Dear Eric:

You’ve been expressing a whole lot of distress over the appearance of your body (mostly your height) over the years, in your many threads (under different accounts and screen names). The following quotes are from your recent posts on this one current thread only: “Yes you can say I feel lonely is due to my social anxiety, but it’s mostly caused by my height. I keep being cautious on how people might perceived me as ‘below average’ when they look at my height, so I mostly spend my time at my room. Even in my uni days, I didn’t go to a club, although I wanna try enjoying it like how young people do. But I know it’ll be pointless for a short guy… I keep getting mad at myself if I failed to conceal my height … I’m 5 ft 5… feels terrible…  unluckily most girls here are about my height, this is why I always use tall shoes so that I can be taller than them, and also look taller in pictures, but I can never do that if I went to someone’s house, because I need to be barefoot and that’s why I never want to meet my friends in their house because they might took a picture of us together and upload it on social media. I don’t want people to know my real height. I also sometimes feel that I have a weird face, like I have puffy cheeks, combine with bushy eyebrows and non-symmetrical teeth, how can it’s considered as attractive? it’s more towards fierce and scary than good looking. This is also why I fear if I visit my future girlfriend’s house later on, I can’t boost my height and the parents will notice my short height and have a bad impression. I always feel afraid of this scenario for a long time”.

From the Mayo Clinic. org website: “Body dysmorphic disorder is a mental health condition in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can’t be seen by others. But you may feel so embarrassed, ashamed and anxious that you may avoid many social situations. When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress and impact your ability to function in your daily life. You may seek out numerous cosmetic procedures to try to ‘fix’ your perceived flaw. Afterward, you may feel temporary satisfaction or a reduction in your distress, but often the anxiety returns and you may resume searching for other ways to fix your perceived flaw. Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.

“Signs and symptoms of body dysmorphic disorder include: * Being extremely preoccupied with a perceived flaw in appearance that to others can’t be seen or appears minor * Strong belief that you have a defect in your appearance that makes you ugly or deformed * Belief that others take special notice of your appearance in a negative way or mock you * Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming or skin picking * Attempting to hide perceived flaws with styling, makeup or clothes * Constantly comparing your appearance with others * Frequently seeking reassurance about your appearance from others *Having perfectionist tendencies* Seeking cosmetic procedures with little satisfaction * Avoiding social situations.

“Preoccupation with your appearance and excessive thoughts and repetitive behaviors can be unwanted, difficult to control and so time-consuming that they can cause major distress or problems in your social life, work, school or other areas of functioning…

“Complications that may be caused by or associated with body dysmorphic disorder include, for example: * Low self-esteem * Social isolation * Major depression or other mood disorders * Suicidal thoughts or behavior * Anxiety disorders, including social anxiety disorder (social phobia) * Obsessive-compulsive disorder..”.

Wikipedia/ Body dysmorphic disorder (BDD): “Most people without BDD may not like some parts of their body, but people with BDD believe that they are so ugly, even though they are not, that they find it difficult to talk or exist with other people, or live normally, scared that other people will be mean to them because of the way they look… They usually think about their body for more than one hour per day, and in bad cases, can stop talking to other people, and may stay at home. People with BDD often have very low self-confidence, because they believe that a person’s value is linked to what they look like, and because they do not think that they are beautiful themselves, they do not think they have much value…

“People with BDD may often have little motivation for anything. This means that BDD people can appear to take a long time to get everything done. However, this is not exactly true, because BDD sufferers will often just stop what they were doing for a long time, so it is not just that they are slow, but find it difficult to concentrate on what they are doing… This low amount of motivation can be in all parts of a person’s life, for example, school, friends, love, family, or work. However, when the person is trying to do things to the way they look, such as combing their hair, or choosing clothes, it is common for the person to have an extreme motivation. Therefore, people with BDD can sometimes not feel motivated for anything in their life, but when they are working on their looks, they will have an extreme motivation that is not normal either…

“BDD is often wrongly thought of as a ‘vanity’ ‘obsession, but it is actually the opposite, because people with BDD believe they are very ugly, even though people without BDD do not think they are. There is not usually actually anything wrong with the way the person with BDD looks, but to that person, there is. A person with BDD can spend hours looking in the mirror, but they are not being vain, as they do not think they are attractive. People with BDD usually realize that worrying about their looks so much is bad, but they cannot help it. ALSO a person with BDD may alternatively avoid mirrors at all costs. Or any reflective surfaces for that matter. Including spoons, windows, mirrors, etc.

“Treatments: Research found that talking as therapy, has not worked to stop BDD. However, Cognitive Behavior Therapy (CBT) has been found to be more effective. In a study of 54 patients with BDD, some of them had Cognitive Behavior Therapy, and some had no treatment. BDD symptoms decreased a lot in those patients undergoing CBT. BDD was eliminated in 82% of cases at post treatment and 77% at follow-up. Due to low levels of serotonin in the brain, another commonly used treatment is SSRI drugs (Selective Serotonin Reuptake Inhibitor).”

What do you think, Eric?

anita

• Face, such as nose, complexion, wrinkles, acne and other blemishes
• Hair, such as appearance, thinning and baldness
• Skin and vein appearance
• Breast size
• Muscle size and tone
• Genitalia

A preoccupation with your body build being too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.

Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may be excessive or not be true, or think that they probably are true, or be absolutely convinced that they’re true. The more convinced you are of your beliefs, the more distress and disruption you may experience in your life.

When to see a doctor

Shame and embarrassment about your appearance may keep you from seeking treatment for body dysmorphic disorder. But if you have any signs or symptoms, see your health care provider or a mental health professional.

Body dysmorphic disorder usually doesn’t get better on its own. If left untreated, it may get worse over time, leading to anxiety, extensive medical bills, severe depression, and even suicidal thoughts and behavior.