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Body Dysmorphic Disorder: Cannot Think of a Particular Organs as Normal

Body Dysmorphic Disorder: Cannot Think of a Particular Organs as Normal

Body Dysmorphic Disorder – ‘My nose looked like an elephant nose. I can understand. Why do not you understand that? Wonder! Anyway, I cannot talk so much. If you can treat, what is the treatment again! If you can, just fix it. If you cannot, I’ll be able to do the operation as soon as possible! Complain about a girl’s disease.

Always concerned with the size, shape, position or image of a particular body or part of the body, you cannot think of your organs as normal in no way, or you cannot accept it as normal, sometimes you even want to change the condition by taking up the operation, most of the times it is not beneficial to increase the risk of further anxiety and this is a mental illness named ‘Body Dysmorphic Disorder’. In short, a psychological disorder in which a person becomes obsessed with imaginary defects in their appearance.

Body Dysmorphic Disorder:
“Body Dysmorphic Disorder” is a special type of mental disease where people are always worried about their normal or slightly modified organs or parts. They think that there is a problem with that part and they remain worried about that only. Eventually, they become obsessed with that part leaving the normal life. They even forget about eating, bathing and even sleeping. They cannot accept that part/organ at anyhow.

They try to do whatever they can do to change that part of the body, for example, trying to change that with hands, using the necessary and unnecessary medicines, putting different types of lotions, holding down, trying to cover that from the people etc. Occasionally, the patient even tries to visit a plastic surgeon (or general surgeon) for changing in his/her own way. Victims, themselves, also become disturbed by the issue and have severe mental stress. Personal, family, social and professional lives have been severely interrupted.

The probable parts about which they get worried generally:
Although there is a possibility of any organs or parts involved in this disease, most of the times, there are more chances for the face and the different parts of the head. For example, maximum sufferers get worried about mouth, nose, ears, eyes, eyelid, lips, teeth, jaw, and throat. The folds of the forehead, any kind of stains on the face, swelling vein or artery of any places in the face or the in body, whether the two parts of the body are parallel or not (less/more than one side), these are also reasons for the patient’s concern. And some special organs like legs, stomach, genitalia, breasts, waist, arm, hip and even male looking like a man or female looking like a woman can be the reasons for patient’s worry.

When and whom?
It is usually found that the disease begins in adolescence, in between 14 to 17 years old. It happens slowly and suddenly with no reason. Girls become more affected than boys. Sometimes the incidence of this problem may be more or less but it can last longer, even for the whole life too! About 2 percent of the total population can suffer from this disease. Although the exact cause has not discovered, it is noticeable that the presence of serotonin in the brain of the affected person is less. Some people make example of the famous pop artist Michael Jackson, who was not happy with the shape/ image of his nose.

Types
Generally, there are two types: Delusional quality and Obsessive quality. Most of the treatment depends on variation of the types.

Treatment:
Delusional quality medicines are usually antipsychotic medicines; for example, aripiprazole and risperidone are good for this. But only medicine is not enough for obsessional quality. Psychotherapy is needed with medicines. Serotonin reuptake inhibitor, such as fluoxetine or sertraline, is quite beneficial medicine. These medicines help to reduce stress as well as anxiety.

On the other hand, psychotherapies (cognitive behavior therapies) help to transform abnormal and negative thoughts into positive and normal thinking. Scientific explanation of the topics is also important for the treatment. In many cases, they also offer surgery advice for peace. In most cases, it is not fruitful.

Professor and Coordinator- Psychiatric Sex Clinic, Dept. of Psychiatry, Bangabandhu Sheikh Mujib Medical University- BSMMU, Dhaka, Bangladesh and Former Mental Skills Consultant, Bangladesh Cricket Board