– by Kellie Smith
My journey with Body Dysmorphic Disorder began at sixteen years old, when I developed a debilitating preoccupation that something was wrong with my face. When I looked in the mirror I saw a reflection that was more creature than human.
My BDD revolved around perceived distortions of my face. I obsessed about its size, shape, and specific features that I thought made it look “sub-human”, such as hair, teeth, and skin.
I spent hours doing rituals that I hoped would “fix” or “hide” the parts that felt disfigured: I picked, scraped, and washed my face until it bled. I wore hats, scarves, and oversized clothing. I cut my hair short, then shorter, until I eventually shaved my head completely.
Within months of the onset of my BDD, my life had essentially ended. I quickly became housebound and was forced to drop out of school. I spent my days hiding in bed, relying on sedatives to stay asleep and avoid thinking about my face. I became suicidal and was in and out of psychiatric units and partial hospitals. The mental agony my own face caused me is impossible to describe, even now. Simply put, I felt too ugly to live.
My attempts to explain this distress to the many mental health professionals I encountered over the next couple of years were pointless. Most brushed it aside as the typical body image dissatisfaction that many teenagers face. Others could be downright cruel. Memorably, one psychiatrist I saw in a time of crisis rolled his eyes and commented “oh well, not everyone can look like Barbie.”
Through countless Google searches, trying to figure out what was wrong with my face, I encountered the term Body Dysmorphic Disorder. I dismissed it immediately. To even consider that diagnosis I would have had to accept that what I saw in the mirror was not reality but an illusion – and that felt inconceivable.
Having lived with OCD since early childhood, I believed I was familiar with the torment of my mind deceiving me. But BDD attacked my sense of self in a way I could never have imagined. At its worst, it made me question whether I was even human.
At eighteen, I was referred to the OCD Institute at McLean Hospital in Massachusetts for residential treatment. At the OCD Institute, I was formally diagnosed with BDD and learned that, as an obsessive-compulsive related disorder, it could be treated using many of the same approaches as my OCD. Over the following months, I participated in Exposure and Response Prevention (ERP) for both OCD and BDD.
Anyone who has participated in ERP knows that it requires tremendous patience, resilience, and flexible thinking. Early in treatment, I became consumed with trying to determine whether the way I saw myself was distortion or reality. In time, I learned to accept that I might never know with certainty how I truly looked. As with every other aspect of my OCD, learning to embrace uncertainty became the key to gaining control over my BDD.
I returned to the OCD Institute for treatment twice in the following years, primarily to continue treating my BDD.
It took hard work and collaboration with my treatment team, but through ERP, along with finding the right medications, I was able to begin reclaiming my life.
After discharging from the OCD Institute in 2019, I completed high school online and enrolled in community college while continuing outpatient treatment. Last year, I graduated with my bachelor’s degree and began working as a Peer Support Specialist. This fall, I begin my master’s degree in Clinical and Counseling Psychology. Along the way, I’ve been able to fill my life with beautiful things: friendships, relationships, dogs, travel, and books – all the things I once believed I would never have in my life because I was so afraid of my face. Perhaps the most meaningful part of my life recently has been my involvement in the OCD and BDD communities. When I participate in alumni panels at the OCD Institute or speak about BDD at the IOCDF conference, I’m able to make peace with the suffering BDD put me through and the years it took from me.
Body Dysmorphic Disorder remains an all-consuming force that can still threaten to upend my life. There are days when I look in the mirror and feel familiar despair, when simply walking out the door feels impossible. But now I have the skills and support to walk out the door anyway. That has made all the difference.
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