The category of medications called serotonin reuptake inhibitors (SRIs), also known as selective serotonin reuptake inhibitors (SSRIs), is considered the first-line medication treatment for BDD.
Cognitive-behavioral therapy, or CBT, is the first line of treatment for BDD. This type of treatment typically involves a technique known as exposure and response prevention (ERP). In BDD, exposure aims to decrease mirror checking, camouflaging, and other compulsive behaviors.
In terms of medication for BDD, anti-depressant medication is recommended, one which is strongly “serotonergic”. These are referred to as SSRIs or Selective Seratonin Reuptake Inhibitors. The dose may need to be in the high range and taken daily for at least 12 weeks to determine its effectiveness.
Although there are no medications specifically approved by the U.S. Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental health conditions — such as depression and obsessive-compulsive disorder — can be effective. Selective serotonin reuptake inhibitors (SSRIs).
It is generally recommended that the FDA maximum dose not be exceeded when treating younger youth. All SRIs are probably equally effective for BDD, but I usually prefer fluoxetine, escitalopram, or sertraline. Clomipramine is a good option if several other SRIs haven't worked.
The most prescribed SSRI drugs for body dysmorphic disorder treatment are: Celexa (citalopram) Lexapro (escitalopram) Prozac (fluoxetine)
There are a number of different SSRIs, but fluoxetine is most commonly used to treat BDD. It may take up to 12 weeks for SSRIs to have an effect on your BDD symptoms. If they work for you, you'll probably be asked to keep taking them for several months to improve your symptoms further and stop them coming back.
Multiple studies have suggested that selective serotonin reuptake inhibitors and various cognitive behavioral therapy modalities are effective first-line treatments in decreasing BDD severity, relieving depressive symptoms, restoring insight, and increasing quality of life.
The treatment of choice in BDD is cognitive behavioral therapy (CBT) and serotonin reuptake inhibitor (SRI) medication.
For resolution of BDD, suggested dosages of SSRIs include the following ranges: fluvoxamine (Luvox), 200 to 250 mg per day; fluoxetine (Prozac), 40 to 80 mg per day; paroxetine (Paxil), 40 to 60 mg per day; or sertraline (Zoloft), 100 to 200 mg per day.
A 2018 study conducted by researchers from the Karolinska Institutet in Sweden found that patients with BDD were twice as likely to be diagnosed with ADHD, and a 2019 study revealed that body dysmorphia is more prevalent with conditions of obsessive compulsive disorder, anxiety and ADHD.
Like many other mental health conditions, body dysmorphic disorder may result from a combination of issues, such as a family history of the disorder, negative evaluations or experiences about your body or self-image, and abnormal brain function or abnormal levels of the brain chemical called serotonin.
Now researchers at UCLA have determined that the brains of people with BDD have abnormalities in processing visual input, particularly when examining their own face. Further, they found that the same systems of the brain are overactive in both BDD and obsessive-compulsive disorder, suggesting a link between the two.
People with BDD most often are concerned with “defects” on their face and head6. They constantly check their appearance in mirrors, and often scrutinize others people's faces. They tend to focus primarily on details, usually on their face, and are not able to see the “big picture” that overall they look normal.
Summary. Body dysmorphic disorder (BDD) is a mental illness characterised by constant worrying over a perceived or slight defect in appearance. Repetitive behaviours are performed in response to these concerns about appearance. BDD usually starts in the teenage years, when concern over physical appearance is common.
There are two subtypes of BDD: Muscle Dysmorphia and BDD by Proxy. Both of these subtypes appear to respond to the same basic treatment strategies as BDD (cognitive behavior therapy or CBT and medications). However, the CBT therapist in particular needs to adjust the treatment so that it has the right focus.
It's not known exactly what causes BDD, but it might be associated with: genetics – you may be more likely to develop BDD if you have a relative with BDD, obsessive compulsive disorder (OCD) or depression. a chemical imbalance in the brain.
The symptoms of both OCD and BDD have similarities; so much so, BDD is sometimes misdiagnosed as OCD. Like OCD, body dysmorphic disorder involves persistent and recurrent obsession-like thoughts that are distressing and often uncontrollable.
Sounds like OCD, doesn't it? Sure. But it's not. Although there are clearly many similarities between OCD and body dysmorphic disorder (BDD), the two are in fact quite different and treatment needs to reflect that.
To put in simpler terms, a person with gender dysphoria is not mentally ill; they are dissatisfied with the gender assigned at their birth. A person with body dysmorphia has a disorder in which they perceive their body or face as “ugly,” “fat,” or otherwise unattractive despite medical or personal reassurances.
Other medications that help in controlling intrusive thoughts are: Paroxetine (Pexeva)—prescribed only for adults. Fluoxetine (Prozac)—for children above seven years and also for adults. Sertraline (Zoloft)—for children above six years and for adults.
BDD is an underrecognized and relatively common disorder that is associated with high rates of occupational and social impairment, hospitalization, and suicide attempts. BDD is unlikely to simply be a symptom of depression, although it often coexists with depression and may be related to depression.
The aim of CBT for BDD is to help you feel less anxious about your body by: Helping you change your attitude to body image and physical appearance. Exploring your worries about your perceived physical flaw(s) Reducing your need to carry out compulsive behaviours.