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Seroquel (Quetiapine)

Seroquel (Quetiapine)

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HOW IS BDD DEFINED: PREOCCUPATION
The Criterion describes the preoccupation that occurs in BDD. People with BDD worry that some aspect of their appearance looks defective in some way. They may describe the body area or areas as ugly, unattractive, flawed, “not right,” deformed, disfigured, or even as grotesque, hideous, repulsive, or monstrous. People with BDD have more than an occasional thought that they don’t look right—they’re preoccupied. They think excessively about their supposed appearance problem; some people in fact find it hard not to think about it. They say such things as “I think about it a lot,” “It’s always on my mind,” “It’s like a second reel that’s always going,” or “I’m obsessed.” People with BDD generally spend at least an hour a day thinking about the supposed defect. On average, they spend somewhere between 3 and 8 hours a day.
The definition then states that the defect is imagined or slight. Some people with BDD “imagine” their defects, in the sense that they’re preoccupied with something that others don’t perceive at all. Other people with BDD actually have a physical defect, such as mild acne, a small scar, or slightly thinning hair, but by definition the flaw is slight. Nonetheless, they’re preoccupied with it and consider it ugly and clearly visible to others. A study from England, which used an objective measure of facial appearance known as morphoanalysis, found that in BDD the disliked body area usually looks normal. I’ve found that about a third of people with BDD have a defect that’s slight, whereas in about two thirds the body part of concern looks completely normal. Considering their overall appearance, in my experience, nearly everyone with BDD is of average or above average attractiveness.
But the word “imagined” is complicated and can be problematic. While some people with BDD realize that they imagine their defect—that it really looks okay and they’re blowing it out of proportion—many are certain—or nearly certain—their view is correct. They think they really do look terrible, and they balk at the word “imagined.” They worry that if they’re imagining their defect, they may be labeled as “crazy.” Some insist that because they’re not imagining the defect, they must not have BDD, even though they really do. One person asked me, “My problem is really there; it’s true. Do you deal with true things or only imaginary things?” He thought that if I dealt only with “imaginary things,” then I wasn’t the doctor he should be seeing.
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