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BDD-PATIENTS SPEAK: CHRISS STORY
One of my first patients with BDD was a shy, articulate young man named Chris, who made an appointment with me to be evaluated for depression. When I first met with him, he told me that depression was his problemthat he’d been feeling down, unmotivated, uninterested in things he usually enjoyed. He was having trouble sleeping, and found it difficult to concentrate on his job. His girlfriend had recently left him.
Chris indeed sounded depressed, and it seemed as though he had a fairly straightforward case of depression. But when I asked him if he was bothered by anything else, Chris seemed unusually hesitant and uncomfortable. He was silent for several minutes and seemed to be struggling to decide whether to tell me something. “There is something else bothering me. I wasn’t sure I’d be able to tell you about it, but I should because it’s why I’m here. It’s my main problem. I’m depressed because of my hair.”
Chris struggled to explain. “This is really embarrassing for me to talk about, but I’m devastated over my hair. I think it’s falling out and that I look terrible. I realize I’m probably distortingthat I really don’t look so badbut I can’t stop worrying about it.” Chris had recently joined a hair club and had tried many hair tonics, which cost him $300 a montha significant financial burden. But none of these remedies had diminished his preoccupation. Now he was considering getting a hair weave and was saving his money to pay for it.
Chris also worried about his nosethat it didn’t look right. He was reluctant to describe this concern, too, but explained that he thought his nose was too wide and too long. “I’m so worried about my nose, and especially my hair, that I can’t concentrate at work. I had a big assignment last month, and I had a hard time getting it done because I thought my hair looked especially bad. I thought more was falling out than usual. This probably sounds ridiculous to you, but I was so distracted by these thoughts and by the fear that I was going to be bald that I was a week late with the assignment. That was a big blow for me because I’m a perfectionist. I do a good job at work, and I pride myself on getting my assignments done on time. What was really hard was that my boss called me in to talk about my lateness and to ask me what the problem was. Of course I couldn’t tell him what it was. I’d be totally mortified. I made up an excuse about a close friend being sick, even though I hate to lie.” Chris worked as an accountant and had deadlines to meet. “It probably sounds ridiculous that I can’t meet my deadlines because of my hair. It really shouldn’t matter what my hair looks like. But I can’t help it!”
Chris was also very nervous going out to parties and bars with his girlfriend. “Before my hair problem began, I didn’t have much trouble talking to people when I went out. I was never the life of the party, but I’d go out. I liked to see people, and I never avoided social events that I wanted to go to. But it’s really hard for me now because of how I look. When I do go out, it’s hard for me to talk with peopleI can’t concentrate on the conversation. All I can think about is whether my hair looks okay and whether they’re noticing how thin it is. I constantly check out their hair and compare it to mine. Then I usually feel worse because I think their hair looks better. That’s why my girlfriend left me. She likes to go out and said she can’t stay with me if I stay home or leave parties early because of my hair. She thinks I look fine, and she can’t understand why I can’t just forget about it.
The final straw for her came last month,” he continued. “Last month was a really bad time for meI’m not sure why. I was supposed to be in her brother’s wedding. I went to the dress rehearsal, but on the morning of the wedding I panicked. I looked in the mirror and I thought ‘Where’s your hair’ I thought I looked balder than ever. I spent about an hour frantically putting gel in it, combing it, and blow drying it, trying to make it look fuller. I even had my girlfriend help me with it, even though she was really frustrated and angry with me. But no matter what we did to it, it didn’t look right. I kept trying to convince myself that it really didn’t matterthat people would be looking at the bride and groom, not at my hair. But I just couldn’t go. I felt so demoralized and desperate.”
*7/204/8*