Ugly self-image has many unable to function in society

Just one look in the mirror is enough to send Carley Finn spiraling into a full-blown anxiety attack
Body Dysmorphic Disorder, or BDD, is described as an excessive preoccupation with a slight or imagined defect in one’s physical appearance. With BDD, a person’s focus is usually on the face and head.
PHOTOGRAPHER:
Body Dysmorphic Disorder, or BDD, is described as an excessive preoccupation with a slight or imagined defect in one’s physical appearance. With BDD, a person’s focus is usually on the face and head.

Just one look in the mirror is enough to send Carley Finn spiraling into a full-blown anxiety attack.

She is plagued by “a bunch” of pimples and blotches that mottle her complexion and is tortured every time she gets a glimpse of her nostrils — one of which, she believes, is smaller than the other, giving her nose a slight lean.

To make matters worse, she thinks she has been “cursed with beady eyes” that look as though they belong to a rodent, and the pores around her nose and cheeks are so distended they resemble what she perceives as “freakish craters.”

With so many appearance-related hang-ups, one might assume Finn would go out of her way to avoid her reflection.

But that is hardly the case.

Debilitating condition

For the past 12 years or so, the Saratoga County woman — who was forced to quit her job and move back with her parents two years ago because she could no longer cope with work and her personal anguish — estimates spending between two and three hours compulsively checking her flaws in myriad mirrors scattered about the house each day.

Finn is one of millions of people suffering from a condition known as body dysmorphic disorder — described as an excessive preoccupation with a slight or imagined defect in one’s physical appearance.

“I can’t even begin to describe how horrible it is to be me,” explained the 34-year-old, fighting back tears. “I am a prisoner in my own body and my home. I can’t even hold down a job because I spend all my time thinking about how hideous I am,” she said.

“I literally spend my days picking myself apart. A few times, I have even attempted to correct what I see with tweezers or by poking at them with needles. It’s no way to live. I guess the reason I check so much is because I just can’t believe that all of the horrible things all over me are really real. I always hope one of these times I’ll look and they’ll be gone. But that’s never happened. If anything, I notice more and more imperfections. There have definitely been times where I’ve thought of ending my misery. I’d do anything to be normal.”

Psychiatric evaluation

Out of sheer exasperation and an inability to find any of the imperfections their daughter finds so debilitatingly distressing, Finn’s parents brought her for a psychiatric evaluation several months ago.

“It was such a relief to me,” said Finn’s mother, Mary.

“All of these years, we’ve tried so hard to understand how [Carley] could see things that nobody else can see, and now we have our answer. At least her condition has a name. We have a diagnosis. We aren’t in the dark anymore. We can focus on getting her better. I’m determined to give Carley a good quality of life.”

With body dysmorphic disorder, a person’s focus is usually on the face and head. Common obsessions involve moles and freckles, acne, minor scars or skin aberrations, facial or body hair, eyes, teeth and the overall size, shape and symmetry of the face.

The disorder affects about 1 to 2 percent of the population, or three to five million people, and it is known to affect men and women equally, according to Scott Granet, a licensed clinical social worker who works at the Palo Alto Medical Foundation in California and is an expert on the topic. He has co-authored “Ten Steps for Treating Body Dysmorphic Disorder.”

Granet said the disorder typically establishes its roots in adolescence, a time when young people are most sensitive about their appearance.

Contrary to popular belief, while BDD sufferers may spend hours scrutinizing themselves before a mirror, they are not narcissistic. Rather, said Granet, these people are consumed with thoughts about being hideous and grotesque. And while they are often aware of the inappropriateness of their behavior, they have great difficulty controlling it.

The severity of the disorder varies. Some people are able to function and cope with daily life, whereas others — like Finn — experience paralyzing symptoms of depression, anxiety and a complete avoidance of social situations.

Getting help

The standard treatment for body dysmorphic disorder is a combination of medications, often antidepressants and other types of treatment, most notably cognitive behavioral psychotherapy.

This therapy involves having the person confront her behaviors, such as mirror-checking and camouflaging, and then having her resist the urge to engage in them.

Edwin Williams III of the Williams Center For Facial Plastic Surgery in Latham said BDD is always on his radar when evaluating patients.

“When I look at [a patient] and I think their findings are out of proportion to what I see, and that it is consuming a person, then this person is showing me signs of BDD,” he said. “As a human being and a physician, I know they are not people to operate on, because I will only disappoint them. They will always find something else to be unhappy with,” he said.

Williams estimates that he sees one to two patients a year with the disorder, and he always strives to identify the people and get them into the right hands.

“Their body language is a huge tip-off,” he said. “I can usually pick up on it within the first two to five minutes,” he said.

Keith Ablow, a New York Times bestselling author also known as “America’s Psychiatrist,” agrees with Granet that psychological help is the only effective treatment for BDD sufferers.

“People with BDD don’t accept that their problem has been fixed by one or two or even 10 procedures,” he said. “That’s because their obsessive belief that they are disfigured isn’t based in reality. They see the defect when it isn’t there. So there’s no ‘fixing’ it, for real. In fact, people with BDD may think the problem has gotten worse when a procedure is used to try to fix it,” Ablow said.

Fugen Neziroglu, clinical director of the Bio-Behavioral Institute in Great Neck, and a psychology professor at Hofstra University, notes that the rate of hospitalization for patients with BDD is about the same as it is for those with schizophrenia, and the suicide rate is quite alarming.

About 80 percent of those with BDD have thoughts of suicide, and one percent go through with it, she said.

“These individuals clearly see something that other people can’t see,” Neziroglu said. To take an online quiz to find out whether you or someone you love is suffering from BDD, Neziroglu advises people to visit www.bio-behavioral.com.

Praying for help

As for Finn, she is just praying that therapy and prescription antidepressants will soon alleviate some of her symptoms.

“I think things are so bad and have been for so long that even a slight improvement will feel like a tremendous change for the better to me,” she said. “It’s not that I want to be able to look in the mirror and think I’m attractive. I don’t think that will ever happen. I just want to be able to look at myself without thinking about how I want to die.”

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