BDD Archives - Page 10 of 10

Hiding Places – The Shame of Body Dysmorphic Disorder

October 5, 2012 By Stephen

In My Room

There were several bathrooms on my college campus that I would frequent the most.

I preferred the handicap restrooms as I could lock the door. In here I could fuel my compulsion without the fear of others noticing.

I remember walking out of the bathroom, and within seconds returning, to deconstruct my face again. Only when I was looking closely at my imperfections and hating on myself, was I free. It is bizarre, maybe it became like cutting in a way. In the pain I could feel something, even if it was the feeling of losing my mind.

With each new class I would find a corresponding place on campus to indulge this compulsion. These compulsions would reveal themselves from time to time in my art and in my music. I remember taking an an intro to drawinng class in college, I drew a large black and white charcoal image of an anorexic woman. I got an A+. My only A+.

Although I never particularly understood what it was about this work my teacher liked so much, it is obvious to me now. The best art is an expression of our soul, and this one was honest, possibly my first truly honest piece of work.

Starting an SSRI (Lexapro) for My Body Dysmorphic Disorder

October 5, 2012 By Stephen

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 by Katharine A. Phillips.

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.

Accutane, Depression and Body Dysmorphic Disorder

October 4, 2012 By Stephen

The Beginning of the end

I started Accutane during my first quarter of college.

It was a last-ditch attempt to rectify my skin problems.

I remember walking into the dermatologist office vividly and I met this amazing medical assistant. She seemed to be the first person I had ever met who knew what I was feeling.

I told her I was here for my acne, she told me that now-a-days there were treatments that could clear up even the worst acne and prevent scarring.

She looked at me kindly, told me her own “skin story” and it is one of the first times I remember being completely comfortable with another human being. And that was it, she walked out. But I remember this encounter, it is a strange thing because it was so short, and seemingly so insignificant.

To this day when I see my own patients who are struggling with acne I think of her. And I try to repeat the words she shared with me, to give them reassurance that someone understands their problem.

It’s not what you look at that matters it’s what you see!

-Henry David Thoreau

The dermatologist walked in the office, looked at me, asked me what I had taken before, gave me a prescription for Accutane then walked out of the office. That was the first and the last I saw of him.

I am not sure he ever looked at me really. He surely didn’t know my name. He wrote my refills though, and started my year long journey on a medicine that would find me on the edge of a roof, holding a cigarette, dreaming of a free fall to the ground that would not require too much pain. A fall in which I could die and be free of the agony free of the judgement I felt from others.

Free from the horror movie that played tandem reals in my mind.

Acne and The Makings of Body Dysmorphic Disorder

October 4, 2012 By Stephen

MY ESCAPE

I am thirty five, day one of this blog should have started over 18 years ago. But I was living in denial. The constant mirror checking, the self hatred, the shame, the fear of catching my reflection in a car window… The inability to enter a dressing room.

As a man the shame was even greater. I had to hide it even deeper. I am not vain, in fact I love everybody for who they are… Except for one person. Myself.

ACNE

It began with Acne when I was in high school. I would stare at each pimple in contempt. It was a small thing at first. And then I lost control. Everything I did to prevent each pimple only made things worse. They hurt, not just emotionally but physically. I could feel them on my face and I could feel people looking into them, looking past me.

It started as one, but as hormones took over one became many. And after time they would leave a small scar, a mark on my skin, and shame was all that was left.

I would admire those who were scarred more than me who did not seem to care.

What I never understood was the casual response of others to my facial scarring . I told very few people of my concerns over my skin and when I did it was only because I ran out of other options. When I was 16 I approached my mom seeking a trip to the doctor to find some kind of treatment for my skin. She provided reassurance that my teenage acne was just a phase, and that mine was really not that bad.

In desperation I tried every product I could get my hands on.

First it was benzoyl peroxide 10%, several iterations of Oxy and Clearasil, this turned into excessive face washing. I would carry skin cleansing alcohol pads in my bag at all times. I would sneak into the bathroom during my breaks to wash my face. Only in this clean and non oily state would I find a bit of peace. And then the oil would return, It was a disgusting layer that I was always conscious of.

The oil to me was a breeding ground for more acne and I was on the offensive. But the more I washed my face the more acne I would acquire. The acne blemishes seemed to always come at the wrong time. My first high school dance welcomed several new lesions. Those would remain for several months. Much longer than my date who left me after we entered the gymnasium. Further proof, in my mind, that I was gross and unworthy of affection.

I finally made it to a dermatologist who started me on oral antibiotics. This helped so much! After the first month when the acne became worse I found my face clear for almost 3 whole months. My confidence grew leaps and bounds, I would look at myself with affection for the first time. I remember this time quite well, it was the first time I could talk to someone face to face without the feeling of the blemishes on my face.

And then the antibiotics stopped working, the acne seemed to become worse, and now unstoppable. I retreated to what I knew best.

Washing and salicylic acid and topical antibiotics and more checking.

The avoidance of mirrors. The occasional avoidance of life.