Stuff You Should Know - How Body Dysmorphic Disorder Works

Episode Date: June 25, 2009

People who suffer with body dysmorphic disorder have a distorted, unhealthy view of their bodies. Learn more about this compulsive disorder in the following podcast from HowStuffWorks.com. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Buffalo Park and Zoo, and sports and literary attractions too. Expand your sense of wonder today at visitmississipi.org slash family fun. Mississippi, Wanderers Welcome. Brought to you by the reinvented 2012 Camry. It's ready, are you? Welcome to Stuff You Should Know from HowStuffWorks.com. Hey and welcome to the podcast. I'm Josh Clark. There's Chuck Bryant. Hi Chuck. Hi. How's it going? I just thought I'd try and throw you off but that can't happen dude. You're a pro. Thanks Chuck. I appreciate that. I imagine if I took off my shirt that way it might be unsettling enough to throw you. Nope. You want to try? No. Come on this will actually work really

well with the uh the the topic. I hand it. I never want Jerry to see my naked chest. Do you, Jerry do you want to see his naked chest? She does that. She should not want to. She's saying hey let's see what you got Chuckers. It's not gonna happen. All right. What do you want me to take my shirt off for this? Oh good gosh. No. Okay. Chuck it's no secret to you that I grew up a little fat kid. I want to see pictures by the way. Okay. I'd love to see that. I'll uh I'll bring some in. Uh yeah I was a little fat kid. I was the Pillsbury Doughboy. Was my nickname? I was chunky then thin and they called me the Doughboy too. Did they? Yeah and they pushed the belly button and all that? Yeah and I would do the little you know wow we're alike.

That's so funny. Yeah well and traumatizing. Yeah exactly. It was kind of traumatizing and I've always wondered. I had heard of uh body dysmorphic disorder before and I don't think I have it to a clinical degree but it occurs to me that like what I'm seeing when I look in the mirror is not necessarily what everybody else is seeing. I wasn't going to bring it up but since you did when I read this article I thought wow that sounds an awful lot like Josh in certain cases. Really? Uh huh. Are you sure you didn't read how narcissism works? Well that was a different article. You're like yeah this one's definitely Josh. I think they kind of are similar in some ways actually. They seem to be yeah because they're both centered around a focus on oneself

right at the expense of you know paying attention to your surroundings or other people. Right. Yeah so let's talk about this. I'm glad you got it out there first. Thanks. I appreciate that of course. Body dysmorphic disorder BDD is the little abbreviation that I'm probably going to use because dysmorphic isn't doesn't roll off the tongue. It's also called dysmorphophobia. Yeah that's no that's no better. No. We'll call it BDD. Okay well then let's stick with BDD. Okay. I am in trouble with that as well. That's pretty funny. You know I have a speech impediment as well as body dysmorphic disorder. I know basically what we're talking about folks out there in podcast land is that if you're completely preoccupied with flaws on your body and not just one flaw but you

know several. Yeah. Your weight. Sure. Your nose which strangely I don't have any kind of BDD around my nose and it's kind of like I have a big nose. You don't have a big nose at all. Look at this thing dude. No it's not big. I have giant nostrils too. Well that's a different story. So it's also Chuck BDD also frequently is a oh what's the word. It's a comorbidity with other mental I guess disorders like obsessive compulsive disorder, anorexia and clinical depression. Right which is why it's misdiagnosed sometimes. Or they think it's probably under diagnosed. I think that about one percent of the population is believed to have BDD but yeah they think that that's probably much higher for a number of reasons. Number one somebody might not want to talk about

their flaws or their therapist. Yeah and you don't want to come across as some vain superficial jerk and but you know we both go to shrinks. Let's just go ahead and toss that out there. I can't believe you said that. That's a lot of disclosure Chuck. I think healthy people go to shrinks as my shrink always says. I worry about the people who don't go to shrinks. Yeah those are the ones that dress up in black and shoot up schools. Right of course he says that as I'm writing the check so. Yeah right just keep coming back chump. So yeah people are afraid to say that to their psychiatrists or psychologists. They're ashamed of the flaws so much that they don't want to discuss it at all. Not just being ashamed of being vain. They're so ashamed of their potbelly or whatever.

Or they may be a lot more likely to go to say a cosmetic surgeon over you know a psychoanalyst of some sort. Which I'll go ahead and ruin this one too. They don't the results of cosmetic surgery usually don't work when you have BDD. No this was scary. You'll get the surgery and you'll still be really ticked off. You're worried that it's going to come back or your obsession will transfer over to another part of your body. Right or you get really angry at the surgeon and say that they didn't fix it right. Right yeah which is that's a scary profession for a number of reasons. Right so Joan Rivers I think might be high on the list. You think. Oh have you seen her lately. I feel bad for people who are who get tons of cosmetic surgery. I mean think about like that.

The depth of their self loathing that they continuously go their junkies for it. Yeah I don't know. It's hard for me to drum up a lot of compassion there but I guess you're right. That's a good point. Thanks Chuck. Now I feel somewhat shamed. Well you should feel shamed and not just about your body. Right but the point is Joan Rivers looks like a sea trout so. Is that even real. She looks like a speckled trout. She's a dream sailor. So back to BDD. Yeah we hit upon something. I said that the obsession will transfer. Sure BDD is a compulsive disorder. The symptoms of it are repetitive and irresistible basically. Right. What are some of the symptoms for people out there who are thinking huh I used to be a fat kid. Well this is pretty obvious but

constantly checking your appearance in the mirror or any reflection. Avoiding mirrors in reflective surfaces entirely. True. Go either end of the spectrum. Yeah that makes sense. I'm constantly comparing your appearance to others. Check. Picking at or otherwise attempting to fix an imagined flaw like excessive grooming. Yeah. Check. Yeah I guess. Measuring touching or checking the defect. Changing your clothes a lot. Refusing to be photographed. Constantly asking for reassurance about your appearance. Check. Check and check. Camouflaging. Masking or disguising the flaw. I do wear a lot of makeup. Like if you have a big belly like wearing this big Hawaiian shirts. Uh huh. And you know. But you're just a fun fat guy there. Yeah. That is

a signal that everybody else that you're a fat guy if you wear Hawaiian shirts all the time. Absolutely. But happily everybody also just thinks that you're ready to party. Right. True. You know. The life of the party. I see I have a bit of a belly as it were and this is a known fact. But I've found that when I wear a tighter shirt and not tight. But you know. A fitting you in tight shirt. A fitting shirt. People say hey dude you look like you've lost weight. But if I wear the Moomoo. Oh no. Yeah I definitely. It actually makes you look bigger. When you reached when you reach a certain point of I guess weight loss or something especially if you go from chunkier. Right. Well you're pretty spelt now. But when I definitely hit a point where I realized like

I look fatter in extra large shirts than in large shirts. Yeah. Exactly. It's a good realization. It is. Yeah. That's all the big ones. Anxiety and fear when you're around other people. Obviously excessive dieting and exercising. Sure. Suicidal thoughts. Yeah. That's the really downside I guess when you're at your worst. And actually there's a lot of people who I think something like on the order of 80 percent of people who have been diagnosed with BDD have reported that they've considered suicide. Yeah. And about 25 percent have actually tried it. I don't know how many successfully but yeah. Yeah that's really sad. It is sad because you know I mean you're at the point where you just hate yourself so much you know you're like I'm just going to try this over

again. Right. And with both disorders that's the darkest end of the spectrum and there is a big range from mild to really severe. I'll tell you the dark end of the spectrum my friend. Oh boy. You ready for this one. People with BDD sometimes self perform surgery. Oh yeah. Can you imagine mutilating yourself. No. To just try to get rid of this flaw. No. Because you know a love handle isn't is much worse than a gaping wound where like this missing missing hunk of flesh used to be. Yeah. I think alcohol might be involved. You know I could see someone just getting completely ripped and you know like I got to get rid of you. Get out the kitchen knife and gone. Go. Leave. That was really that was chilling. And you know actually we're making light of that.

That does happen and people do reach those steps. So that that's an awful thing to make fun of. Sure. What you just did. I was just trying to reenact what it might be like. Yeah. Well Chuck thank you for that. It's actually what happened to me last Friday night because it would you carve off. Oh just a little bit of a love handle. Thank God. And then I was like oh I thought you looked like you'd lost some weight. Yeah. Just a hint of a love handle. It's very painful. A day of travel brings a basket full of learning in Mississippi with family friendly places like the Mississippi Aquarium the Hattiesburg Zoo and Tupelo Buffalo Park. Explore today at visitmississippi.org slash family fun. Mississippi Wanderers welcome. I Heart Radio and Grim and Mild present Bridgewater

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over at grimandmild.com slash Bridgewater. So let's talk about what BDD is. We're not entirely certain how a person gets this or we know how it manifests itself but we're not entirely certain what's going on. If you think about it it's kind of bizarre that you don't see yourself the way other people do when you're looking at your reflection in a mirror. Right. I think a lot of people have that to a certain degree. Sure. Because I mean how many people when they see a photo of themselves say God do I look like that. Mine's always do I sound like that. Oh really. You got a great voice though. Thank you. They've done some research as far as the biological causes. Let's go ahead and start with the biological. Is that okay. Yeah. And some researchers

showed 25 people half of which so I guess 12 and a half people. I noticed that BDD and the other half did not and they would show them three different images of faces and different resolutions high regular and low. Sure. Large medium and small. Right. And they hooked them up to an MRI and they showed that the BDD folks use the left side of their brain. Which is the analytical side. Indeed. Yeah. To process all of the images and the other participants use the left hemisphere only for the high res images. So that means Josh is that or what it could mean is that the minds the brains of people with BDD want to acutely process visual details even when there are no visual details. They're always looking for that. It's one explanation. It's reasonable.

Moving on. I've got one better for you. Okay. Hit me. It's much more likely in my opinion that it is an imbalance in the brain chemistry specifically with the uptake of serotonin. All right. Let's hear it. All right. So serotonin is a neurotransmitter right. It's produced in the brain. Actually it can be produced anywhere in the body but the stuff that affects your mood and sleep and things like that. Sure. It's actually produced in the brain by tryptophan. Tryptophan as you know is from you know you can find it in Turkey. It's an amino acid. Everyone says it makes you go to sleep. Supposedly. Actually ironically tryptophan works best on an empty stomach. Right. And when you eat a bunch of stuff at Thanksgiving. Yeah. We covered this

in Thanksgiving. I think we did too. So I'll just stop there. Well basically you gorge yourself anyway. Right. You're actually digesting. That's what's making you sleepy. But tryptophan is uncommon in that it's one of the few amino acids that can cross the blood-brain barrier. So you eat some tryptophan. It gets separated from your turkey and crosses the bloodstream into the brain where it's used as an essential ingredient in serotonin production. Right. In a paddle boat. That's how it gets there. Yeah. With the giant frog. And so once the tryptophan gets to the brain yada yada yada you got serotonin. Right. Yeah. Did you like that explanation. Very scientific. Serotonin is a neurotransmitter. So it goes from the presynaptic

neuron which is the one where it's produced to the postsynaptic neuron where it's accepted. Right. But it loses a little love on the way. It does. Not all of it's taken in by the postsynaptic neuron. Right. And it's just kind of floating there in the synaptic cleft the space between neurons where these electrochemical messages are firing between. Right. And actually that can be good. If it accumulates too much then that's not too good because you've got basically a blockage and you have enzymes that actually clear out the serotonin. But if it lingers a little longer the communication is stronger. Right. Right. What SSRIs are serotonin I'm sorry selective serotonin reuptake inhibitors do. They actually prevent some of the serotonin from being taken

back. Right. By the presynaptic neuron. So we're talking Prozac and Paxil. Right. These things. Yeah. What they do is they allow some of the serotonin to linger which makes for a stronger message which improves mood. Actually it stabilizes mood. What we're seeking is a stable mood rather than ups and downs. That makes sense to me. Does it really? Holy cow. Well I mean not only did you do a fine job of laying that out there but I think anytime you're dealing with something like this sure there's certain other explanations but the brain dude that's where it's at. I agree. The brain is the thing. So the reason why they think that this is that BDD is a chemical imbalance or the result of a chemical imbalance is because BDD patients respond very well to selective serotonin

reuptake inhibitors like. Right. Zoloft and stuff like that. Paxil. So so select solos. Prozac. You know all those antidepressants. All that good stuff. Yeah. Cultural factors. Should we talk about that? Are we done with biology? Those are the only two theories that I know are going on right now biologically. Okay well let's move over to the cultural and physiological side of things which this one you know of course the media and magazines. The media always gets blamed. It does. The media is too lazy to really do anything that's actively bad in my opinion. Yeah that's true. I think it's all the result of just an inability to do real research. Yeah true that's pretty lazy to blame it on the media but we'll do that right now. Sure. The media of

course with all the perfect bodies and the perfect faces that certainly doesn't help. I don't think it can cause this but I don't think it helps the situation. If you're born with like a mild case of BDD you seeing you know Giselle on the cover of a magazine probably to make you feel any better about the hairy mole on your lip. Probably not. Although if you see a picture of Cindy Crawford you probably feel pretty good about the hairy mole on your lip. That's a beauty mark buddy. Same thing. Big diff. It all depends on what face it's attached to. Exactly. Yeah. I always thought that was pretty funny. Yeah. Because that on my face would be a mole or worse. Yeah. The talking mole. A talking mole. Cindy Crawford not too bad. It would command you to burn things.

Was that a Simpsons? Yeah. Was it? Yeah. Ralph Sleprechaun commands him to burn things. Right. Okay. I thought you meant the talking mole part. For people who love food there's no place on earth quite like Mississippi where a melting pot of culinary talent blends the flavors of yesterday and today. Sweet, savory, spicy and smoky flavors that'll satisfy your spirits wherever you choose to wander. Plan your next dining adventure and visit Mississippi.org slash dining. Mississippi. Wanderers welcome. I Heart Radio and Grim and Mild present Bridgewater Season 2. A lot of people now actually believe that there is some kind of mystical force in this region that attracts monsters and

paranormal activity. The Bridgewater Triangle. Now that sounds about right. You're still denying that there's something beyond our understanding going on here. Starring Supernatural's Misha Collins, The Walking Dead's Melissa Ponzio and Rogue One's Alan Tudyk written by Lauren Shippen and created by me, Erin Mankey. Something about all of this doesn't feel right. Hello? Is someone there? Something went wrong here. Olivia, we should hurry. We have a much bigger problem. What is that? Olivia, run! Listen to Bridgewater now on the I Heart Radio app, Apple podcasts, or wherever you get your podcasts. And learn more over at grimandmild.com slash Bridgewater. So, yeah, those are the societal cultural theories. And this is the one that they documented

as far back as the 1800s. That's so funny. You just referenced another podcast. I know. I'm all over the place. Yeah, which kind of undermines the idea that it's media sensationalism. Because it was before media. Well, yeah, pretty much. I mean, would you have like the Saturday evening post in there? Right. They showed a little ankle and all of a sudden, you know, women are like, my ankles don't look like that. Right. Norman Rockwell is disturbing millions of people. I think also this would be a good point to say that this does not just affect women. It affects men as well. Oh, yeah, sure. But in a very sexist way, men have their own version of it. Muscular body dysmorphia. Right, which is the need to be buff and muscular,

which I clearly could care less about. Same here. Oh, yeah, same here. But it's not just related to the muscles or the lack of muscle. It's also related to thinning hair. Right. Genitalially speaking, it has something to do with that. Sure. Do you ever see that one kids in the hall with Mr. Cabbage Head? Do you remember him? Yeah, yeah. Where he was trying to pick some woman up and he was like, it's not a cucumber. It's a gherkin. It's a gherkin. Exactly. Yeah, he probably would have had muscular body dysmorphia disorder. Probably so. Sure. There are also maybe some childhood traumas that could kickstart this whole thing. Like being beaten about the head and neck. Yeah, and that makes sense and teasing like you were

talking about. They did a study. They found 78% of the participants reported maltreatment during their childhood, the study of people with BDD. Yeah, but the study didn't say whether, they didn't ask whether the maltreatment happened before or after the onset of BDD. It's a slightly dodgy statistic. But they also found that 40% said the maltreatment was severe. All right. So that kind of makes sense at all. I think it could be a soup of all these things. You may be born with a little bit of it. Society chimes in with making you feel worse about yourself. You're maybe your parents did. Schoolmates, that kind of thing. Right, but and I'm saying this as a former fat kid, eventually you have to get to a point where

you can't let other people define you. You know what I'm saying? Eventually you have to stand on your own two feet and just say, yeah, I was a fat kid when I was little and yeah, I had some jerks poke me in the stomach. Who cares? They're all digging ditches right now. Do some therapy and look at you. But I just did. I was a late bed wetter. Oh my God, Chuck. Were you really? Oh yeah. Holy cow. All right, let's see if I can one up you. Oh really? No, do it. No. Got some worse than late bed wetter? Yeah. And you know, for those of you out there that are late bed wetters, it's okay and it will stop at some point. Eventually. Or you could just stop drinking late at night. I'm still waiting on that day. Yeah. So Chuck, you have any more revelations?

Well, it affects supposedly about one to two percent of the general population, which late bed waiting. No, sorry, the, the, the BDD. Okay. And so, but they think that might be kind of low because of the lack of diagnosis and stuff like that. Nice. Well, how do we treat this, Chuck? We already said SSRIs. SSRIs is one and then you have the old CBT cognitive behavioral therapy. Yes. Which was developed in the 50s. It's psychotherapy where you, it's got different approaches. You focus on the concept that your thoughts are the root of the behavior and the feelings as opposed to like outside influences. So it's sort of tackling it from the inside out. Not eating and smoking cigarettes helps a lot too, as I understand it. Right. Sure.

So in closing, are we closing? Yeah, let's do it. In closing, I would say just from someone who has had issues with weight here and there and Josh and bedwetting and bedwetting is, you know, no one's perfect. It's, you're going to live a long life full of let's hope. And you're going to have issues with yourself here and there. Get over it. And it's not that big of a deal. Everyone has their flaws. And so just accept, accept your own. Yes. That's my advice. Beautiful Chuck, beautiful, beautiful words from a beautiful, beautiful man inside and out. Right. Surround yourself with people who support you. You know, I agree. And the jerks out there that are calling your names and stuff. They don't know what they're talking about. You know,

yeah, we should probably especially target this to the younger listeners too. Sure. It ends eventually, but it ends when you allow it to. And you know, I guarantee you, and I can say, this is an older guy, those same jerks who were teasing you and poking and prodding you, like Josh said, they're probably losers and they will go on and their true colors will come out later. They agree. And they will be losers for life. All right. So that's body dysmorphic disorder. If you actually, this was a fine, fine article written by Jessica Toothman. I thought it was excellent. The Toothster. The Tooth. And in it, she says that if you think or suspect you might have body dysmorphic disorder, you should go seek help from a therapist. Sure. Absolutely.

Even if it just seems mild, because oftentimes it's a lot worse than you think it is. Yeah. And you don't want to get out of hand. Yeah. So, uh, yeah, that's body dysmorphic disorders, I just said, which means that it is time for listener mail. Maybe why not? Josh, I'm going to call this corrections and suggestion because there's one suggestion. Okay. And two corrections. Nice. I'm going to go through these kind of quick. This comes from Julie. She says a geologic nitpick from the CCS podcast pronunciation of, I believe we said basalt. I said basalt. You said basalt and she says it's actually pronounced basalt basalt with the influence on or the emphasis on salt basalt. Right. But that comes from Julie, our friendly neighborhood

pedantic geologist is how she builds herself. Yeah. So thanks for that, Julie. Thanks, Julie. This comes from Peter and this is about Tesla. And wait, Tesla? The band or the guy? Yeah, Nikola Tesla. That guy, dude. Okay. And he said that, um, and we've gotten this email from a few folks that we were knocking DC power boo DC. It's actually got lots of great applications. I guess. And we didn't highlight those. We might do that later. Is there a camp of people who are fans of DC electricity? Yeah. Wow. You stated a couple of times that DC is a poor transmitter of electricity across long distances. Actually, a lot of talk is going on now in the energy business about the possibility of using high voltage DC or direct current to transmit electricity across long

distances at high voltages, direct current experiences much lower line losses than AC. That is not what I understand. He said they're looking into it, buddy. Okay. You want to take Peter to task? No, no. Okay. That means you don't want to email him back. And then this final one is from Andrew in Nashua, New Hampshire or Nashua. I'm not sure how it's pronounced. He says he has an addendum to our innovations podcast and he thinks a really cool one would be wireless electricity and don't say battery. And he said, don't say battery. He said that sustained sustained energy with wireless would be really cool. So when you take out your vacuum cleaner, you just use it around your house via wireless power. No cords to trip over. No having to move from outlet to outlet.

And you could have an infomercial with a woman in black and white whose hair is all frazzled over a vacuum cord. Then looking into the camera with a frustrated look, as she blows the unkempt hair out of her face, then show her in full color, smiling from ear to ear as she wirelessly vacuums. And I think that is a very sexist infomercial, buddy. Yeah. I think you should be a guy. This guy's really, really thought this out though. Yeah. That'd be cool. Yeah. I'm not sure how practical it is. It seems dangerous if you ask me, because you'd have to beam that electricity somehow. That's a good point, Chuck. So whatever. But thank you. We should close every listener meal. Yeah, whatever. Whatever. But we want to

thank Andrew and New Hampshire for sending that sounds like a pretty groovy idea. Thanks to all three of you for writing in and everybody who's written in, even if we haven't gotten to your letters, we actually do read every single one. It's pretty cool. If you want to send us a letter, it may or may not be read on the air, but at the very least you'll know Chuck's beautiful eyes of gaze over it. You can send that to stuffpodcastathowstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com. Want more howstuffworks? Check out our blogs on the howstuffworks.com homepage. Brought to you by the reinvented 2012 Camry. It's ready. Are you?

A day of travel brings a basket full of learning in Mississippi with family-friendly places like the Mississippi Aquarium, the Hattiesburg Zoo, and Tupelo Buffalo Park. Explore today at visitmississippi.org slash family fun. Mississippi. Wanderers, welcome. In 1968, five black girls were picked up by police after running away from a reform school in Mount Megs, Alabama. I'm writer and reporter Josie Deffie Rice. And in a new podcast, I investigate the abuse that thousands of black children suffered at the Alabama Industrial School for Negro children and how those five girls changed everything. Listen to unreformed on the iHeart Radio app, Apple Podcasts, or wherever you get your podcasts.