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Imagined Ugliness: Teen Body Dysmorphic Disorder and Treatment

Social Anxiety | ParadigmMalibu.com

For teens, it’s easy to believe that there is something wrong with their body. Perhaps they feel their nose is too big for their face, even when it’s precisely proportionate. Some teens might believe that they are too fat, even though the scale indicates their weight is within a normal range for their height. Others might believe that they are ugly and not have a specific trait that they obsess over. However, the belief that something is wrong, that there is an ugliness to the face or body, is entirely imagined. It is a belief despite what’s actually true.


In fact, this is the very definition of a delusion. Delusions are false beliefs that might be shaped by anxiety or paranoia. Typically, in the case of a psychotic disorder, such as paranoid schizophrenia, an individual might have the belief: “The FBI is after my family.” These false beliefs continue to exist despite evidence that disproves it. Although it might sound scary to think that you or someone you know has delusional thinking, knowing that a thought is delusional can help with responding to it differently. If you know that it’s not true, you won’t respond with attempts to change your looks or obsess over it.


Both male and female adolescents, men and women, can suffer from Body Dysmorphic Disorder (BDD), which is sometimes called Imagined Ugliness because that’s often the experience of teens who have BDD. The severity of thoughts and beliefs about your body may vary with each person. For example, Body Dysmorphic Disorder is also known as Dysmorphophobia. Notice the word phobia in the second half of the word – this relates back to the anxiety or paranoia that comes with believing there’s something “ugly” about you. For some teens, BDD can become so severe, turning into an obsessive fear or terror that your body, or a part of it, is repulsive in some way. For some teens, dysmorphophobia impairs their ability to function, preventing them from going out in public, such as going to school, engaging in any social activities, or spending time with others because of their fear.


If you think you suffer from a form of BDD, or can see the beginning signs of it, contact a mental health professional or an adult you trust. Some teens might first go to a dermatologist thinking that by repairing the physical problem the issue will go away entirely. However, the physical condition is not the problem; it is the psychological experience you’re having in response to it. Therefore, the best treatment to seek is that of the mental health field, such as a therapist or psychologist.


BDD is often treated with Cognitive Behavioral Therapy (CBT), a type of therapy that examines the thoughts and beliefs of a patient in order to change his or her associated behavior. The underlying premise of CBT is that thoughts, beliefs, feelings, and behavior are intimately related. By thoroughly examining thoughts, particularly those that are related to a specific behavior, and replacing them with healthy ones, the related behavior will also change. With teen Body Dysmorphic Disorder, a therapist might help you explore the thoughts related to the way you see your body, and as a result, replace them with new thoughts, facilitating a new body image and sense of self. Medication, specifically serotonin re-uptake inhibitors (SRI’s), which are a form of anti-depressants, is also a treatment method. Often, a combination of medication and therapy is the most effective.


It might be easy to disregard thought patterns that reflect a skewed body image because those thought patterns are common among your friends. However, this isn’t a reason to not do anything about what later might become a severe disorder, as discussed above. It would be worth talking to an adult about it. At the very least, even if you are not diagnosed with teen Body Dysmorphic Disorder or Dysmorphophobia, doing so can facilitate feeling great about all parts of your body and promote feeling joyful about your life.



By Robert Hunt
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