I am reading a wonderful book, if not the only real book on the successful treatment and management of BDD.
It is called Understanding Body Dysmorphic Disorder
It has been helpful. It has given me both clarity and confusion. Sometimes as a BDD sufferer the hardest thing to do is to differentiate what is real from what is a delusion.
This is where it is good to have a third party.
Treating BDD with an SSRI
What the book definitely recommends is beginning treatment of your BDD with an SSRI.
There are many options and the studies she presents are from her own practice and are limited.
But she makes a convincing case for the use of antidepressants and reports significant benefits, in the realm of 85% response rate with the addition of an SSRI.
With that I decided it was time to give it a try.
Choosing the Right SSRI
Honestly, looking at her data they all seemed appropriate, most of her studies were based on a rather small sample size. But the choice seemed to come down to two.
- Lexapro
- Celexa
These are both generic and good inexpensive options.
With both medications, the point is to start low and then increase the dose based on the response. Usually, this can be done at two-week intervals and should be continued for 12 weeks regardless of the perceived benefit. As long as there are no really bad side effects. I will talk later about augmenting these SSRI’s or changing to a different SSRI. But for now I just want to talk about my experience.
Beginning Lexapro 10 mg daily for the treatment of Body Dysmorphic Disorder
So I started treatment of my BDD with Lexapro 10 mg taken first thing in the morning.
I started exactly 7 days ago.
I wish I could say I felt like a million bucks, but I really haven’t noticed much difference. The thing that makes the difference is sleep. Which to be honest during my recent “attack” has been hard to come by.
So, to overcome this I also started taking 10mg of Ambien (Zolpidem) at night. Last night was the first night I took the Ambien and I feel so much better. Simply relaxing my mind and finally getting some sleep did more for my mood than anything.
I don’t particularly want to take sleep medications, but if you are up at night worrying about your appearance I would highly recommend the addition of either a cheap generic sleep aid such as Ambien (Zolpidem) or if your anxiety is out of control maybe a benzodiazepine such as Diazepam at a dose of 5mg.
The anxiety is the hardest part for me to overcome. I am fine at home and while I sit here and write, but outside in the daylight when I am around people it is hard.
I haven’t talked much about what has made things so bad recently, but it involves a recent accident I had, that caused a rather significant scar on my left cheek. This coupled with my underlying disorder has sent me over the edge. I will talk a bit more about this in the future.
If you have any questions feel free to drop a line in the comments section.
his is a wonderful book! Written by the Director of the MGH OCD and Related Disorders Program, and Founder of the Body Dysmorphic Disorder Clinic, this book offers individuals suffering from Body Dysmorphic Disorder with critical tools to understand BDD and to bring their disorder under control. The step by step approach detailed in the book is exactly what is needed for patients and clinicians alike. I have enthusiastically been recommending it to all of my clients who have BDD, and to colleagues interested in learning more about it. This book offers new hope to the millions of people worldwide who live with this troubling, but treatable disorder.
Hi Stephen, I have suffered with anxiety/depression all my life, now I’m not sure if I have BDD but I do have an obsessive, life dibilitating, thought regarding my penis, I’ve been to a urologist, he said it’s fine, my girlfriend says it’s fine, she’s even pregnant!! but this obsessive thought is there every second of every day. I’ve been told it’s just anxiety “doing its thing”, as in my anxiety makes me focus on things that would bother me the most or I perceive to be imperfect. I also have very strong stomach rumblings, very tight chest, tinnitus and other symptoms that tell me I am suffering from anxiety so maybe it is just an anxious obsessive thought, if you could shed any light on this and wether it maybe BDD I would be very gratefull, Many thanks Luke
Hi Luke,
Although I have avoided making the step for years, I have finally began the process myself of going to counseling. I think labels matter less than how what we are feeling is affecting our life. And without a doubt this unwanted obsession and the anxiety it is causing is resulting in stress and the physical ailments that come along with it. In these cases it is best to consult with a professional. I recently wrote a post on how I have started the process of finding a counselor in my area. Have you considered this option?
Stephen
Did the lexapro help? I’m suffering pretty bad from a variation of this disorder and don’t know how much longer I can go on like this. Therapy is not working.
Lexapro made me more anxious but I have found Zoloft at 50 mg to be working some. Enough to have continued it for 7 months. Seems to curb my obsessions.