MELBOURNE: Cases of a debilitating, deadly mental illness are skyrocketing among young people, but Australia does not have any public treatment programs and the condition is poorly understood, experts warn.
This country does not have any public treatment programs and the condition is poorly understood, experts warn.
Body Dysmorphic Disorder (BDD) is an obsessive-compulsive disorder where an individual cannot stop thinking about a perceived appearance flaw, causing significant distress and disruption to their life.
Swinburne PhD student and BDD researcher Katrina Holmes à Court said it went well beyond the normal insecurities everyone experienced.
She said patients’ perceived flaws were typically non-existent or unnoticeable.
“If you’re not really loving your chin, it’s not the same as being so terrified by how prominent it is that you don’t want to leave the house,” she said.
“They’re so ashamed at what they perceive is so ugly that they want to kill themselves.
“About 80 per cent of BDD patients contemplate suicide.
“It also has really high completed suicide rates compared with even other serious psychiatric disorders.”
She said people with untreated BDD can be so affected by the obsessive thoughts and repetitive behaviours – such as constant mirror checking – they struggle to stay in school, work or have relationships, but high levels of shame mean about 80 per cent are never diagnosed.
“They’ll tell us they go to a psychologist or a GP and say I’m depressed, I’m anxious, I don’t want to leave the house,” she said.
“They find it so much harder to say that’s because they don’t like their chin, because it doesn’t seem reasonable even to them.”
Swinburne professor and cognitive neuropsychologist Susan Rossell said more support was needed.
“We’ve got a massive, massive gap in Australia,” she said.
“Compared to internationally we have no BDD services in Australia.
“You cannot call a hospital and say ‘can you refer me to your BDD service’, because there isn’t any.
“There are some specialist clinics that do have BDD services but they’re private clinics and they’re constantly full and they constantly have long waiting lists.”
She said cases had increased significantly, rising from 1.7 per cent of the population 15 years ago to 2.2 per cent – with another 4 to 5 per cent with “borderline” symptoms nearing the diagnosis threshold.
“The prevalence rates of BDD are absolutely going through the roof,” she said.
Professor Rossell, who was part of a government advisory group that recommended the under-16 social media ban, blamed social media.
She said mobile phones and online platforms allowed people concerned about their looks to “confirm” their fears by constantly checking their appearance and comparing.
She said the condition was often misunderstood as “excessive vanity” but this was not true and her research has shown it impacts everything from attention, memory, processing speed and decision-making.
She said, if it wasn’t a cognitive problem, then cosmetic procedures would ‘fix’ the distress but research shows people with BDD – who make up an estimated one in five plastic surgery patients – often feel worse post operation.
“It’s a psychological problem, so a physical solution doesn’t solve it,” she said.
Butterfly National helpline manager and clinical psychologist Sarah Cox said, despite misconceptions that BDD impacts only women, it affects a “similar” number of men – the so-called ‘flaw’ may just vary.
“Men may be more likely to experience muscle dysmorphia,” she said.
“Muscle Dysmorphia involves preoccupation with the idea that one’s body is too small, lean or not muscular enough.”
She said BDD can co-occur with eating disorders, but they were separate disorders which require their own treatment.
“Unlike eating disorders, where symptoms tend to focus on body weight, size and shape,
symptoms of BDD may relate to any element of physical appearance,” she said.