True Life “I Hate My Face:” Inside the myths and reality of body dsymorphic disorder (BDD)

Many people completely misunderstand body dysmorphic disorder, the condition featured in tonight’s True Life “I Hate My Face” (MTV, 11 pm EST). It’s not a condition of vanity, a character flaw or something that people can simply snap out of.

There are two causes of body dysmorphic disorder (BDD), which may be interlinked: neurological and psychological. The disorder is often grouped with Obsessive Compulsive-type disorders because of the constant obsessive thoughts and anxiety that sufferers experience.

Most people can find something about their face or body that they don’t like, but people with BDD cannot stop thinking about whatever flaw they perceive until their actual perception becomes distorted. When they look in the mirror, they don’t see what other people see. Eating disorders, drug abuse, isolating behavior, and suicide occurrences are much higher among people with BDD.

It’s hard for normal people to understand, especially if there is nothing wrong with the person’s appearance, like the young ladies profiled on tonight’s True Life episode. Here’s a preview clip, in which one of the subjects tries to relate to her boyfriend. He was intially drawn to her because he thought they both had similar issues, but now realizes that she has something much deeper, illogical, complicated, and tortuous happening to her :

Here’s a description of what it’s like to life with BDD from someone’s who’s recovered (Via Wellshpere):

“Throughout my life, I have been told time and time again to shut up about it. Stop being silly, stop complaining. You have a nice face. Gripped with blind panic, while my nails bore into the door frame and bleed at the corners, stop overreacting. Stop whining. Stop crying. Shut up. When I’ve been smashing my head against a wall sobbing because I am too ugly to be seen by anybody, teeth-grinding annoyance, rather than sympathy, has been my bedfellow. It irritates me too because I don’t want it to matter. My behaviour, when it comes to my looks, is very draining and irritating to people.”

True Life follows 26-year-old Pamela, a very beautiful young  woman has been been seeing a psychiatrist for ten years, but all he does is give her drugs. She’s been obsessed with her perceived ugliness since she was a child wears a bindi to distract people from her face. Her mom wants her to get intensive cognitive therapy, but she wants to get a nose job.

Another pretty lady named Mandie is obsessed with her chin, and her crows feet. She also takes pills for anxiety and wants plastic surgery. Oddly enough, she’s a lingerie model and somehow allows her face to be photographed because “people aren’t looking at my face.” She likes when the makeup artist puts on lots of makeup and she can cover her face with her hair. She imagines that plastic surgery will help her become a more successful model, and is putting off her wedding with her fiance Dan until she’s had her plastic surgery. When she consulted with the doctor about her crow’s feet and wiggly chin, he suggested Botox, which she didn’t like. She must have been hoping for something a little more Heidi Montagesque.

After Mandi has Botox injected, she feels better initially, but realized that she still hates her face. She admits to the camera that her problems are probably much deeper than just how she looks outwardly. The next morning, she feels a little better about her face, and wants to go ahead with a boob job, a move to distract people from looking at her face.

Pamela dies her hair blond and gets a nose job, but she still feels unsatisfied with her life. After another brief season with her therapist, the update screen reveals that she decided to have a baby to get over her BDD issues, and is currently pregnant.

Treatment for BDD is much like any treatment for a psychological disorder. As Pamela’s therapist noted, you have to want to get better. You have to delve inside yourself and find the root of your problem “fight, not freeze.” Also, like most emotional and psychological disorders, it takes a lot of pain and facing your worst fears to overcome. It’s a process that doesn’t happen overnight. For those of you who think these girls are just wanting attention, that may be part of the reality, but there is another deeper part that they must overcome in order to live healthy, happy, productive lives.

The episode’s producer, Leigh Stieglitz noted in MTV’s Remote Control Blog that the worst part of BDD is the resulting isolation:

“What struck me as one of the disease’s worst aspects is the utter isolation it causes. Mandie has extreme anxiety about leaving the house — she feels that she isn’t even pretty enough to go to the drug store — and it results in her spending most of her time at home. Very few people in her life knew how deeply she suffered.”

UPDATE: As of 2012, Pamela had given birth to a baby and married her boyfriend Jason. For while she felt better, but was unable to escape her BDD. She constantly has negative thoughts about her looks, and saves up money for plastic surgery.

Pamela has gotten lipo on her stomach and back, eyelid surgery, and butt injections.