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BDD FROM THE PAST AND AROUND THE WORLD : THE VIVID CASE DESCRIPTIONS
The vivid case descriptions written during the past century bear testimony to BDD’s long history and to the fact that people from a variety of cultures have suffered from it. Indeed, BDD is well known and recognized in certain countriesJapan, for examplebut has escaped adequate recognition in many others, including, until very recently, the United States.
While it’s not entirely clear why BDD has been largely unknown in the United States and certain other countries, a likely reason is that it’s often kept secret. Keith wasn’t my only patient to take several years to reveal his concerns. Some people, like Jennifer, tell family members and friends about their worries and may even describe them to doctor after doctor, but many others keep them secret.
Some have finally mustered up the courage to mention their concern to someone they trust, but when they’re reassured that they look fine, they feel misunderstood. They may interpret reassurance to mean that the person they’ve told doesn’t take them seriously and doesn’t understand their suffering. So they may never mention it again.
Others don’t realize their problem is psychiatric. They go to surgeon after surgeon, dermatologist after dermatologist, hair club after hair club seeking a nonpsychiatric cure for a psychiatric problem. This, too, has contributed to BDD’s underrecognition. If people with BDD do see a psychiatrist, they may be too ashamed to bring it up. They may muster up only enough courage to talk about the depression and anxiety that people with BDD often experience, keeping the reason for their suffering a secret even from those who can help them.
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