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Other names: Clomicalm

Anti-DepressantI should emphasize, however, that in my experience the need to make difficult judgment calls is the exception rather than the rule. Of the patients I’ve seen, only 3% have had an unassessable defect in the absence of others I could assess. Only about one-third have had an actual defect, and in only a minority of cases was it difficult to determine whether it was “slight” (therefore qualifying for BDD) or clearly present. Most people I’ve seen had what I considered a nonexistent defect. In some cases, the disliked body part is actually very attractive. One woman who was obsessed with her “ugly” hair actually had beautiful hair. While she despaired because she thought it was “frizzy and ugly,” other women asked her who her hairdresser was so they could have theirs done in a similar style. Another young woman had been asked to work as a model, and as a child she’d been told that she would someday be Miss America; however she believed that such requests and statements were motivated by pity for her ugliness.
It’s worth considering whether people with more noticeable, “clearly present” defects (who don’t qualify for a BDD diagnosis because of the obvious nature of their deformities) might nonetheless have features of BDD. Do people with birth defects, accident victims, or others with very noticeable physical flaws have experiences similar to those of people with BDD? Are they preoccupied with their flaw? Do they suffer as a result? Does it interfere with their functioning? Do they feel very self-conscious in social situations?
I’ve met some individuals with obvious defects for whom the answers to these questions are “yes.” And research findings suggest that, for some individuals, the answers are “yes.” Although by definition they don’t have BDD because their defect is very obvious, they’re preoccupied, distressed, and sometimes impaired by their appearance concerns. It’s possible that much of what I’ll be describing in this book applies to them as well. And what about people with physical features that, strictly speaking, aren’t defects or flaws—for example, tattoos they no longer like? Do some of them have features of BDD? Some appear to. This is another important question that needs to be studied.
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