Dysmorphophobia is the exaggerated preoccupation with a self-suspected physical distortion. So it is a wrong body perception. Also known as disfigurement syndrome, this psychiatric disorder is characterized by an obsessive and excessive urge to perceive yourself as obnoxious or ugly. For a long time scientifically controversial, body dysmorphic disorder is now again the focus of medical discussion.

What is dysmorphophobia?

According to Polyhobbies, the word dysmorphophobia consists of three compound Greek syllables – “dys”, “morph” and “phobios”. It denotes the shyness, fear or fear of one’s own external appearance, of one’s own external shape. Today the so-called body dysmorphic disorder is classified and recognized as an independent, psychiatric disease picture. If a patient is diagnosed with dysmorphophobia, the patient is entitled to adequate therapy.

The mental illness often has a very negative impact on the lives of those affected due to the false perception of their own self-image and often leads to depression; suicides due to dysmorphophobia have also been proven.

Due to the possibilities of cosmetic plastic surgery, which has made enormous progress in recent years, this psychiatric disorder is moving more into focus again. If one’s own self-perception is permanently disturbed, however, it is questionable whether the patient can really be helped permanently with such an intervention.

Causes

In the case of dysmorphophobia, an unprocessed, inner-soul conflict is assumed. Performance and quality of life decline more and more as the mind loops of those affected only revolve around the alleged distortion of the face or other parts of the body.

Even if the affected person is credibly assured by relatives or doctors that there is a distorted picture of their own perception and reality, this is negated by the patient. In addition, it is often the case that the sick fearfully avoid the advice of specialists, for example specialized psychiatrists.

Body dysmorphic disorders are often associated with a lack of self-esteem and hypochondria. Since many sufferers avoid contact with a doctor in connection with their misguided body awareness, a high number of unreported cases must be assumed. Everyone has certain physical characteristics that characterize them and make them unique. Most people get along well with it, but the concerns of patients with dysmorphophobia are always characterized by a clear exaggeration.

Symptoms, ailments & signs

There are no reliable data in the medical literature on the gender distribution of the disfigurement syndrome, as exact studies have not yet been carried out. Specialist authors assume an equal distribution between men and women, others describe a slight predominance of the female sex.

What is certain, however, is that dysmorphic behaviors can already begin in childhood and adolescence. Once the excessive preoccupation with one’s own physical appearance is set in motion, the symptoms and complaints worsen with increasing age.

However, the longer the symptoms persist, the more difficult it is to initiate adequate psychiatric therapy. The sick experience themselves as supposedly ridiculous, repulsive or ugly, although objectively they look completely normal. The idea of ​​one’s own ugliness often relates to the whole body, less often to individual areas.

In particular, the shape, symmetry, size or position of certain body areas or extremities are questioned. Typical examples are the distribution of fat, dissatisfaction with the position of the teeth, a tendency to redden or the wrong assumption that the lips, chin, cheeks, mouth or nose are ugly.

Diagnosis & course

Those affected suffer from a self-created vicious circle of self-rejection and agonizing apprehension. It is typical that one’s own appearance is constantly questioned or checked in mirrors. The deep psychiatric diagnosis often reveals narcissistic personality traits and profound inferiority. Due to the general tendency to withdraw and shyness, the psychosocial consequences for those affected are often considerable.

In many cases it is the general practitioner who, with his good knowledge of the patient, makes a suspected diagnosis, which must then be corroborated by a psychiatrist or psychological psychotherapist. An adequate therapy should therefore be initiated early enough so that a tendency towards chronification can be effectively counteracted. Because the course of the disease is considered to be protracted, and it is not uncommon for those affected to remain prisoners of their fears of pathological disfigurement for a lifetime.

When should you go to the doctor?

As a rule, those affected suffer from a number of different psychological complaints due to the dysmorphophobia. For this reason, a doctor should be consulted with this disease if there are significant inferiority complexes or a reduced self-esteem. Urgent treatment is especially necessary if these symptoms occur for no specific reason. Medical treatment is also useful if teasing or bullying occurs in order to avoid further complications and complaints.

Furthermore, the dysmorphophobia can also lead to thoughts of suicide. In many cases, the patient’s parents and relatives must also be aware of the symptoms and contact a doctor. In severe cases, it makes sense to stay in a closed clinic. This can significantly alleviate the symptoms. Most often, the diagnosis of dysmorphophobia is made by a psychologist. Treatment can also be carried out by a psychologist. The earlier the disease is diagnosed and treated, the higher the chances of a complete cure for the patient.

Treatment & Therapy

A schematic psychiatric treatment for incorrect body perception is still not known, which is why every therapy for a dysmorphic disorder must be based on the individual situation and problem of a patient. The therapist must first manage that a patient opens up to him, gains trust and wants to be helped at all. A causal, i.e. cause-related therapy, is not possible because the psychological background of the dysmorphophobia is still unknown today.

Only if depression occurs at the same time is the administration of psychotropic drugs justified. The therapy is otherwise limited to accompanying psychotherapeutic sessions of behavior therapy. If patients express varying, vague or diffuse complaints, cosmetic operations are strongly discouraged. Because the mental impairments hidden behind the complaints cannot be removed by a desired medical cosmetic surgery.

Outlook & forecast

In dysmorphophobia there is a prospect of a cure as soon as the disease is professionally treated therapeutically and the diagnosis and therapy take place at an early stage.

Most patients experience an improvement in their health with cognitive behavioral therapy. The therapy can be carried out on an inpatient or outpatient basis. When used in conjunction with drug treatment, significant relief of symptoms is seen in patients.

The administration of medicinal products without psychotherapy have proven less effective. In most cases, symptoms resolve as soon as the prescribed drugs are discontinued. The best prospects for recovery are the combination of therapy and medication. Therapy lasts for several months or years. The complaints recede gradually until a symptom-free condition can be achieved.

If left untreated, the dysmorphophobia can develop into a chronic course. The prognosis deteriorates significantly. Spontaneous healing is considered very unlikely. The symptoms of the disease fluctuate in intensity as the disease progresses. At the same time, however, the symptoms get worse the longer the disease is present. As the symptoms increase, the patient’s risk of suicide gradually increases. Timely therapy is crucial so that no critical or life-threatening situation occurs.

Prevention

Dysmorphophobia is a highly complex, sometimes bizarre, picture of suffering with a persistently negative body perception. Since it has to be assumed in many cases that the cause of the symptoms is laid in childhood, prevention should start here.

In the case of children and adolescents with a tendency to withdraw or who are constantly preoccupied with their own deficiencies, sociotherapeutic corrections should be made at an early stage or conversational psychological offers should be made.

Aftercare

Since dysmorphophobia is a serious and, above all, serious psychological disorder of the person concerned, the person concerned is usually first dependent on intensive psychological treatment by a doctor. In most cases, self-healing cannot occur, so treatment should always be carried out. Measures or options for follow-up care are usually not available to those affected with dysmorphophobia.

The triggers for this disease should definitely be recognized and avoided. The earlier the disease is recognized and treated, the better the further course is usually. The dysmorphophobia is treated with the help of medication and psychological counseling. It is important to ensure that the dosage is correct and that the medication is taken regularly so that there are no further complications.

The relatives and family of the person affected must understand the disease and deal with it in any case. In doing so, intensive discussions with the person affected are often necessary. In serious cases, the relatives should persuade the patient to have treatment in a closed institution so that there are no further complaints. The dysmorphophobia does not reduce the life expectancy of the person affected.

You can do that yourself

In the case of dysmorphophobia, the options for self-help in everyday life are only possible to a very limited extent for the sick person. Normally, the person affected is not able to carry out the health-promoting measures on their own initiative. The disorder is based on psychological causes and the impossibility of a real assessment of oneself. Therefore, there are only few action variations for the person concerned.

The own body is not deliberately misperceived. The disturbance can therefore not be controlled deliberately. It is part of the appearance of the disease that it is not possible for the person affected to see their own body for real and to recognize the contours. For this reason, people from the close social environment are often more responsible. They should ask the sick person about the help they need. A stable relationship of trust is necessary for this. In severe cases, the relatives also need advice and help from expert staff.

Information about the disease and its appearance are necessary in order to learn and implement the correct approach to dealing with the sick person. Patience, calm and comprehensive information about the disease are essential for this. The person concerned must not be harassed or put under pressure through everyday comments. Shame, feelings of guilt, or doctrinal words should be avoided whenever possible.