Mirror on the wall…are you depressed by what you see?

What do you see when you look into the mirror? I mean, the ordinary kind of mirrors, not the magical Harry Potter-type ones. Do you like what you see? Are you scared of what you see?

Let us talk about body dysmorphic disorder, or BDD, which is “a psychiatric condition that causes them to believe, wrongly, that they appear disfigured and ugly.” People with BDD tend to fixate on small details — every tiny blemish is a big thing — rather than viewing their face as a whole.

Researchers at University of California Los Angeles (UCLA) report that people with BDD may have a lot in common with people who have obsessive-compulsive disorder (OCD) and the pathogenesis of the two disorders might be related to abnormalities in processing visual inputs to the brain. About 1 to 2 % of the population suffers from BDD.

According to lead author Dr. Jamie Feusner, assistant professor of psychiatry at UCLA

“People with BDD are ashamed, anxious and depressed. They obsess over tiny flaws on their face or body that other people would never even notice. Some refuse to leave the house, others feel the need to cover parts of their face or body, and some undergo multiple plastic surgeries. About half are hospitalized at some point in their lifetimes, and about one-fourth attempt suicide.”

The researchers compared the brain activity of people with BDD to those without BDD while viewing photos of two faces – one of their own and one of that of a famous good-looking celebrity known to the participant. The photos were first shown as they were, then shown again after being altered in two ways. The first alteration used high–spatial frequency information that highlighted blemishes and hairs on the face. The second alteration used low–spatial frequency information, showing only the general shape of the face and downplaying the blemishes. Brain activities were measured using functional magnetic resonance imaging (fMRI).

The brain activities of those with BDD were abnormal when viewing the photos, even the unaltered and the downplayed versions of the photos. Their brain activity  and their reactions to the photos corresponded to the severity of the symptoms. The more repulsive or disgusting they found the photo, the more abnormal were the brain activity measurements. The researchers believe that people with BDD have difficulties in perceiving correctly information about faces as a whole as well as the relationship between individual facial features.

Dr. Feusner continued to explain:

“This may account for their inability to see the big picture — their face as a whole. They become obsessed with detail and think everybody will notice any slight imperfection on their face. They just don’t see their face holistically.”