HOW BDD AFFECTS LIVES – SOCIAL CONCEQUENCES: BDD AND RELATIONSHIPS
Many people have told me that they haven’t had children—or never will— because of their BDD. As one patient told me, “I grew up praying that my brothers wouldn’t look like me, and I was always reluctant to have children for the same reason.” Like this man, many are afraid that their children will be ugly. Others worry that their children will have BDD and don’t want them to suffer with such a painful illness.
BDD also often interferes with friendships. Friends may find it hard to understand why social events are missed or attended only after much urging and encouragement. They may be puzzled and frustrated by lateness and last-minute cancellations. Many a person with BDD has ended up spending an evening or day alone instead of with friends as planned.
“I can barely be with friends because I think they’re thinking how ugly I am,” a 28-year-old woman told me. “I haven’t seen my friends in the past 20 years,” another said. “The main reason is I’m afraid they’ll see how I’ve aged and that my hair is thinner. I become really upset whenever I see people I haven’t seen in a while. I think they’ll notice how I’ve changed. It’s gotten to the point where I totally avoid people. I’ve cut myself off.” Family get-togethers, weddings, and funerals may be anticipated with great trepidation and fear—or missed altogether. “I’ve missed a ton of social events because of my appearance,” Guy told me. “To tell you how bad it is, I missed my two best friends’ weddings! I felt too ugly to go. I’ve missed Christmas get-togethers. If I went, I wouldn’t enjoy myself because of how I look. I’ve hurt other people because of it, by not showing up. My BDD is too overwhelming to go. I’ve humiliated my parents by not showing up at relatives’. It really bothers me. My family and friends never knew the extent to which I was worried about this.”
It’s sometimes difficult to determine how much the BDD symptoms themselves are responsible for social problems such as these. It is simply the BDD? BDD is so often accompanied by social anxiety and low self-esteem that it can be hard to tease them aDart. But people with BDD generally say that their BDD symptoms are the cause of their social problems or significantly contribute to them. My research findings show that the more severe BDD symptoms are, the poorer social functioning is. This is also true for overall functioning. And when BDD responds to psychiatric treatment, social functioning usually improves, sometimes rapidly and dramatically and sometimes more slowly, especially if symptoms are long-standing and severe.
Researchers have shown that social anxiety and fear of social rejection are
more commonly experienced by less attractive people and by those with a negative body image. While people with BDD aren’t in reality less attractive on
average than other people, they think they are.
Teresa summed up what so many people with BDD feel: “I feel so ugly and unpresentable that I avoid parties and dates. I feel too anxious when I’m around other people. I think they’re evaluating how ugly I am and that they’re thinking I’m ugly and disgusting. I feel like a leper. I’ve stayed in a lot in the past few years. This problem has utterly and completely limited my social life.”
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