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Custom Treatment of Body Dysmorphic Disorder Essay

Body dysmorphic disorder(BDD) is a chronic mental illness that makes it hard for a person to stop thinking about flaws that he/she may have in his/her personal appearance. Psychologists argue that the flaw identified by this person can either be real or imagined flaws. Patients suffering from this type of disorder spend most of their time worrying about their appearance. Due to this, they develop a distorted view of their personal looks. Patients with BDD exhibit certain behaviors. They constantly compare their looks with the looks of other people. Some of the patients also spend a lot of time in front of the mirror looking at their personal appearance. Some patients also avoid mirrors since they may be disappointed with their looks and appearance. Such patients are also very secretive. They do not seek professional help or the help of other people since they feel that these people may view them as self-obsessed and vain. Most patients suffering from BDD become distressed because of their facial appearance. Due to this, they may end up seeking cosmetic surgery in order to improve their facial appearance. Another symptom of this type of disorder is that the patients always try to seek reassurance from other people concerning their personal appearance. It is also common for these patients to feel that other people take special notice on their negative appearance. Due to this, these patients always try numerous cosmetic surgeries in order to fix the defects that they may have on their facial appearances. Such patients also refuse to take pictures.

Medical experts have identified several causes of BDD. One of the key factors causing this disorder is genetics. According to medical studies, body dysmorphic disorder is more common among people whose family members suffer from this condition. This suggests that there is a high possibility that some genes are associated with this type of disorder. Brain chemical differences also increase the chances of a person suffering from BDD. Researchers have established that brain chemicals known as neurotransmitters may cause this disorder. The environment in which an individual lives in can significantly contribute to the risk of this person suffering from BDD. It especially happens when the environment that a particular person lives in makes him/her to have negative thoughts concerning his/her body image. Psychologists also argue that past life experiences of a particular patient may make him/her to develop this condition. A child who was bullied or teased while growing up has a high chance of developing BDD in future. Patients with anxiety and depression are also at a high risk of developing this complication compared to the other patients. Societal pressure for example people expecting that all people in the society should be beautiful increases the chances of a person suffering from BDD.

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BDD is dangerous mainly due to the complications that are caused by this disease. This is the main reason that researchers have been trying hard to seek treatment for this disease because it has many complications. Patients suffering from this disorder may start having suicidal thoughts. Such thoughts are caused by the fact that they feel that people in the society hate them and view them as ugly. In addition, such patients also have obsessive-compulsive disorder. This will make them to have repeated and unwanted thoughts that may be brought about due to obsessions. Such patients may also start having compulsions. Patients suffering from BDD may also start abusing substances. The common substances abused by such patients include alcohol, bhang and cocaine. Psychologists argue that these patients abuse substances since they feel that it helps them to escape from reality. Another complication that is brought about by this disorder is social isolation is eating disorders. Eating disorder is dangerous since it exposes the patients to the risk of becoming obese. This will expose them to diseases such as type  diabetes and cardiac complications. These patients are also suffer from social isolation. They prefer living on their own and this increases their chances of suffering from depression.

Physicians conduct several tests in order to assess whether a particular patient may be suffering from BDD. One of the tests that they may perform is psychological evaluation. During this test, the mental health provider assesses the thoughts, feelings and behavior of the patient in order to establish whether the patient suffers from BDD. Physicians may also consider conducting a physical exam. Measuring the blood count of patients may also help the doctors to assess whether a particular patient suffers from BDD. This paper focuses on the proven treatments of BDD. It is important to focus on the treatment of this disease since cases of patients suffering from this disease have been on an increase in both United States of America and United Kingdom. The methods of treatment that are discussed by this paper include cognitive behavioral therapy, medication and cosmetic research. It also gives future directions of research on the treatment of this disease.

Proven Treatments for Body Dysmorphia

Doctors argue that it is difficult for patients suffering from BDD to seek treatment. This is because patients suffering from this condition may not be comfortable to tell their physicians about the condition that may be affecting them. However, doctors always encourage patients suffering from BDD to seek treatment especially if the show distressing symptoms that may threaten their social life. Proven treatments that patients can seek from health care providers include:

Cognitive Behavioral Therapy

It refers to a psychotherapeutic treatment that enables patients to understand how their feelings and thoughts may influence their behavior. This form of therapy is used in the treatment of mental disorders such as depression and anxiety. It is based on the notion that the thoughts of a particular person largely determine the behaviors and feelings that these people exhibit. The feelings and behaviors that a person has are not influenced by external situations such as adverse events or people. The success of this therapy depends on the therapeutic relationship between the psychologist and the patient under therapy. Therapists participating in this process argue that a good and trusting relationship between the therapist and the client will help in ensuring the success of the therapy process. Collaborative effort between the therapist and the patient is also encouraged in order to ascertain the success of the therapy session. This is because it helps the therapists to know the personal goals of their clients in order to establish whether it is necessary to change these goals.

It is mostly used to treat mental conditions that may be affecting patients. Examples of mental conditions that can be managed by this form of therapy include anxiety disorders, phobia and substance abuse disorders. Other conditions treated using cognitive behavioral therapy includes posttraumatic stress disorder, schizophrenia, depression and sexual disorders. This therapeutic is also very common in the management of emotional challenges that may face a particular client. Such therapeutic sessions are successful in preventing the relapse of particular symptoms of mental illness. Some physicians also prefer to use cognitive behavioral therapy to treat mental illnesses in cases where other treatment medications have failed. This form of therapy is also used to help patients overcome grief that may be affecting them. It is especially common for patients who may have lost their loved ones. Physicians also encourage this form of therapy to be performed on patients having chronic physical symptoms such as insomnia, fatigue and pain.   

Exposure and Response Prevention Therapy

Exposure and response prevention (ERP) therapy is a therapeutic technique that is used to treat BDD. In this technique, the patients are exposed to situations and thoughts that may create anxiety. This will help them to know the strategies that they can use in order to avoid engaging in any related compulsive behavior. During the first therapeutic sessions, the patient is educated about this disorder and the treatments that he/she may adopt in order to prevent this disorder. This is because repeated exposure of the thoughts and situations enables the patients to learn that any anxiety that they may be having is irrational. They also learn that their worst fears may not have been realized yet. It makes any anxiety that they might be having to reduce. As the sessions progresses, the therapist and the patients are able to develop an anxiety hierarchy. This enables them to classify and rank situations and thoughts starting from the least to the most anxiety provoking. Using cognitive therapy, the patient is able to challenge the beliefs that he has, which support the BDD condition. This helps the patients to prepare themselves in order to start the process of ERP.

During each session, the patient is exposed to all the situations that are located in his/her anxiety hierarchy. With time, the patient is able to deal with the situations that would provoke anxiety. Margarita proposed a case study that was used to treat BDD using exposure and response prevention. The main participant of this case study was called Samantha. She was deeply bothered by an acne that was on her face. She used to constantly checked on her face for about 12 times in a day. She used to constantly pick her acne. Moreover, she compared her skin with the skin of international celebrities that she liked. She went to a therapist in order to receive exposure and response prevention. Samantha together with her therapist created a ritual hierarchy in order to reduce the behaviors that were making her to develop BDD. They ranked the habits starting with the least difficult habit to give up to the most difficult habit. Photo comparing was given a rank of 20, skin picking 30, mirror checking 50 and camouflaging her acne with make up 80. She was advised to close her eyes for about 10 minutes every time she felt like checking her acne in the mirror. Her treatment succeeded. This study helped to show that exposure therapy can help to treat patients suffering from BDD.

Cognitive Restructuring

Another cognitive behavior technique that can be used to deal with BDD is cognitive restructuring. Therapists use this technique to identify and correct any negative thinking patterns that may be exhibited by the patients. In this technique, the negative automatic thoughts are altered so that they do not affect the reasoning and thinking of a particular patient suffering from BDD. Research has established that patients suffering from BDD have many negative thoughts about their personal appearance. In cognitive restructuring, patients are taught the techniques that they can use in order to change their negative patterns of thoughts to become positive thought patterns. Such patients also learn to challenge the validity of their negative thoughts that are related to their distorted body. The therapists ask the patients to provide any evidence that they have regarding their negative thoughts. Margarita also conducted a case study on a patient known as Sandra in order to identify whether cognitive restructuring was a major treatment option for patients suffering from BDD. Sandra always felt that she hideous. She strongly felt that nobody would date her or love her since she did not deserve to be loved by anybody due to her looks. She argues that her large mole located on her face would make it impossible for people to date or fall in love with her. The therapist handling her sessions encourages her to challenge the distorted idea that her small mole is a hideous flaw on her face. She is also taught the techniques that she should use in order to eliminate the belief that nobody would date her because of her mole. It helps her to overcome her fears.

Mindfulness Therapy

Mindfulness therapy is also a cognitive therapy technique that can be used to deal with BDD. Mindfulness therapy is a therapeutic technique that is designed to help clients to deal with the day-to-day challenges that may be affecting them by making the patients to be in control of their own minds. The therapists aim at making the patients to become aware of their bodily sensations and thoughts. This helps the clients to know the means that they can use in order to cope with the emotional problems that may face them. During these sessions, the therapist discusses with the patients the thoughts and situations that are problematic. This will help the patients to become mindful about these situations making it possible for them to avoid them.

The aim of the therapist is not to change the thinking of the patients but to make them become aware of the unhelpful thoughts that they might be having. Successful therapy sessions will help the patients to achieve stability of their minds. In addition, their mind also becomes flexible. They also become self aware of the thoughts that run in their minds. It gives them an opportunity of understanding the typical patterns of their minds. According to psychologists, the main aim of mindfulness therapy is to make the patients to become non-judgmental while dealing with psychological experiences that are uncomfortable. This is because most of psychological distress comes from the fact that people like to eliminate their unwanted thoughts or the discomfort that they may be experiencing.

However, several studies do not support mindfulness therapy as a way of treating BDD. According to, mindfulness therapy should not be used as a treatment to BDD because the number of times that it has succeeded to relieve psychiatric symptoms is minimal. It is argued that in some cases this therapeutic technique may end up making the symptoms of a particular patient to become worse instead of assisting the patient to improve psychologically. A study was given on how mindfulness therapy failed to assist a woman deal with her psychological problems. This woman found it hard to manage anxiety that was threatening to significantly affect her mental health. She went to a therapist known as Tex, whose office was in Austin, in an attempt of seeking psychological treatment for her anxiety. This psychiatrist was famous since she incorporated mindfulness meditation into her practice. The psychiatrist found out that the anxiety of this woman was caused by factors such her divorce and the mental illness of her child. The mindfulness therapy sessions that she had did not help her since she continued being anxious. The above study was important to this paper since it suggests that there are some instances where mindfulness therapy may fail to treat BDD.

Mirror Retraining

Mirror retraining is also another cognitive behavioral technique that is used to treat patients that may be suffering from BDD. Psychiatrists using this technique to treat cognitive behavioral therapy argue that patients spend a large portion of their day looking at their personal image in the mirror. The reason that drives them to engage in this act is that selectively focus on certain details of their body. A patient may look at a small scar that is in his/hr face instead of appreciating the fact that the rest of his/her body is beautiful. Using the mirror retaining therapeutic techniques, the patients learn of the importance of paying attention to their appearance. They are taught of the things that they can do in order to give a neutral and positive feedback about their body. One of the chief aims of neutral therapeutic sessions is to ensure that patients learn that their rituals of looking at themselves through the mirror increase their anxiety. When a teenage boy keeps wear keeps wearing a hat in order to hide a particular mole on his head will learn that her anxiety will reduce if he removes his hat since people will not stare at him. Westwood Institute of Anxiety Disorders conducted a study in order to find out whether mirror retaining could be used to help patients affected by BDD. They used mirror retraining method and crooked mirror externalization therapy in their study. Six out of the seven patients treated with mirror retraining method significance gains.

Medications

The Food and Drug Administration of the United States has not yet approved the clinical drug that should be used to treat BDD. However, some researchers argue that the drugs that are used by psychologists to treat depression and anxiety should also be used to treat BDD. Some of the medications that can be used to deal with BDD include:

Selective Serotonin Reuptake Inhibitors (SSRIs)

This is the most common antidepressant that is prescribed by psychologists. Patients take this prescription in order to deal with depression. SSRIs reduce depression symptoms by affecting the neurotransmitters that are responsible for the communication of the brain cells. It changes the level of one or more of the naturally occurring brain cells. In addition, they also block the reabsorption process of neurotransmitter serotonin that is released in the brain. Due to this, the mood of the patient taking this drug is boosted. Changing the balance of serotonin helps the brain cells to receive and send chemical messages. This leads to a boost in the overall mood of a person. Researchers have established that people suffering from any form of depression release limited amounts of serotonin. The main function of the SSRI drugs is to prevent the brain from absorbing serotonin leading to a boost of the overall mood that a particular person has.

Doctors prescribe patients suffering from BDD to take SSRIs. This is because this drug will help such patients to control their repetitive behaviors or any obsessions that they may be having. However, treatment of BDD using SSRIs requires the use of high doses compared to the doses of this drug that is used to treat depression. Treatment of BDD through the use of SSRIs may take at least 12 months before the symptoms of this disease start to disappear. However, after the 12 months are over, it is advisable for the patient to return to the physician handling his/her treatment in order to be advised whether to continue taking the medication  or stop the medication. Before an adult suffering with BDD is offered SSRIs, he/she should first take Fluoxine Prozak. Researchers have established that this drug works better than other drugs. If the patient shows significant improvement after four to six weeks of treatment, then it is advisable that the physician giving the medication should gradually improve the dosage given to this patient. It is advised that patients should not stop the medication of SSRIs immediately. Instead, they should reduce the dosage slowly considering the medical advice that they may be given by their doctors. Cases exist where the symptoms of BDD resurface after a particular patient stops taking the medication.

However, some people oppose the treatment of BDD using SSRIs since they argue that its side effects are very many and can be fatal to the patient seeking treatment for BDD. Some of the side effects that are brought about due to the use of SSR include diarrhea. Some patients also experience severe headaches after taking SSRIs. It is sometimes hard for them to concentrate on their normal tasks and this makes them to consider quitting using the drugs. Studies have also shown that some of the patients become restless and anxious after using this drug for a long time. Some patients also have sexual problems after taking this drug. It may make them to strongly feel that it is better for them to quit using the drug. However, doctors always advice patients to continue using this drug if the side effects that they experience are mild. This is because most minor side effects wear off after one week. Studies have also revealed that some patients experience suicidal thoughts after taking SSRIs. Research has established a strong link between feeling suicidal and taking SSRI antidepressants (Grimes, 2008). This made the Medicines and healthcare Products Regulatory Agency (MHRA) of the United Kingdom to investigate whether this link exists. However, they did not establishing any evidence between SSRI antidepressants and suicidal behavior. Patients are advised to seek the help of doctors as soon as they become anxious, agitated or restless.

SSRIs also have withdrawal symptoms. Some of the common withdrawal symptoms identified by medical experts include the patients having sleep disturbances. The patients may also have abdominal cramps and sleep disturbances. This may end up elevating the level of their stress. Flu like symptoms are also very common withdrawal symptoms that may end up affecting BDD patients. Withdrawal symptoms are not supposed to last more than two weeks.

Code: Sample20

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