Contact Burning Tree

Our Promise: Deliver life-changing clinical interventions to those who have been unable to find freedom from the unending cycle of relapse.

Send us a Message

Body Dysmorphic Disorder & Substance Abuse in a Dual Diagnosis

Addressing both BDD and substance addiction requires a comprehensive, integrated treatment approach to tackle the complexities of co-occurring disorders effectively.

Contents by Sub Topic

Shattered Reflections: Addressing the Challenges of Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD), as outlined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a mental disorder characterized by an obsessive focus on one or more perceived defects or flaws in physical appearance, which to others are either minor or not observable. This preoccupation can lead to significant distress or impairment in social, occupational, or other important areas of functioning.

  • Impact on Life: People with BDD engage in repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking) or mental acts (e.g., comparing their appearance with that of others) in response to appearance concerns. This can severely affect their daily life, leading to social isolation, relationship difficulties, and avoidance of public or work-related activities. The intense shame and anxiety associated with BDD can also contribute to depressive symptoms and suicidal ideation.
  • Scientific Research: Research on BDD has included neuroimaging studies, genetic investigations, and cognitive-behavioral analysis. Neuroimaging research indicates abnormalities in the visual processing and frontostriatal systems, suggesting that people with BDD have differences in how they perceive and process visual information, especially related to faces and bodies. Genetic studies hint at a familial component, suggesting that BDD may have a heritable predisposition. Cognitive-behavioral studies have focused on distorted beliefs and excessive attention to details in visual processing.
  • Prevalence of Addiction and BDD: Research on the comorbidity of BDD and addiction is limited, but studies suggest that individuals with BDD may have a higher risk of substance use disorders compared to the general population. The exact percentages vary, but some studies indicate that substance use disorders might occur in approximately 30% to 40% of individuals with BDD, often as a means of self-medication for their distress and anxiety about their appearance.
Colorized Photo of Main Building at Burning Tree Ranch
People with BDD engage in repetitive behaviors or mental acts in response to appearance concerns.

Compounded Challenges: Understanding the Intersection of BDD and Drug Addiction

Addiction can significantly complicate Body Dysmorphic Disorder (BDD) in several ways. Addressing both BDD and substance addiction requires a comprehensive, integrated treatment approach to tackle the complexities of co-occurring disorders effectively.

Increased Psychological Distress

Substance use can exacerbate the anxiety, depression, and stress associated with BDD, leading to a worsening of symptoms.

Impaired Judgment and Decision-Making

Addiction may impair cognitive functions, making it more challenging for individuals to make reasoned decisions about their health and treatment.

Escalation of Compulsive Behaviors

Individuals might use substances as a form of self-medication to alleviate the distress caused by their perceived appearance flaws, potentially leading to an increase in compulsive checking or grooming behaviors.

Treatment Interference

Substance abuse can interfere with the effectiveness of BDD treatments, including both psychotherapy and pharmacotherapy. Substance use can reduce the efficacy of medications prescribed for BDD and may also reduce an individual's engagement and progress in therapy.

Social and Financial Consequences

Addiction can lead to further social isolation, financial strain, and occupational impairment, exacerbating the social withdrawal often seen in BDD and complicating recovery efforts.

Increased Health Risks

The combination of BDD and substance use disorder increases the risk for overall poor physical health, including complications from drug use and potential self-harm behaviors associated with severe BDD.

The Silence of BDD: Barriers to Seeking Aid

People with Body Dysmorphic Disorder (BDD) often do not seek help for several reasons:

  • Shame and Embarrassment: The intense shame about their perceived flaws can make it difficult for individuals to open up about their struggles, fearing judgment or misunderstanding from others.
  • Lack of Awareness: Many people with BDD may not realize that their preoccupation with appearance is a recognized and treatable mental health condition.They might believe their concerns are valid and that their behaviors are justified.
  • Fear of Confirmation: There’s a fear that seeking help will confirm their worst fears about their appearance, making the distress even more unbearable.
  • Misplaced Priorities: Individuals may prioritize changing their appearance over seeking mental health treatment, believing that cosmetic procedures or alterations will resolve their distress.
  • Hopelessness: The chronic nature of BDD can lead to feelings of despair about the possibility of improvement or recovery, discouraging them from seeking help.
  • Stigma: The stigma associated with mental health disorders can be a significant barrier to seeking treatment. Individuals may fear being labeled or perceived as vain or superficial.
  • Poor Insight: Some individuals with BDD have poor insight into the irrationality of their beliefs about their appearance and may not recognize the need for psychological help.

These barriers highlight the importance of increasing awareness and understanding of BDD, reducing stigma, and providing accessible, empathetic treatment options.

Grain Silos at Burning Tree Ranch
Some individuals with BDD have poor insight into the irrationality of their beliefs about their apperance and may not recognize the need for psychological help.

In-Depth Treatment Strategies for Body Dysmorphic Disorder (BDD)

These comprehensive treatment strategies are aimed at addressing the complex nature of BDD, focusing on both symptom relief and long-term recovery.

Tailored Cognitive-Behavioral Therapy (CBT)

  • Designed to confront and alter distorted self-image and obsessive thought patterns.
  • Involves exposure and response prevention (ERP) to reduce avoidance behaviors and ritualistic actions.
  • Techniques include cognitive restructuring to challenge and change negative thoughts about appearance.
Illustration of Number 1

Selective Serotonin Reuptake Inhibitors (SSRIs)

  • First-line pharmacological treatment for BDD, aiming to reduce obsessive-compulsive symptoms.
    Commonly prescribed SSRIs include Fluoxetine (Prozac), Sertraline (Zoloft), and Escitalopram (Lexapro).
    Dosages may be higher than those used for depression, based on individual response and tolerance.
Illustration of Number 2

Complementary Strategies

  • Mindfulness and Stress Reduction Techniques: To manage anxiety and improve overall well-being.
  • Body Image Therapy: Group or individual sessions focusing on improving self-esteem and body acceptance.
  • Family Therapy: Educates family members about BDD and how to support the individual without reinforcing BDD behaviors.
Illustration of Number 3

Long-Term Management

  • Emphasizes the importance of continued therapy to prevent relapse.
  • Regular follow-up appointments for medication management and to adjust treatment as needed.
  • Encourages the development of healthy coping mechanisms for stress and thoughts related to appearance concerns.
Illustration of Number 4

From Distress to Recovery: Essential Guides on Body Dysmorphic Disorder

Each of these books contributes valuable perspectives and practical advice for understanding, treating, and living with Body Dysmorphic Disorder, making them essential resources for sufferers, their loved ones, and mental health professionals.

"The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder"

by Katharine A. Phillips, M.D.

This foundational book provides a comprehensive look at Body Dysmorphic Disorder (BDD), offering insights into its diagnosis, the suffering it causes, and treatment options. Dr. Phillips, a leading expert in the field, combines patient stories with data to illustrate the depth of BDD's impact.

"Feeling Good about the Way You Look: A Program for Overcoming Body Image Problems"

by Sabine Wilhelm, Ph.D.

Written by a clinical psychologist and researcher, this book offers a cognitive-behavioral approach to overcoming the distress associated with BDD and related body image problems. It provides strategies for readers to improve their body image and reduce the urge for cosmetic procedures.

"The Adonis Complex: How to Identify, Treat and Prevent Body Obsession in Men and Boys"

by Harrison G. Pope Jr., Katharine A. Phillips, and Roberto Olivardia

In this memoir, psychologist and researcher Kay Redfield Jamison, who herself has bipolar disorder, offers a vivid account of her experience with manic-depressive illness, blending the personal with the professional to shed light on this complex disorder.

"Body Image Problems and Body Dysmorphic Disorder: The Definitive Treatment and Recovery Approach"

by Thomas Cash and David Veale

Bringing together two leading experts in the field of body image, this book addresses the spectrum of body image issues, including BDD. It lays out evidence-based strategies for treatment and recovery, providing tools for therapists and sufferers alike.

"Overcoming Body Dysmorphic Disorder: A Cognitive Behavioral Approach to Reclaiming Your Life"

by Fugen Neziroglu, Sony Khemlani-Patel, and Melanie T. Santos

This workbook, grounded in cognitive-behavioral therapy, offers a step-by-step program for individuals struggling with BDD. It aims to help readers understand their disorder, challenge their negative thoughts about their appearance, and stop their compulsive behaviors.

Managing the Complexities of BDD & Addiction

Final Words for Families Considering Long-Term Treatment

In conclusion, effectively treating Body Dysmorphic Disorder (BDD) alongside addiction requires a cohesive, long-term approach that addresses both issues concurrently. Integrating cognitive-behavioral therapy with suitable medication offers a robust pathway to managing the complexities of BDD and substance abuse together.

Such integrated treatment in a long-term setting enhances recovery outcomes, providing individuals with the tools for a more sustainable healing process. Improving access to and awareness of these comprehensive treatment options is critical, encouraging those affected to pursue a journey towards recovery and a more fulfilling life.