Living With Mild Body Dysmorphic Disorder

I can't remember a time in which I wasn't obsessed with my appearance. There is a harsh, vindictive little critic who sits on my shoulder and breathes his bile into my ear incessantly... He tells me I'm grossly overweight, unattractive, and undesirable. He turns my head towards every reflective surface and excoriates every lump, bump, crease and curve, imagined or otherwise... I no longer feel I have any concept of what I actually look like.

I can't remember a time in which I wasn't obsessed with my appearance. There is a harsh, vindictive little critic who sits on my shoulder and breathes his bile into my ear incessantly. He smirks and squirms, clapping his hands with glee. His invective floats around my head and makes me queasy. He tells me I'm grossly overweight, unattractive, and undesirable. He turns my head towards every reflective surface and excoriates every lump, bump, crease and curve, imagined or otherwise. Thanks to him, I no longer feel I have any concept of what I actually look like.

I would love to flick him off his little perch and have done with it.

For years upon years, I have woken up with the same thought - I hate my body. I HATE it. Every single morning, without fail. Can you imagine such an all-consuming obsession? If you can, and you are still managing to function on a daily basis, then I salute you. Truly, I do.

I frequently feel, quite literally, like the elephant in the room. I seek reassurance about my appearance irritatingly often, and when people do not offer it of their own accord I often interpret this as an implicit "you look hideous today, let's not even acknowledge it." My obsession causes me to crave this reassurance, which in turn probably comes across as needy, vain, and perhaps even pathetic, or so I often feel.

After years of feeling this way each and every day, I began having anxiety attacks at university. I would sweat profusely, my breathing would become erratic, and, most worryingly, I began indulging in suicide ideation, something my counsellor would later describe as an 'escape hatch' mechanism for my mind to cope with the constant onslaught of anxiety. Although I knew I was not feeling agitated enough to harm myself, the thoughts alone were frightening.

I also began experiencing short periods of derealisation, possibly one of the most surreal and unpleasant symptoms of anxiety, in which I felt a hazy disconnect from my external surroundings, causing basic interaction to become a considerable concerted effort. Then finally, shortly after visiting a close friend at another university, I found myself in my own University health centre, hyperventilating uncontrollably, shaking, and feeling like my body was shutting down. I flopped myself down in front of a GP, grey, sweating and horrendously upset. Although familiar with mild depression from my late teens, I had never experienced anxiety like this before, and it was horrifying.

So, in the last academic year, I was put on a course of anti-depressants and anti-anxiety medication. It was disappointing, the last time this happened I ended up having to withdraw from my first university after only a term. But crucially, this time, I was also offered counselling for body dysphoria. It helped just to verbalise my thoughts and feelings; I felt that I was finally able to rationalise them, think about them, and dig down to their roots.

During one of my first sessions with my counsellor, who had a gloriously warm smile and frequently wore bright purple tights, I made a throwaway remark about how dreadfully overweight and unattractive I was. I told her that, when in public, there isn't a single moment in which I am not thinking about how I look. She looked genuinely puzzled. "You aren't overweight?" she said. It was something I had heard constantly for years, from family, friends and even from previous counsellors. I described my long walk to class each day, passing what felt like hundreds of people, feeling their collective gaze crawling over me; sensing their judgement so intensely that it made me feel sick. She referred to this sensation as the 'spotlight effect', a term which speaks for itself I think. I had taught myself to think that people were dangerous and ruthlessly critical, which meant that merely being in public triggered my 'fight or flight' response.

For the most part, my anxiety stems from my obsession with body appearance. Whilst writing this piece, for instance, I got up to check if my face still looked as chubby as it did this morning. That is absurdly illogical, and if you're amused then I don't blame you. I know that I face months, maybe even years, of cognitive retraining to address my issues with body image. It follows that an all-consuming obsession such as mine is bound to take a psychological toll. Of course, there are those who suffer from body image issues, and body dysmorphic disorder, more severely, whose lives are largely constricted by it. I can only speak for myself, and I can tell you that this is something that will not correct itself overnight.

Despite all of this, things are getting a little better for me, as of very recently, and aside from attempting to document some of my own experiences, one of the primary objectives of this piece is to encourage you, if you have felt or are feeling like I do, to seek help. Go to your GP, talk to your friends, parents or family, see your personal tutor or visit your university health centre. University can be a lonely place for those with mental health issues, but it is crucial to remember that a support network usually exists.

In short, do whatever you need to do, because I have no doubt that you are fantastic and deserve better than to listen to that harsh, arsey little critic.

Much like Jon Snow, he knows nothing, and he's much less welcome on your shoulder.

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