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Other names: Wellbutrin, Bupropion
HOW IS BDD DEFINED: PREOCCUPATION – THE DEFECT IS REALLY ONLY SLIGHT
Occasional BDD sufferers themselves agree that the defect is really only slight and that they have a distorted view of how bad it is. They’re more likely to recognize this after they’ve had psychiatric treatment. As one young man told me, “My view of my appearance is illogical?I know I really look okay. I’m making a mountain out of a molehill.”
If the defect is slight, then BDD’s definition requires that the person’s concern is “markedly excessive”?that is, they must be preoccupied. In addition, they overreact to the minor defect in terms of how it affects their life. Charles, a college student, left his dorm room only once during a two-week period when his mild acne worsened. He missed his classes and avoided all social activities. He even didn’t visit a close friend who just learned he had cancer. True, Charles had some pimples, but hardly enough to warrant such extreme avoidance. Charles qualified for BDD because his defect, while present, wasn’t particularly noticeable, and his reaction was excessive.
What if I can’t assess the severity of the defect because of its location? This is another challenge in diagnosing BDD. Many people with an “unassessable” defect have another supposed defect that’s visible and can be assessed, which allows the diagnosis to be given. For example, although I didn’t evaluate one patient’s buttocks, I could see that his concern with his “crooked” eyes was unfounded. In other cases, an “unassessable” defect has been assessed by someone else who thinks it’s fine; men with penis concerns often say that spouses and doctors alike have told them the size is normal. This information also allows a presumptive diagnosis of BDD to be made. Making the diagnosis can also be complicated if skin picking (a common symptom of BDD) has caused noticeable scarring. If it can be ascertained that the acne or scarring was fairly mild before the picking began, the person is a candidate for the BDD diagnosis.
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COMING OFF DRUGS: RELAPSES AFTER LONG-TERM SOBRIETY
Unfortunately, chemical dependence is a relapsing illness, no matter how long you have been clean and sober. As we have said before, the susceptibility to drugs or drink remains. An addict or an alcoholic is never cured.
Relapses often occur when NA or AA members begin to take sobriety for granted. They stop working at the Twelve Steps and feel that they have their drugs or drink problem beaten for ever. Sometimes they drift away from meetings. At other times they keep up their meetings, but it is merely surface compliance.
Sometimes they simply get bored with NA or AA. Occasional periods of boredom or disenchantment do not matter as long as you keep going to meetings and remember why you are there. One easy cure for boredom is to get involved in helping addicts or alcoholics who are still using drugs or still drinking. It reminds you how lucky you are to be clean and sober.
There is a very quick check you can run on yourself any time that you begin to feel bored or disenchanted with NA or AA. Ask yourself the following questions.
1. Do I have a home NA or A A group?
If not, why not? The advantage of regular attendance at the same NA meeting is that people get to know you and you can get close to them. Because they know you, they are likely to notice if your thinking is moving away from the Twelve-Step programme. They will also notice odd behaviour. That way, they may be able to warn you in time if you are drifting towards a relapse.
2. Am I in regular touch with my sponsor?
The idea of having a sponsor is that you have somebody who knows all about you to whom you can talk if difficulties arise. It’s no good having a sponsor whom you never see or never talk to (though you need not be ringing them ceaselessly). If you haven’t got a sponsor, does it mean that you think you can manage without one? Or that you don’t want somebody to know all about you?
3. Am I working on the Twelve Steps?
You don’t have to be a saint, but you should be leading a life which more or less conforms to your and other members’ interpretation of the Twelve Steps. If you have decided that you can do without them, then you are risking much unhappiness. Is there something in your life that you are not feeling good about? Resentments, self-pity, guilty secrets or defiant behaviour could all be signs that you are heading for trouble.
4. What am I doing for the addict or alcoholic who still suffers? Helping other addicts and alcoholics is an essential part of recovery, and if you are not doing it, you are taking risks with your own sobriety. You can help others by volunteering for Twelve-Step calls, doing volunteer, phone duty, helping run a meeting, helping order literature, taking care of the tea and coffee, or putting out the chairs for a meeting. Practical involvement in NA or AA should be continued, for without it you put your sobriety at grave risk. Not being regularly involved may be the first sign that you are drifting away.
*123/116/2*