A History of Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is a mental health disorder in which an individual fixates on a perceived physical flaw, most often unnoticed or undetectable by anyone else. The original term, dysmorphophobia, was coined in 1891 by Italian physician Enrique Morselli who first described the illness.

Despite being well-researched in the 19th century, BDD was not formally added to the Diagnostic and Statistical Manual of Mental Disorders (DSM) until 1987. Today, DSM-5 classifies BDD as a somatoform disorder-a disorder with unexplained physical symptoms-with a delusional variant.

It is estimated that between 1.7 and 2.9 percent of people in the US experience symptoms of BDD.

Symptoms of Body Dysmorphic Disorder

The predominant symptom of BDD is a preoccupation with an imagined physical ugliness. The individual with BDD will be absolutely convinced that the perceived flaw is not only noticeable to others but also disturbing or unattractive enough to keep them from going out in public. In reality, the “flaw” may be completely non-existent or far more subtle than described by the BDD patient.

Patients who suffer from BDD have a poor quality of life. Their preoccupation with the supposed physical defect or defects often leads to social isolation, depression, and difficulty forming relationships.

BDD patients are at high risk for suicide, with one study reporting that as many as 80% of surveyed patients had experienced suicidal ideation. Patients with BDD may also be more likely to seek out unnecessary and risky cosmetic procedures.

Treatment of BDD

Treatment for BDD consists of pharmacological and psychiatric interventions. SSRIs and cognitive-behavioral therapy have traditionally been used, though the exact therapy will depend on the specific patient.

The Emersion of Zoom Dysmorphia

The onset of the COVID-10 pandemic saw a global shift in the workplace dynamic. In-person meetings were replaced with virtual ones, and platforms such as Zoom became ubiquitous. Even as more of the population becomes vaccinated, it appears that the virtual meeting place will continue to play an important role in the hybrid work model.

With the rise of these virtual platforms, a phenomenon known as Zoom Dysmorphia is gaining attention in the psychiatric and plastic surgery communities. This appears to be related to BDD, with a focus on imagined facial flaws. Individuals are forced to see an unedited version of themselves in direct comparison to their colleagues’ faces.

Ignoring factors such as lighting, makeup, and bad camera angles, individuals are coming to the conclusion that their faces need surgical alteration to be worthy of Zoom.

The authors of a recent paper on the subject noted a “surge in patients citing their appearance on Zoom as a reason to seek care, particularly concerned with acne and wrinkles.”

Despite a halt in many elective procedures at the beginning of lockdown, the American Academy of Facial Plastic and Reconstructive Surgery estimates a 10% increase in cosmetic procedures since the start of the pandemic.

The Zoom Dysmorphia phenomenon is in the very early stages of research, and it is not yet known for certain if this is an emerging mental disorder. It is concerning, however, that these individuals appear to exhibit many of the features of BDD, including the desire to seek cosmetic rather than psychiatric treatment.

Given the potentially severe consequences of untreated BDD, it may be wise for individuals to consult with a licensed clinical psychiatrist to rule out psychological causation before attempting any surgical procedures.

If you are experiencing anxiety, depression, or social withdrawal due to a preoccupation with your physical appearance, you may be suffering from Body Dysmorphic Disorder. The Crane Center specializes in all mental disorders. We are accepting new patients and here to help. Call us to schedule your consultation.