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WHY BDD IS UNDERDIAGNOSED – ADDITIONAL CLUES: DEPRESSION, SOCIAL ANXIETY, AND OTHER SYMPTOMS
Many people with BDD are depressed. Others have problems with alcohol or
drugs. Many are anxious, and some have panic attacks. Indeed, BDD often
coexists with or causes other psychiatric symptoms and disorders, which can
Anti-Depressant
Anti-SmokingI and other researchers have carefully assessed the frequency of other psychiatric disorders (e.g., depression) in people with BDD. Conversely, we have studied BDD in patients with other psychiatric disorders. Appendix D shows these findings in greater detail. These study results indicate that major depression is the most common disorder in people with BDD. Major depression is characterized by depressed mood, decreased interest and pleasure, and other symptoms, such as sleep and appetite disturbance. While major depression is fairly common, affecting 10 to 20% of the general population at some point in their lifetime, more than 80% of people with BDD have major depression at some point in their life. For many, the depression is quite severe. In some cases, the depression and the BDD seem to be somewhat “separate,” whereas in many cases, the depression appears largely due to BDD.
In a study that my colleagues (Dr. Andrew Nierenberg of Harvard Medical School) and I did, BDD was more than twice as common as OCD in people with depression. In a research study of depressed people in Italy, BDD was more common than many other disorders, including OCD, social phobia, simple phobia, generalized anxiety disorder, bulimia nervosa, and substance abuse or dependence. These results are striking because, as a little-known disorder, BDD generally isn’t looked for in people with depression. In addition, Dr. Nierenberg and I found that depressed people who also had BDD had onset of depression at a relatively young age and unusually persistent depression. These findings suggest that depressed people—especially those with long-standing depression— should be asked whether they have BDD symptoms.
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