment program and a research unit. Patients are treated with cognitive behavioral treatment and/or medication. The Research Unit currently focuses on studies regarding information processing, perception and interpretation, neuropsychology, neuroimaging, prevalence, and treatment of BDD. In addition to active clinical and research services, the Clinic serves an educational purpose with research fellows and graduate students currently involved in clinical and research activities.
Body Dysmorphic Disorder is an illness about which there is inadequate awareness among healthcare professionals, as well as the general public, insufficient research, and meager funds for treatment. Working in close connection with the MGH Obsessive-Compulsive Disorder Clinic & Research Unit and the MGH Trichotillomania Clinic & Research Unit the mission of the BDD Clinic is to educate healthcare professionals and the general public, advance research, and conduct state-of-the-art treatment and research aimed at improving the standard of care for people suffering from BDD and related disorders.
Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a severe preoccupation with a perceived defect in one’s appearance. Any body part can be the focus of one’s concern. Individuals with BDD frequently have face-related preoccupations (e.g., their nose is too big or their eyes are too small). Some patients may worry about their hair or skin (e.g., that their hair is thinning or that their skin is scarred). Often, people with facial or skin concerns pick at their skin. Some BDD sufferers have concerns involving body symmetry. Others have muscle dysmorphia, where they worry that they are not muscular enough or that they are small and weak. Most of these concerns are imaginary, but if a slight “defect” is in fact present the concern is regarded as overly excessive.
Individuals with BDD spend a great deal of time – at least one hour a day - thinking about their perceived appearance flaws. Commonly, BDD patients will repetitively check their minor or imagined flaw in mirrors. In other cases, patients will often go to great lengths to avoid mirrors. Individuals with BDD may attempt to gain reassurance from others or try to convince them of their imperfections. They often have difficulty controlling the negative thoughts about their appearance and often have poor insight or awareness of their problem. Individuals with BDD frequently try to hide their defect with make-up, sunglasses, clothing, etc. Some engage in excessive grooming behaviors (e.g., combing hair or picking at their skin) to remove imperfections. These rituals may take several hours per day and usually only provide temporary relief. Some BDD patients will seek cosmetic surgery or dermatological treatment for their perceived defects but will usually find only temporary relief, as BDD patients are typically dissatisfied with the outcome of their procedures.
BDD can result in significant distress (e.g., anxiety or depression) and impairment in one’s social life, relationships, employment, schoolwork, and overall functioning. People with BDD often avoid dating, miss school or work, and feel overly self-conscious in social situations. Though the severity of BDD varies, in general, patients have a very poor quality of life. While some BDD sufferers experience manageable distress, others find the disorder to be tormenting. Left untreated, such torment can lead to hospitalizations and suicide.
HOW TO DETERMINE IF YOU HAVE BDD?
If you answer yes to several of the following questions you may have BDD. Please note that the questions cannot provide you with a final diagnosis of BDD.
- Do you worry a lot about your appearance?
- Do you consider any part or parts of your body especially unattractive?
- Do you spend a lot of time thinking about your defect(s)? At least one hour per day?
- Do your appearance concerns interfere with your work or social life?
- Do you repetitively check your appearance in mirrors or go to great lengths to avoid mirrors?
- Do you often ask people for reassurance about how you look?
- Do you spend a lot of money on make-up, cosmetics, etc., to camouflage your flaws?
- Do you often compare your appearance to that of others?
- Do you pick at your skin?
- Have you had repeated cosmetic surgeries?
BDD usually begins during adolescence and tends to be chronic. Though the disorder is currently diagnosed equally among men and women, it is frequently misdiagnosed or undiagnosed for a number of reasons. Many BDD sufferers are embarrassed by and ashamed of their symptoms and, therefore, have difficulty revealing them to others. There is also a lack of familiarity with BDD among healthcare professionals. The majority of physicians are unaware of the disorder. Misdiagnosis can also occur because BDD produces symptoms similar to those of a number of other psychiatric problems, including anorexia, obsessive-compulsive disorder, trichotillomania (compulsive hair pulling), social phobia, and others. In addition, several BDD patients see dermatologists, plastic surgeons, and other physicians rather than mental health professionals and, therefore, do not receive proper treatment.
HOPE
There is hope for BDD sufferers. Studies have shown that when treated with cognitive-behavioral therapy and/or medication patients have shown a significant improvement in symptoms and overall functioning.
BODY DYSMORPHIC DISORDER RESOURCES:
Butler Hospital Body Image Program
Los Angeles Body Dysmorphic Disorder Clinic
Mount Sinai School of Medicine BDD Research
Mount Sinai School of Medicine BDD and OCD Treatment
Fernand-Seguin Research Center
7331 Hochelaga St.
Montreal, QC, Canada
H1N 3V2
Tel.: (514) 251-4015 ext. 3585
Fax.: (514) 251-2617
Written by MGH BDD Clinic Director Dr. Sabine Wilhelm, the new book Feeling Good About the Way You Look contains information for both clinicians and BDD patients alike, including self-assessment tools to help readers better understand BDD and help them to determine if professional psychiatric treatment is necessary; step-by-step instructions on how to overcome your BDD-related symptoms; information for friends and family members who believe a loved one may be suffering from BDD; and much more. on Google Books: click here to view.
OBSESSIVE-COMPULSIVE DISORDER RESOURCES:
Obsessive-Compulsive Foundation
Massachusetts General Hospital OCD Clinic & Research Unit
GENERAL RESOURCES:
National Institute of Mental Health
Anxiety Disorders Association of America
American Psychological Association
American Psychiatric Association
Massachusetts General Hospital
Massachusetts General Hospital Department of Psychiatry
The MGH Mood & Anxiety Disorders Resource Center
