UCLA researchers believe it could be a result of an altered, dysfunctional, or damaged visual processing center:

Now researchers at UCLA have determined that the brains of people with BDD have abnormalities in processing visual input, particularly when examining their own face. Further, they found that the same systems of the brain are overactive in both BDD and obsessive-compulsive disorder, suggesting a link between the two. The research appears in the February issue of the journal Archives of General Psychiatry.

“People with BDD are ashamed, anxious and depressed,” said Dr. Jamie Feusner, an assistant professor of psychiatry and lead author of the study. “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.”

What triggers BDD is largely unknown, as is the strength of the connection between BDD and environmental factors like bullying or sexualized pop culture. The important take away here is that the BDD brain stops perceiving reality the way a typical person would; a BDD sufferer literally sees themselves differently in the mirror than the rest of us. What is frightening is that because we largely don’t know what triggers the shift, be it genetic predisposition or  a self-reinforcing mental state or something else entirely, is that we don’t really know how to cure it.

BDD is particularly troubling because it is based in the part of the brain that deals with normative judgments, meaning that, by and large, the problems of which it is hyper-aware are almost entirely socially constructed. Even if the problem is rooted in a physical or chemical problem, the norms selected by society are what become over-amplified and dangerous. It is very troubling and very sad, because it seems that regardless of what the standards of beauty are, those with BDD believe they do not live up to them and take dramatic measures to try and correct the problem. I hope research like what is being done at UCLA helps us at least understand the mechanism so that we can work to mitigate its effects.

[“Why the mirror lies” – Science Daily]

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