Another part of me: my BDD

Trigger warning: this blog post contains themes about eating disorders, eating, weight and other related. If that will upset you, please read no further. You can reach out to BEAT for support at:

As you might have seen from Twitter, I wasn’t sure about writing this blog post. Not because I’m embarrassed to discuss my mental health, but because I kept stopping and starting as it felt self indulgent. Thank you to everyone who gave advice, support and shared their experiences.

When I woke up today, I knew I wanted to share this story. Firstly, because it helps me reflect on who I am and the journey I’ve been on. Secondly because a few people at work asked me what BDD is, and I want to raise awareness and create understanding.

So here’s me, at my most vulnerable. Please do check the trigger warning above before proceeding.

I have body dysmorphic disorder.

To give you a quick background, I think I probably started to develop BDD when I was just 13. From there, my unhealthy relationship with food started when 17, but my behaviour was quite ‘mild’ compared to my friends who had eating disorders. It wasn’t until I was 25 that I developed anorexia, reaching my lowest weight on Christmas Eve 2010. I was 6st. I started purging on Christmas Day, then binge eating in January and using laxatives soon after that.

I tried to ‘fix myself’ for a couple of years. With the help of my friends, I finally admitted I couldn’t do it alone and needed help. My doctors formally diagnosed me with a number of eating disorders, anxiety and BDD, and I started Cognitive Behavioural Therapy (CBT) in 2013.

The story gets a lot brighter. A few months after starting CBT, I met him and found my fairytale happiness. After years of abusive and harmful relationships, I was finally with someone I wanted to be healthy for. I’ve had a number of blips over the past five years, but can say with pride that 2018 is the first year in a long time that I haven’t binged, purged, used laxatives or skipped a day of food.

Back to why I’m writing this. I think people generally know what an eating disorder (ED) is and some of the different types of ED. When I’ve shared with people that I have BDD, it’s not something they’ve heard of. There’s not a single search result for BDD on the BEAT website, even though the EDs and BDD share similar symptoms.

BDD is a mental health condition where people feel ashamed or anxious about their body image. As defined by MIND, BDD can come in two main forms:

  • experience obsessive worries about one or more perceived flaws in your physical appearance; the flaw cannot be seen by others or appears very slight
  • develop compulsive behaviours and routines, such as excessive use of mirrors or picking your skin, to deal with the worries you have about the way you look

At the height of my BDD, it was all consuming. I could spend up to 6 hours a day obsessively thinking about how disgusting, abnormal and vile I looked.

My most physical compulsive behaviour is rubbing/picking my face. I can still do that now if I’m feeling particularly anxious. Most of the time I don’t realise I’m doing it, and I don’t know when or why I picked up the habit. I would guess it was when I started wearing contacts at 16 as suddenly more of my face was exposed, and I felt like I had to keep rubbing at it until it was ‘perfect’.

I developed a number of ‘checking’ behaviours. These were instant checks I could do to make sure I wasn’t getting too fat or ugly. (Honestly, it’s strange to read this stuff back now. Most people would go by weight, measurements, the fit of your clothes — but BDD overrides logic). My checks would mostly be checking in the mirror how pronounced my collarbone and sternum was. Or it would be excessively checking all of my ‘defects’ in the mirror. Or it would be checking with two fingers how much my spine ‘stuck out’. If I wasn’t satisfied, I’d just stop eating for days.

When I went into CBT and admitted those checking behaviours, my therapist asked me to keep a record of how many of those checks I’d do each day for that week. I came back a week later with hundreds of little tally marks in my diary. When I showed my friends, they cried. I still have that diary, to remind myself of how far I’ve come.

Most people with BDD will fixate on their face, but you can get obsessive about any part of you. I particularly hated my stomach. I’d spend hours trying to find outfits that would cover it up. I would try to ‘position’ myself so that no one could see how ‘huge' it was. I’d cover the area with handbags, cushions, or any other prop I could find when with people. I developed a habit of subconsciously pulling my muscles in — so much so that I didn’t realise I constantly tensed my stomach until I went into therapy. I’d spend hours lying on my bed, prodding and poking in an attempt to make it flatter.

I’d avoid having my photo taken in case I ruined it for everyone else. And whenever I saw a picture of me I would selfishly dissect every little part of me, rather than focus on the other people or the memory of the social occasion.

I even had a month long excessive tanning phase where I would get a sun-bed every day/every other day(!) in an attempt to look less fat and ugly.

These days it takes me 10–15 minutes to get ready. Those days it could take hours. And if I thought I didn’t look good enough to leave the house, I would cancel plans with my friends. Fortunately I have an incredible network of women who would come round to my flat, find me in amongst piles of clothes, and pick me back up again. My incredible friends were the ones who coaxed me to the GP – I look back and realise how much I put them through when I really believed I was handling it myself or that I was ‘better’.

I went on a waiting list for CBT and had my first appointment after six months. I didn’t think anything would change, but I look back on who I was before I got professional help and who I’ve become since completing my CBT and they feel like two different people.

Between 0.5%-1% of the UK population have BDD. But professionals believe the number to be much higher, and that people don’t speak to someone about how they feel as they worry they’ll be seen as vain or self-obsessed.

Today I wince when I think of the unkind words I used to hammer myself with. I’m really happy with who I am, and I value self-love and self-care.

The logical part of my brain knows that I now weigh between 8st7 – 8st10, and that I am a healthy weight. I know what my measurements are, and that I tend to wear a size 8. There may still be times where I think I’m much bigger than I am, but I now have the mindset and techniques to control this and not let it have the impact that it used to on my life.

I now take photos with my friends and family because I don’t want to look back and regret not capturing these memories. But every time I look at a photo of myself, I am still filled with dread that it will show how ‘huge’ I am. Through CBT I’ve managed to get my obsessive/checking behaviours under control, but there are some habits that take longer or may always be with me.

I’d like to end this with a paragraph from Paul Wyse’s blog post about his anxiety which says exactly what I want to: ‘And if you know me/work with me I hope this is an interesting insight, but be assured I’ll still get the job done like I always do. If you might employ me in the future, and why wouldn’t you, please don’t let this put you off. And if you don’t know me but one bit of this is useful then I’m happy.’

Thank you for reading, and thank you to our NHS for helping to put me back together.

Design, leadership, open culture, data, ethics, justice. These are my personal thoughts on work.

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