"I Hate My Face": Looking At Body Dysmorphic Disorder

Last night, MTV's True Life focused on BDD, a psychological condition that affects how sufferers perceive their physical features. One woman—Pamela, 26—says her hatred for her face kept from her finishing high school, or ever getting a job.

With no job or higher education, Pamela spends her time shopping and comparing herself to women in celebrity weeklies. Before looking in the mirror, she sprays some kind of moisture on it, to soften the blow of what she claims is her own hideousness. She wears excessive makeup and bindis as a way to distract people from her perceived ugliness. She's been seeing a psychiatrist for years who merely medicates her, but refuses to go into intensive therapy, because she says, "Therapy is not gonna help me be pretty."

Financially supported by her mother, Pamela seems to have a shopping addiction, and says that buying things is the only thing that makes her feel better, albeit temporarily. What she really wants is a nose job, which her mother refuses to pay for, because she (wisely) believes that the only thing that Pamela needs to change is the way she feels about herself.


Pamela's family—particularly her brother—has a hard time understanding her disorder. It's difficult for them—seeing all of her Chanel and Louis Vuitton shopping bags, and knowing she is not employed—to be empathetic with her plight. I remember the first I ever did mushrooms, I looked in the mirror and became convinced that I was the ugliest person in the world, and was horrified that I'd been walking around all my life without a bag over my head. When I woke up the next day, I realized that I'd just been hallucinating and I was fine. Having BDD must feel like you're staring in the mirror while on a bad trip 24/7, which sounds like torture.

Eventually, Pamela convinces her boyfriend to take out a loan for her plastic surgery. (Judge Judy would be livid about that!) Against her mother's wishes, she gets the surgery (and opts for breast implants, as another distraction from her face). Initially, she was elated with her results and felt like she was cured, but two months later, she hated her looks again. She agreed to go into intensive therapy, but only lasted for one day.



So, I've been in therapy for over a year now treating a combination of BDD and ED. Those two often go together and it compounds both psychological disorders and their fun little self-loathing cycle.

Like ED's, it can seem like just extreme vanity or selfishness. But it's actually really serious. I don't know about this girl in particular, but there's a really high suicide rate among people with BDD. The level of hatred you have for how you look is obsessive, disproportionate, extreme, and often debilitating. Sometimes it's just one feature, sometimes it's everything, but it's basically like seeing a monster every time you look in a mirror.

I'm lucky that while mine has been bad, it's never kept me from functioning. But I think that's because I used my ED as an outlet and way to cope with it. Which means I've had a lot of mental bad to unravel to get at what the real issues are.

The thing about psychological disorders like BDD and ED's is that...you have to kind of view them like an abusive partner. They don't want you to get better. They find ways to convince you that you don't deserve to get better, that you can't be helped, that you're unlovable and wrong and worthless. So while it should seem simple and "easy" to get help for them, it's anything but. You are the exception that can't ever get better. And it takes a lot to get past that and ask for help.