We’re all a little vain. Having the perfect hair, the shiniest manicure and the sweetest perfume; it’s okay to want to look good.
But what happens when looking good becomes an obsession?
The Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD) is a disorder where one is preoccupied with an imagined defect in their physical appearance or when one has a distorted perception of their body image (Alavi et al., 2011; Franca et al., 2017; Ribeiro, 2017) which causes distress and hinders daily life functionality (APA, 2000). It stems from the Obsessive Compulsive Disorder spectrum and individuals must show the following signs in order to be diagnosed and treated:
- Fixation with one or more perceived defects in appearance which are not visible to others
- Repetitive behaviors and/or mental acts regarding appearance – mirror checking, excessive grooming, reassurance seeking
- Significant distress and impairment in social, occupational and other functioning areas
- Obsession with the appearance isn’t better explained by an eating disorder
Categories of BDD:
- Non-significant impairment in global functioning.
- Appearance concerns are localized.
- Concerns are realistic to psychosocial norms
- Patients show impairment in global functioning and display avoidant behavior
- May have depressive or anxious symptoms
- Extremely preoccupied with defect and have delusional beliefs about appearance – may indulge in constant mirror checking or even self mutilation
- Cosmetic procedures seem like a safety net
Both Severe and Mild Symptoms:
- Frequent anxiety regarding appearance
- Constantly checking mirrors and comparing self to others
- Display referential thinking, feeling that others feel the same way about the defects
- Resorting to unnecessary cosmetic/dermatological procedures and making abnormal demands to surgeons
Social Interaction or Social Altercation?
Social interactions have long been the primary way of human survival. Programmed by genetics to survive in packs, human interaction is one of the most important evolutionary behaviors. However, as time passed, the world changed.
So did people.
Interacting with people doesn’t necessarily mean a healthy survival. With negative behaviors of the likes of derogatation, racism and stereotyping being displayed, those with sensitivities to physical appearances might not fare too well.
Cognitive-Behavioral and Learning models have claimed that negative experience of body image (bullying, teasing) at an impressionable age condition values and beliefs about attractiveness and body image. Usually, these are accompanied with anxiety, shame or disgust at one’s appearance. (Neziroglu et al., 2008).
A study also found out that children who suffered from emotional, sexual and physical abuse may show tendencies towards developing BDD, stemming from the results of a study that showed 38% of 50 BDD patients reported abuse (Neziroglu et al., 2006).
Nearly 93% of adolescents have access to the internet and 89% of the 18-29 year age group is active on social networking pages. With internet becoming a very staunch source of learning, there’s no escaping what it has got in store. (Madden et al., 2013; Neziroglu, 2004)
Adolescents consider the perfect selfie picture on their social media feed as a measurement to achieving popularity amongst their peers. While these kids upload their selfies to win the beauty race, they’re also internalizing the dark message of beauty media, peers and others are enforcing on them.
The Dark Side of Social Media
With the advent of social media, where mainstream channels like YouTube, Twitter, Snapchat, Facebook, Instagram, Tinder, Bumble and various other channels of online social interaction exist, so does the problem of realistic beauty standards.
With brilliant photo shopping programs available for free downloads on smart phones, the world is now putting their most glamorous face forward. With options to edit your physical features like eyes, nose, ears and lips, and even change skin tone, hair and eye color, our social media feed is full of picture perfect people.
With BDD developing in adolescence, and the legal age of social media memberships being lowered to early teenage years, the presence of such perfect pictures has reinforced unrealistic beauty standards on adolescents worldwide, conditioning them to appreciate computer generation perfection. Never-before-seen freckles, a slight turn of the nose, a small scar behind the ear – all these things begin to look unappealing.
Preying on the Weak: Social Media and Self Esteem
Creating and online identity has become a very common phenomenon. Those with body image concerns can take it too far and let it impose body image concerns on them, especially females. In fact, a psychiatrist remarked that 2/3 of his BDD patients felt the compulsion to repeatedly take selfies and upload them on social media
The Selfie Fiasco
Females with BDD have rigid and perfectionist views about how they should look, indulging in negative self evaluation and low self esteem (Wilhelm, 2006). Such individuals try to indulge their narcissistic tendencies by uploading selfie photos on social media to gain validation, and according to the self verification theory, this is a means to receive self verification through positive feedback; for those with serious body issues, the constant need to seek appreciation and comparisons with others causes depression (Sawnn, 1983).
Research has also shown that since 2013, there’s been a 10% rise in rhinoplasty procedures, 7% increase in hair transplants, and a 6% increase in eyelid surgeries (Vats, 2015).
In early 2018, the negative effects of filters on applications like Snapchat and Instagram were highlighted. Patients had begun to visit plastic surgeons and demanded to look like their filtered pictures, leading one doctor to politely counsel his patient to look towards psychotherapy to correct her body image.
A professor at Northwestern University has remarked how the unrealistic manipulation of features, skin tone and looks had led individuals to lose perspective on how they really look, and doctors are now being warned to look out for BDD tendencies in their patients.
Instagram and Orthorexi
Social media not contributes to distorted self image in the BDD disposed individuals, but also makes them turn to certain acts to achieve that picture perfect look; in some ways, BDD feeds Eating Disorders, and vice versa.
A study was conducted on Instagram influencing an eating disorder: Orthorexia Nervosa. This disorder is characterized with an obsession to eat healthy and eschew certain impure or unhealthy food groups. In this case, the echo-chamber effect of social media comes into play, where individuals perceive their own values to be common even though they may be far from the norm. The #fitspiration tag on Instagram, which follows the healthy eating movement, revealed super toned bodies alluding to healthy eating and exercise, but with dangerously objectifying elements that could harm the BDD prone (Tiggemann & Zaccardo, 2016)
Interventions for Body Image Problems Arising Due to Social Media
Mental health organizations have said that social media does not necessarily bring the onset of BDD but definitely serves as a trigger for those who are predisposed towards BDD, currently are suffering from it, or those who have low self esteem and negative self image.
Either way, real life does not come with a filter, and neither is social media going to stop introducing newer ones. Various organizations and researchers are now working together to use social media to promote positive body image.
Practicing safe use of social media can be practiced by oneself and impose don younger children. Not interacting with social media pages that trigger body image issues and being wary of real and modified material on the internet is a must.
Parents and adults can limit their time spent on various social media applications, and monitor use of their children by observing their behavioral responses to what they are exposed to. Positive psychology has started advocating for positive self talk; practicing self esteem and self affirming self talks is one way to internalize positive feelings about oneself.
The Hashtag Control
The National Eating Disorders Association (NEDA) has been reportedly working with social media platforms to remove certain hashtags and ban provocative feed material.
They also launched their own website in 2011, Proud2BMe, which encourages adolescents to embrace their natural bodies and have a healthy relationship with food and self image. They also promote positive hashtags.
Various people have realized the detrimental cost to body image with photo shopping and filtering applications. Many of those recovering from Eating Disorders or trying to fight the demons of BDD are now sharing their recovery stories to encourage others with their real life examples.
Check out how this top runway model made her vitiligo her biggest strength.
Cognitive Behavioral Therapy
CBT modifies distorted thought processes through intensive talk therapy. Therapists try to understand and excavate the root cause of the problem and try to help their patient modify destructive thought patterns and equip them with coping skills to fight off their triggers.
For example, in CBT for BDD, a practitioner may focus on armoring their patient’s self esteem and modifying their self body image to make them braver and more self assured.
Some studies have found decreased serotonin transporter density, a depletion of tryptophan, greater white matter volume, small orbitofrontal cortex and a small anterior cingulated in certain BDD patients.
To counteract the behavior which these brain differences elicit in individuals, psychiatric evaluation and medication is also a route to recovery. Serotonin agonists, fluoxetine, and various other psychotrophics are utilized in the medical treatment of the disorder.
Social Media is Here to Stay
Social media is here to stay. With millions of people having access to all sorts of people, information and interactions online, this medium of communication is now a culture of its own. Of course, with every culture, there are those who do not benefit from the majority discourse.
It’s perfectly fine to care about one’s personal grooming and putting the best face forward; however, when the desire to be the best begins to cause distress and interrupt daily life responsibilities, that is the time to seek help. With psychiatric disorders, there’s only a thin line which distinguishes acceptable from the maladaptive.