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BDD – A SPECTRUM OF SEVERITY: DEPRESSION CAN BE SEVERE AND LIFE-THREATENING
So BDD’s severity spans a spectrum, ranging from relatively mild to life-threatening. In this way, BDD is like other medical problems. Severe diabetes can lead to hospitalization and serious medical complications, such as blindness, whereas people with a milder form can remain active and productive. Heart disease, too, spans a spectrum from severe to mild; it can seriously limit one person’s ability to work and engage in leisure activities but impose few limitations on another person’s activities and enjoyment of life.
Psychiatric problems are no different. Depression can be severe and life-threatening: a severely depressed person may be unable to eat, sleep, or get out of bed, and may even commit suicide. But depression can be milder: many depressed people, despite their suffering, manage, with effort, to function adequately. No one would ever know they were depressed. One person with a severe phobia may not be able to leave her house, whereas someone with a milder case may go out despite her fear. BDD is similar. When it’s severe, it’s as crippling as any serious psychiatric or medical illness. At the milder end of the spectrum, it’s more manageable and even shades into normality.
Some people I’ve seen, who had heard or read about a particularly severe case of BDD, told me they thought they didn’t have the disorder because their symptoms “weren’t that bad.” Others, with severe BDD, thought they might not have the disorder because their symptoms were so severe there couldn’t possibly be other people who had the same problem, who suffered as much as they had. But they all had BDD.
BDD varies from person to person in other ways. Some people are preoccupied with their hair, others with their buttocks, others with their legs, testicles, or eyebrows. Any body part can be the focus of concern. Even among people concerned with the same body part, exactly what they dislike can differ. One person might think her hair is too flat, whereas another believes his sticks out too much. One person may think his skin is too red, whereas another feels hers is too white.
Although no one with BDD has exactly the same experience as anyone else with BDD, all people with BDD have important things in common. The severity may differ, the body areas may differ, the behaviors may differ somewhat from person to person, but there are many things they share. Everyone with BDD is concerned with some aspect of their appearance that they consider ugly, unattractive, or “not right” in some way. Everyone is distressed or doesn’t function as well as they might because of their preoccupation. The details differ from person to person, but these basic themes are shared by all.
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