What Causes BDD
What causes BDD?
We don't know exactly what causes BDD and we're in the process of trying to find out what are all the causes of it. The research has really only been going on for BDD for probably the past couple decades and we're just starting to do more and more biology research and neurobiology research into what may be some of the causes. So far there are several theories that cause it. Given that there are some similarities to OCD, some people have developed hypothesis that there are problems with similar brain regions as you see in OCD. Some brain studies have shown there are brain abnormalities in the same regions. There may be some abnormalities in other regions that we see as a result of brain injury. There are some people that have brain injury to their frontal lobe that can develop BDD symptoms all of a sudden. We're trying to figure out if there is some type of pattern of an abnormal brain region that is causing some of these symptoms. Those only account for part of the problem because there are other problems that people with BDD have. One is that they value appearance a lot and they think that other people value appearance so they think not only am I ugly, but attractiveness is the most important thing in somebody's life. It's what everyone else is using to evaluate everyone else. If they just thought they were ugly, then they wouldn't have this problem.
Is BDD a brain disease?
Yes, it could be a brain disease. We've seen that there have been some cases of people that actually can develop BDD symptoms from brain injuries in certain regions of the brain. Some neuro-imaging studies have found that there are abnormalities in some parts of the brain -- the basal ganglia, it's called. Also, there's some research that I have done that has looked at visual processing, and there seems to be some abnormalities in visual processing of faces, as well. So there could be partly a brain-based problem here.
What role do neurotransmitters play in BDD?
Neurotransmitters are chemicals that the brain uses for signalling and they are involved in all the brain processes that we have. How it is involved in BDD we don't actually know exactly how they are involved. There are different neurotransmitters, for example, serotonin, where when you change the functioning a bit, for example, by giving a medication, serotonin reuptake inhibitor, that patient's symptoms can actually get better. We know that dopamine is involved in psychotic processes like in schizophrenia, for example, and people with BDD can have delusions. They have a fixed false belief and so in that way it is possible that dopamine is also involved in some of these delusional thoughts but we don't know exactly. We really need to do more research on these neurotransmitters to find out if and how they may be connected to BDD.
Is BDD genetic?
BDD probably is genetic. We do have some information from family studies indicating that BDD tends to run in families of people with OCD, for example. There's been one study looking at a connection with a certain type of serotonin gene. So there may be some susceptibility of developing it related to the connection with this gene. I can almost say for sure there's not one gene for BDD, but there may be a gene or genes that predispose somebody to developing either OCD or BDD if something else happens along with that.
Do BDD and depression have the same genetic roots?
Depression also runs in families and we know a lot more about the genetics of depression, so that we know it's not just an environmental effect, that it does happen in twins that are raised apart, for example. But the story is also very complex, with depression, that, again, there's no one gene that caused the depression, but there are probably a gene or genes that predispose somebody; make it more likely they'll have depression, if they have some other stress in their life, for example.
Are women more susceptible to BDD?
People often think, "This must be a problem that mostly women have." Eating disorders are--actually mostly women have eating disorders, but it's pretty close male to female in terms of number of people that suffer from BDD. It's almost 50-50. The recent research has shown that it's probably more like 60 percent of people with BDD are female and 40 percent are male, but it's pretty close, one to one.
Are certain personalities more susceptible to BDD?
Well, something that has actually been studied is the trait of perfectionism, so the trait of perfectionism is very common in people with BDD. And that would be perfectionism not just about their own appearance, but about other things as well: schoolwork, work, anything else. So that is one thing that may make somebody a little more susceptible to it, and also the propensity to have obsessive type of thinking, meaning that they have a hard time not thinking about something, thoughts keep coming back; that that probably also is an underlying trait that predisposes somebody to developing this problem.
Are certain cultures or ethnicities more susceptible to BDD?
You know we really do not know exactly because people have not compared directly when ethnicity or culture to another. But so far from what we see and where BDD has been studied in different parts of the world, it does seem to exist in every part of the world, where it has been studied. Different European countries, Asian Countries, United States obviously and also in my experience in treating people and in my research studies just anec totaling in Los Angeles, I have seen people from all races, all socio economic classes. It really seems like it can affect just almost anyone.
Can a painful childhood contribute to BDD?
It definatly can contribute. A lot of people will report that they've had an experience as a child of maybe being teased for somthing. It may be apperance or otherwise or they may have experienced, say family that put a lot of emphasis on apperance. And it could be positive or negative.Some people that were constantly being praised for being a cute kid then can develop this idea that this is the important thing about their being is their appearance.And so that can significantly contribute to how they feel about the importance of appearance when they get older.
Can teasing or criticism trigger BDD?
Teasing or criticism certainly can trigger BDD. Most likely they're not the cause of BDD, because pretty much everybody has been teased at some time in their life and not everybody develops BDD. But it can trigger it in the sense that somebody can start thinking about something that they're teased about and perhaps start focusing in on it and perceive it as being defective and going into a whole negative spiral through their thinking about it.
Can stress cause BDD?
Stress can definitely trigger BDD, but probably stress alone is not enough to cause it, otherwise everybody would develop BDD. But certainly it can trigger it, that a person can feel stressed, they can start feeling maybe depressed or anxious, and that often in somebody that already has BDD, can make their symptoms come up, or make them get worse.
Are beauty and fitness magazine images to blame for BDD?
A lot of people think the media has a lot to do with body dysmorphic disorder, that the media places so much importance on appearance and that maybe this is causing people to be overly concerned about it. But the way that I see it is that the media focus on appearance makes people suffer more who already have BDD, but probably doesn't actually cause it. So if they're bombarded with images all the time of a lot of people that are very beautiful or that are enhanced in some way, they may feel worse about themselves. But again, it probably didn't cause it. Especially because in other countries where the media's not so focused on appearance, like for example in Germany, the rate of BDD was the same as the group they studied who were American.
