Body Dysmorphic Disorder is not easy to overcome, but specialized treatment has proven successful for many patients. Most doctors use psychotherapy – specifically cognitive-behavioral therapy – and medications, such as selective serotonin reuptake inhibitors as a primary means of treating BDD. Patients may also benefit from a combination of traditional talk therapy, family therapy, and group therapy.
Cognitive-behavioral therapy (CBT) teaches patients about their thoughts, feelings, and behaviors in relation to Body Dysmorphic Disorder. Using the insights and education gained through psychotherapy, BDD patients begin learning healthy ways of confronting obsessions and compulsions. Over time, they can minimize those responses and ultimately feel better about themselves as a whole. Therapists usually customize treatment options, such as therapy type, number of sessions, and duration of treatment according to each patient’s needs and the severity of their disorders.
Exposure And Response Prevention
BDD patients who are undergoing CBT are encouraged to recognize the irrational nature of their appearance-related thoughts and engage in a form of behavioral therapy known as exposure and response prevention (ERP). During ERP sessions, unhealthy compulsive behaviors such as mirror checking, skin picking, and camouflaging are examined, and patients are tasked with resisting the urge to engage in them. Additionally, ERP confronts avoidance behavior and may involve participation in anxiety-inducing activities that promote habituation. For example, an individual who normally wears a lot of makeup would purposefully go into public with no makeup in order to address uncomfortable feelings of exposure and establish a tolerance to the situation. One of the primary goals of ERP is for BDD patients to learn that many of their concerns about appearance are excessive and uncharacteristic of healthy behavior.
The Food and Drug Administration (FDA) has not yet approved any medications for the treatment of Body Dysmorphic Disorder. However, some psychiatric medications that have been approved to treat other conditions can be prescribed to treat BDD. Usually, selective serotonin reuptake inhibitors (SSRIs) like those used to treat depression are initially prescribed and may include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), sertraline (Zoloft), fluvoxamine (Luvox), and paroxetine (Paxil). BDD patients usually require higher doses of these medications than patients who are taking the drugs to treat depression, and it may take up to 12 weeks for patients to notice improvements in symptoms. Cosmetic procedures such as plastic surgery to improve the perceived defect have no scientific support and the dissatisfaction with the perceived defect remains or moves to another part of the body. Dysmorphophobia can rarely be cured altogether, but one can work with alternative thoughts and do so so as to be as symptom-free as possible and can live a relatively normal life.
In select cases, patients are prescribed more than one medication to treat BDD symptoms. Specifically, some doctors may prescribe an anti-psychotic medication to treat BDD-related delusional thinking, as well as anti-anxiety medication to manage anxiety or agitation. Some patients may need to take these medications for a considerable amount of time, especially those who have a history of suicidal thoughts or behaviors. Patients taking prescription medications should carefully follow doctor advice for use and report any sudden changes or side effects immediately.