Intrusive therapeutic or diagnostic procedures, such as insertion of a nasogastric tube, bladder catheterization, administration of intravenous fluids, endoscopy, and cardiac catheterization, can also threaten a patient's body image. Disturbed body image is a nursing diagnosis that was approved by the North American Nursing Diagnosis Association, defined as confusion in the mental picture of one's physical self. Men and women are equally affected. Patients are typically upset if someone or something interferes with or interrupts their ritual. The obsession, repetitive behavior, and constant covering up create stress for the affected individual and can have a negative impact on daily functioning and quality of life. The disorder appears to be equally common in men and women.
You may find that negative thoughts about your body are hard to control. New York: William Morrow, 1992. Major depression is common in those with body dysmorphic disorder, as are suicidal thoughts and behavior. No one else even notices it, but to Leslie, it appears that her nose is completely taken over by the bump. If unchecked, this behavior can create an inability to maintain employment or a social life, which can ultimately lead to the sufferer becoming housebound with anxiety and even attempts at suicide.
The diagnostic criteria specify that the condition must be sufficiently severe to cause a decline in the patient's social, occupational, or educational functioning. It has two major components: how the person perceives their physical appearance, and how they feel about their body. This involves gradually facing situations that would normally make you think obsessively about your appearance and feel anxious. Also requiring investigation are the optimal number, duration, and frequency of sessions as well as the relative efficacy of group versus individual treatment. If you stop, symptoms may come back. Patients may present to clinicians revealing only anxiety, depression, or suicidal ideation. The diagnostic criteria specify that the condition must be sufficiently severe to cause a decline in the patient's social, occupational, or educational functioning.
Diagnosis Imagine that you are a psychologist and Leslie comes to see you. Most patients also have impaired academic, occupational, or role functioning. Your doctor will keep a close eye on you over the first few weeks. Research into a neurobiological connection is still in early stages. The majority of patients in research studies to date have been Caucasians, but it is not clear whether this reflects racial patterns in the wider society or whether it represents referral bias, in that most study subjects are patients in private psychiatric hospitals. Body Traps: Breaking the Binds That Keep You from Feeling Good About Your Body. It can be very upsetting and have a big impact on your life.
The best treatment is probably a combination of the two. A minority, however, react in the opposite fashion and avoid mirrors whenever possible. Alcohol and recreational drugs can worsen symptoms or interact with medications. She's so embarrassed by it that sometimes she doesn't even want to go out of her house. But Leslie and people like her take this insecurity to a new level.
Beginning as a nagging insecurity, this illness can lead to compulsive symptoms such as hair plucking, skin picking, excessive grooming, eating disorders, repeated cosmetic surgeries, and varying degrees of clinical depression. In reality, the imperfections are imagined or only slight and barely noticed by others, if at all. They may use excessive makeup or try to use clothing to camouflage the imagined defect. It usually begins in your adolescence or teenage years. As the insecurity grows, the attempts to hide the flaw can lead to obsessive ritualistic behavior in the preparation for each day. However, the diagnosis is usually missed in clinical settings. Research indicates that the features most likely to be the focus of the patient's attention are in order of frequency complexion flaws , blemishes, , wrinkles ; hair on the head or the body, too much or too little ; and facial features size, shape, or lack of symmetry.
Even if you're feeling well, resist any temptation to skip your medications. New York: Henry Holt and Company, Inc. The term, body dysmorphic disorder, refers to a condition in which people perform excessive, repetitive behaviors or have repetitive mental thoughts due to a perceived or actual defect in their appearance. This is generally recommended only when you aren't able to keep up with day-to-day responsibilities or when you're in immediate danger of harming yourself. What Leslie is experiencing is, in some ways, not unusual. Low serotonin levels are associated with depression and other. Leslie might apply makeup several times a day, perhaps even several times an hour, in order to try to hide the bump on her nose.
This can lead to a rejection of the altered body image and feelings of depersonalization that can involve avoidance of interpersonal contact and an unwillingness to discuss the deformity or to accept corrective medical treatment or vocational rehabilitation. Some people also find it helpful to get together with friends or family, or to try doing something new to. The goal of treatment is to reduce or eliminate obsessive and compulsive behaviors, learn to recognize triggers and manage the stress associated with the behavior, as well as learn to view themselves in a non-judgmental fashion. After all, whenever she looks in the mirror, she can see a huge bump right in the middle of it. You may even spend hours each day worrying about how you look. Your treatment plan may also include family sessions in addition to private sessions.
Leslie is anxious and upset about her nose, which is a sign of distress, and sometimes she ends up staying in her house because of it, which impairs her social life and ability to hold a job. Her family and friends assure her that it looks normal to them, but she knows they're just being nice. Cognitive-behavioral therapy for adolescent body dysmorphic disorder: A pilot study. The patient's concerns may, however, involve other body parts, and may shift over time from one feature to another. They can fixate on other body parts too, however. This mental illness stands apart from typical insecurities about appearance in that the person who suffers is obsessed and chronically anxious about the perceived defect to the extent that quality of life is impaired.