BDD…WT Actual F???????

Content note: this post is about body image, dysmorphia and disordered eating with mentions of self-harm.

So I know I have a diagnosis of bipolar affective disorder II with rapid cycling of mood. I have a further diagnosis of emotionally unstable personality disorder, although I have been diagnosed with one or the other condition based upon the weather than particular day.

(Seriously, during one two-week hospital admission I was flip-flopped between these two diagnoses no less than four times, according to which consultant was on duty. And each consultant was vehement that the other one was completely wrong. So please excuse me if I’m sceptical about what, if any, diagnosis is actually correct).

One of the difficult things that happens when you receive a diagnosis of a serious illness like bipolar or EUPD is that any other symptoms you may be having get subsumed within that diagnosis. So I have Generalised Anxiety Disorder which is not addressed because it’s just viewed as one of the manifestations of my BP/EUPD. I am scared of leaving the house and travelling, to the extent that I probably leave the flat about three days in every seven. This is certainly social anxiety/agoraphobia but again, it’s not treated separately to my bipolar/EUPD.

But today I want to talk about a different set of symptoms. I need your help because I don’t know what is normal and despite doing online research I haven’t found the answers.

The reason I frequently don’t leave the house is because I can’t bear to look in a mirror to apply makeup (and going out makeup-free is an even worse proposition). I am afraid of dressing my fat body, the way my clothes look (unflattering) and feel (tight) and I can’t bear to inflict this image on the world. I can’t dress without looking in a full-length mirror and I don’t want to look at my body. As a result, attempts at getting ready to go out are often aborted, and I will change back into my loose fitting pyjamas that obscure my physical form.

There’s close friends I haven’t seen for months because I’m embarrassed at how big I’ve become, especially my friends who work in a very image-obsessed industry where thinness is highly prized. They may know that this concept is bullshit, but they’re still online with their protruding ribs and thigh gaps.

But actually for the purposes of this blog, size (mine or others) is irrelevant. There is no objective size/state/body shape that would feel OK to me right now. This is all about my own perceptions and feelings.

I’d like to know: is it normal to compare your body size and shape to every single woman you see in public or on TV or in a magazine? If I see someone who I perceive to be the same size as me, I try and guess if others would view their body as revolting. Does everyone do this? I have done this all my life. I know we are all raised in the ‘does my bum look big in this’ culture, but how much comparing is normal? I’ve been on Oxford St today and the amount of comparing with others (everyone seems so skinny) plus trying to ignore my reflection in shop windows was just a nightmare.

What about plastic surgery? Where’s the line between a bit of botox and multiple and regular operations? Some days I want to slice off my fat.

Regarding food, I’ve suffered with bulimia in the past (again, never treated and viewed as a symptom of bipolar) but rarely purge nowadays. I’d say I have a fucked up relationship with food, but probably not a lot more than the next person.

I feel like I need some professional help with this preoccupation with my body, with avoiding mirrors, with feeling hideous. But I don’t know if I’m just suffering with anxiety which is exacerbating the general social pressures on women to look a certain way.

My mental health nurse told me straight out I don’t meet the criteria for Eating Disorder services, and that’s fine – I know many people with EDs and they are much more ill than me. I don’t think an ED (although a feature) is actually the main issue here. I think it’s much more to do with Body Dysmorphia. But I am pretty ignorant about this area of mental health provision. From the little I’ve read on the NHS website, the treatment would be little different to what I’ve already had over the years ad nauseum: CBT plus SSRIs.

If anyone can help, I would be so grateful for your comments and thoughts. Edit: even if these thoughts and feelings don’t affect you, I’d still like to know. If you’d like to comment privately, make that clear and I won’t publish it. Thanks.