Body Dysmorphic Disorder

Mental health
1

I didn't really know were to post this but I felt depression was most appropriate for the time being as this is how I feel with everything going on in my head.

I've suffered with depression for a long time a lot I think as a result of severe bullying in school and how I've been treated in the past by exes. I'm 25 now, I have a stable career, great friends and an amazing partner. Those things have been behind me for a long time and there are moments where I'm happy and it feels like there's nothing wrong.

These feelings just keep returning though- but with my better state of mind for the past few years, I've been able to start identifying habits and compulsions that I've ignored for years. When I was 16 I was anorexic and didn't fully recover until I was about 18-19. So I've always known I have issues and obsessions with my body image.

Lately though even my partner has began to notice how much I look in a mirror every day, it feels like such a vain thing to say but it's not vanity that draws me to look at my reflection; I look for and find anything and everything I can hate about myself, particularly my face and my hair. Some mornings I brush and play with my hair for 20 minutes before I can leave the house for work- I've gotten to a stage where I'm 'okay' to not wear makeup to work but if I'm going out with friends, I start getting ready 3 hours before because I know this is how long it will take me to feel okay about going out. 

Some days I've spent 2-3 hours staring in a mirror, looking at my face, picking my skin to try and smooth it out and just making it worse with acne scarring. I've had long hair, a bob, and recently I decided to shave the side of my head, nothing I do with my hair makes me happy, I just find more reasons to be upset about what I've done to it.

I never knew what this way and just thought it was all in part of my depression but my partner stated to me "no wonder you feel depressed if you keep doing this to yourself" and I had a little bit of a lightbulb moment. I'm not doing this because I'm depressed, I'm depressed because I'm doing this.

I did some research online and found some things on BDD. I've always hated self-diagnosing as far too many people do it, I've seen people diagnose themselves as bipolar just because they have mood swings when we all know there's far more to bipolar disorder than that. Thing is, I've worked for the NHS for 7 years previously in a hospital setting and now in a GP surgery, I'm clerical but I do feel like I have gained a lot of knowledge just from this background of work and I can almost feel certain from what I've read that this is what I have.

My issue is that I don't know how to tell a GP. I feel silly telling people about this because it sounds like such a stupid and vain thing to be doing. My partner who has never experienced mental health finds it hard to understand but tries his best to sympathise which is all I can ask him to do but his reaction is the reaction I fear I will get from everyone else, including the GP. "Just don't look in the mirror, why does it matter how you look anyway I think you're beautiful." And he's right, why does it matter? I know it shouldn't care- I know that- at least my rational mind know's that. It doesn't matter, one day we're all going to be old and wrinkly and I've never cared what other people think of me but this is more about how I think and feel about myself.

The saddest part is that when my boyfriend tells me I'm beautiful, I just think it's a lie because he wouldn't exactly tell me if he thought I was ugly. I just smile accept the compliment and die a little inside wishing that I could feel beautiful, even just a little bit.

I looked up treatment for BDD and the two main options were talking therapy and taking SSRI's. I've tried talking therapy in the past and it really doesn't help me- I have this attitude about people who don't have mental health trying to understand you just because they've got qualifications. No one can qualify you to understand depression if you've never had it, let alone understand how it affects every individual person differently. So I started considering very much about SSRI's as they were offered to me a long time ago but I refused because I was scared.

They wanted to give me Prozac (Fluoxetine) because I told them I was scared of antidepressants that caused weight gain due to my history of anorexia. I've read that some people become suicidal on this and a lot of people lost their sex drive. I'm going to be crude here but I love sex with my partner and as it is I'm already struggling with my mood because of the depression and how I feel about my image, so I'm scared this will make things worse- equally I was told that if it made me feel 'better' that it might actually improve my sex life because the medication will outweigh the depressive mood.

I just don't know what to do. I was just hoping someone could tell me how to approach a GP about this and if anyone has any experience with Prozac or other fluoxetine based antidepressants and the side effects, or whether their life has been changed by taking them.

Thank you

2

Hi Chloe. It really is a struggle having to deal with depression alone much less complicate it with additional disorders. I am glad that you wrote to us. I am glad to hear that you are open to antidepressants. Prozac was the second one that I took and my doc told me that in about two weeks my smile would come back. And that's exactly what happened. Now I know that all of us are different and not all of us have that experience because the first one, Zoloft, that I tried did not work for me. So I quickly moved on. I am a big advocate of therapy because though I worked very hard and it took a long time I am a different person today because of that. Hope something that I have said helps. Diane

3

Darling, reading this makes me think that your partner is already in complete support of you. He thinks you're beautiful and he's NOT lying. Of course, if you continue to argue with him on this point, and cause him to doubt you, it may end up in you creating a problem that really wasn't there - for him, at least! Would you actually want him to think that you were ugly?? You KNOW it's all about perspective....

Given that you know more than most about symptoms, causes, treatment and side effects, you will appreciate that your partner doesn't spend much time at all thinking about these things, and can only show a certain amount of support? 

I was eventually diagnosed with depression and anxiety (prescribed with Cymbalta), but the most helpful and life-changing therapist I ever had pointed out that -even though I wasn't OCD- some of my thoughts could be treated as obsessional. I don't know if this would help you, but a short course of CBT worked wonders for me, and stopped the repetitive behaviour/ thoughts with practice.

All the best angel xx

4

Hi again Chloe. Just take what is useful to you and leave the rest. How are you? Diane

5

Thank you so much for your comment Diane. I find talking therapy difficult because of my 'good' days; when I have days that I feel more rested, less sad and basically more human I worry that a Dr or Therapist would think the same if I walk in feeling 'fine'. I also suffer with my nerves and talking openly with people; I once made a GP appointment to talk about depression and ended up making out I felt unwell because I couldn't bring myself to talk about it as I felt stupid.

Medication is something I want to try alongside exercising more as I've taken up more activity which does give me a great boost in my mood but not enough for the compulsions, talking to a cognitive behavioural therapist just didn't help me and if anything I felt like I was talked to like a child as all she did was repeat what I was saying, asking if she had understood correctly and then saying she "could see how that would make me feel" sorry but personally I call BS on that because she would never understand without going through it. I'm glad it's helped you though.

Have you found prozac to have any adverse side effects, I've heard reports of it causing acne and loss in libido and these are things I worry about a little.

Thanks again

6

Hi Kate,

Thank you for your reply, I've learned from mistakes in the past about arguing against compliments people wish to give me, so i try not to stifle my partner when he gives them. It's just hard.

Unfortunately CBT didn't work for me at all and at the end of my last session she agreed she didn't really feel like it was right for me or something they could help with personally. I don't get on with therapists in general as to my viewpoint of trying to relate or sympathise with something they can't understand on a personal level, but I'm glad to hear it helps some people.

I think medication is something I need to try as I was first offered this at 17 and have put it off for 8 years. Of course if it's not right for me I've already considered that this is something i might have to continue tackling myself. I feel I've done well so far but just haven't quite knocked it on it's ugly head.

Thank you