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Of the many patients I’ve seen over the years, those with BDD have been among the most tormented. As a 21-year-old man said to me, “This obsession is the perfect torture. I’d rather be blind or have my arms cut off. I’d be happy to have cancer, because it wouldn’t isolate me the way this does, and people would believe that something was wrong with me. They wouldn’t trivialize it. I could talk to people about it, and they’d understand.”
Since treating Carrie, David, and Jane, I’ve met and treated many people with BDD. They have all suffered. Families and friends, girlfriends and boyfriends suffer as well. They worry about their loved one and may endlessly reassure them, hold mirrors, or apply hair tonics—to no avail. They may care for them, pay for surgery, try to find help—for a problem that makes little sense to them. Sometimes they don’t even know what the problem is. They know that their loved one is depressed or won’t go out, but they don’t know why. People with BDD may be too embarrassed to reveal their concern to anyone, even their closest friend or spouse.
After hearing about Carrie’s, David’s, and Jane’s concerns, I decided to learn more about this fascinating and little-known disorder. I hadn’t even heard of it during medical school or in the lectures of my psychiatric training. I hadn’t noticed any articles about it in scientific journals. I did, however, remember seeing BDD in the psychiatric profession’s diagnostic manual. The description there was brief but enough to make me think that Carrie, David, and Jane had this mysterious disorder. I started my search to learn more about it.

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