Many articles in dermatology journals state that patients with BDD frequently have a poor response to dermatologic treatment. Of great concern is a study done in two dermatology practices in England, which found that the most frequent causes of patient suicide were acne and BDD. I’ve talked with dermatologists who told me about BDD patients of theirs who committed suicide. One dermatologist said that six of his patients with probable BDD had committed is and how important it is for people with this disorder to get effective psychiatric treatment.
There’s a great need for more studies of this important issue. What’s especially needed are prospective studies, in which patients are followed over time and carefully assessed before and after surgery or dermatologic treatment to see whether their BDD improves, is unchanged, or worsens. Patients should be clearly identified as having BDD, and their outcome after these treatments should be assessed over a long period of time.
Even though BDD appears unlikely to get better with these treatments, some people who initially consult surgeons, dermatologists, or dentists may be reluctant to see a psychiatrist. If this is true for you, keep in mind that as best we know, these treatments usually don’t work. Seeing a psychiatrist or therapist doesn’t mean you’re “crazy.” It simply means that you have a potentially treatable illness that in many ways is no different from heart disease or any other medical illness. Psychiatric treatment is very likely to help you feel a lot better. There’s a good chance it will give you more control over your obsessions, help you get your life back on track, and relieve your mind of worry, anxiety, and depression.
It may be hard for you to accept this advice if you think your defect is real and truly looks bad, as almost all people with BDD do. Most people with BDD have the hope that a physical change in their appearance will solve their problem. But look back at what my patients have told me about how they wish they’d never had surgery. Remember that as best we know, these treatments almost never help. And keep in mind that regardless of what you actually look like, if you’re obsessing about an appearance flaw, and if you’re distressed over it or it’s causing problems in your life, psychiatric treatment is likely to quell your obsessions, alleviate your suffering and distress, and help you function better and start enjoying your life again.
There’s a great need for more studies of this important issue. What’s especially needed are prospective studies, in which patients are followed over time and carefully assessed before and after surgery or dermatologic treatment to see whether their BDD improves, is unchanged, or worsens. Patients should be clearly identified as having BDD, and their outcome after these treatments should be assessed over a long period of time.
Even though BDD appears unlikely to get better with these treatments, some people who initially consult surgeons, dermatologists, or dentists may be reluctant to see a psychiatrist. If this is true for you, keep in mind that as best we know, these treatments usually don’t work. Seeing a psychiatrist or therapist doesn’t mean you’re “crazy.” It simply means that you have a potentially treatable illness that in many ways is no different from heart disease or any other medical illness. Psychiatric treatment is very likely to help you feel a lot better. There’s a good chance it will give you more control over your obsessions, help you get your life back on track, and relieve your mind of worry, anxiety, and depression.
It may be hard for you to accept this advice if you think your defect is real and truly looks bad, as almost all people with BDD do. Most people with BDD have the hope that a physical change in their appearance will solve their problem. But look back at what my patients have told me about how they wish they’d never had surgery. Remember that as best we know, these treatments almost never help. And keep in mind that regardless of what you actually look like, if you’re obsessing about an appearance flaw, and if you’re distressed over it or it’s causing problems in your life, psychiatric treatment is likely to quell your obsessions, alleviate your suffering and distress, and help you function better and start enjoying your life again.
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