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Body dysmorphic disorder: distorted self-image

February 18, 2010 12:00:00 AM PST
Imagine a psychological disorder in which you are so obsessed with the way you look you can't live your life. Body dysmorphic disorder affects one in 50 people. That's more people than autism. But few people understand what this condition is."I was afraid that I looked like a monster," said Jessica Martin, who suffered from the disorder.

For 10 years, 25-year-old Martin was obsessed with mirrors.

"There were mirrors all over my apartment to remind myself as to how ugly I was," said Martin.

She saw herself as hideous, overweight and distorted. It got so bad that she wouldn't leave her home even to eat.

"When the person delivering the food would arrive, I would wear a veil so he wouldn't have to see what I looked like," said Martin.

Martin suffers from body dysmorphic disorder. People with BDD get fixated on one, maybe two or three facial features or body parts. The cause is a mystery.

Now UCLA scientists think they've figured out a piece of the puzzle. The brains of people with BDD have a defect when it comes to visual processing.

"In order to understand body dismorph disorder and visual processing, we did a type of brain scan," said Dr. Jamie Fuesner.

Using functional MRIs, psychiatrist Jamie Feusner studied the brains of 17 BDD patients versus a control group. They showed participants three different face images with different degrees of detail. Different parts of the brain are used when processing each one.

Feusner discovered when BDD patients looked at the "low-detail" face, they couldn't fill in the blanks, or as he says, "see the whole picture."

"Their brains were underactive for processing shape and configuration," said Feusner. "They may be seeing details, but in isolation."

So those isolated parts of faces appear distorted to someone with BDD. Feusner says teaching patients how to visually reprocess could be very effective. Research will hopefully help toward developing a treatment.

Jessica Martin saw a BDD specialist for two years. At first, she only ventured out at night because she wanted to hide her face. Cognitive behavioral therapy helped her deal with her obsession with mirrors.

"It's amazing," said Martin. "My life is completely different now, and I'm completely different now and I'm very, very grateful.

"I can leave the house. Nobody else cares. It's OK."

She still struggles with her self-image, but Martin understands there's much more to her than what she sees in the mirror.

The researchers at UCLA are now recruiting teens who may suffer from BDD or anorexia.

For more information: UCLA's Body Dysmorphic Disorder Program


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