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Press Clippings and Media Coverage
Golden Girl Uma admits to having Body Dysmorphic Disorder (BDD) By Sherry Kahn
May 15th, 2001 -- In Snow White, the princess' evil stepmother gazes into the looking glass, asking, "Mirror mirror on the wall who's the fairest of them all?" Here in the real world, a person who gazes into a mirror thinking, "Mirror, mirror on the wall, I know I'm the ugliest of them all," may be suffering from BDD, or Body Dysmorphic Disorder - certainly something far more dangerous than the stepmother's vanity. In a recent interview with Talk Magazine, even beauty goddess Uma Thurman admitted to struggling with the disorder - one that has its victims feeling that they are simply not attractive. The lanky 6-foot blonde admitted to "being troubled about her weight" ever since giving birth to her daughter, Maya, in July 1998. Thurman, whose beauty and bodacious body are celebrated world-wide, has recently been named the spokesmodel for Lancome's Miracle perfume. She also stars in a new movie released this week, Golden Bowl. "I see myself as fat," Thurman confessed to Talk Magazine, adding that she has body dysmorphic disorder. Thurman even reportedly threw a piece of bread back in the basket during her Talk interview, exclaiming in frustration, "I don't want to eat bread! Why am I doing it?" But in an age where body and face have taken on extreme importance, Ms. Thurman is certainly not alone. The disorder has been growing in the past five years, to the point where qualified plastic surgeons are being trained to detect the tell tale signs of BDD, so they know when to recommend a psychiatrist rather than liposuction. Repetitive mirror gazing is one of the symptoms of BDD. Unlike the evil queen who demanded reassurance of her beauty from the mirror, people with BDD are preoccupied with an imagined or imperceptible defect, which, they are convinced, makes them repulsively ugly. They typically spend a lot of time in front of the mirror, checking and rechecking their imagined flaw ‚ or trying to camouflage it. Although first described in the European psychiatric literature more than a century ago, the American Psychiatric Association has classified BDD as a clinical disorder only since 1987.
A Paralyzing Condition BDD occurs in both children and adults, but it most often appears during mid-adolescence. Both women and men are afflicted in equal proportions, according to researchers. Perceived facial flaws are the most common focus of BDD. However, any part of or the entire body can be of concern. People with BDD imagine their minor or nonexistent defect to be obvious and grotesque, but "I can never guess correctly what body part my patients are obsessed about," says Dr. Andrea Allen, psychologist at Mount Sinai School of Medicine's Compulsive, Impulsive and Anxiety Disorder Program in New York, New York. While most people are dissatisfied in some way with their appearance, the dissatisfaction is so extreme with BDD that those suffering with the condition are gravely disabled. They typically spend hours each day consumed with worry and rituals, such as mirror checking, excessive grooming or skin picking. BDD sufferers tend to avoid social interactions and relationships. Children refuse to go to school and adults avoid going to the office. As many as a third of BDD patients may become housebound. Patients with BDD have high rates of psychiatric hospitalization and frequently attempt suicide, researchers report.
Causes Unknown While the research of the last decade has contributed to understanding more about the condition, much remains to be learned. Because the characteristics of BDD include intrusive obsessive thoughts and repetitive behaviors, psychiatrists have classified the illness as an obsessive-compulsive spectrum disorder. "Although media influences and negative parental messages may reinforce the condition, its cause may be more biochemical," says Allen. "It also appears to be stress-related, as symptoms become worse when patients are stressed." Researchers are hopeful that brain imaging and genetics investigations, currently underway, will provide useful prevention, diagnostic and treatment information.
Treatment Helpful Cognitive- behavioral therapy (CBT) has been found to be effective in decreasing BDD symptoms. The cognitive part of the therapy consists of challenging patients' misperceptions of their appearance and the importance they place on appearance. The therapy involves training patients to identify their thinking patterns and then, over time, to substitute more realistic thoughts. The behavioral approach may involve systematic desensitization. Patients are gradually exposed to threatening situations and learn how to curtail their tendencies to hide and obsess about their appearance. As each situation is successfully handled, a more distressing one is presented. While CBT alone can be effective in mild cases of BDD, success is more frequently obtained with a combination of CBT and medication, according to Allen. Recent studies by the Mount Sinai group and by Brown University School of Medicine researchers in Providence, Rhode Island have shown that selective serotonin-reuptake inhibitors (SSRIs), such as fluvoxamine (Luvox) and clomipramine (Anaframil), improve symptoms. SSRIs keep the neurotransmitter serotonin in the spaces between the nerve cells and prevents it from being absorbed back into the cell. "These medications definitely help people with BDD, but we don't know yet why they work," Allen says.
BDD and Cosmetic Surgery The majority of people who are mentally healthy are very satisfied with cosmetic surgery. Their self-esteem and other psychological measures typically improve, report British researchers. It is a different story, however, for people with BDD. As many as half of all patients with BDD turn to cosmetic surgery or dermatological treatments to correct their perceived defects. In contrast to those without the condition, people with BDD are usually dissatisfied with the results. In many cases, symptoms get worse after the cosmetic procedure. Dr. David Veale, of the University College in London, notes that patients who are dissatisfied with their operation "feel guilty or angry with themselves or the surgeon for having made their appearance worse." They feel depressed about having failed to achieve their ideal. This leads to increased mirror gazing and often more surgeries, the psychiatrist explains. "Even patients who are satisfied with the surgical results will transfer their preoccupation to another part of their body. Surgery doesn't solve the problem. People with BDD should not have cosmetic surgery," advises Allen. This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. Copyright 2001 talksurgery http://canoe.talksurgery.com/consumer/new/new00000056_1.shtml |
