Reflecting back

By Michael Wills

Morgan Park High School

Let’s paint a pretty but deceptive picture of an ailment. In schools, on magazine covers, in music videos, down cosmetic aisles and in many other aspects of teen life, there is a bombardment of beautiful faces and bodies. But for some teens who are good looking that image isn’t reflected back at them in the mirror.

This is a real disorder for thousands of teens in the United States. It is called body dysmorphic disorder (BDD) that affects those who psychologically don’t think they are attractive despite the contrary and who go to extremes to fix their “problem.”

“My sister’s friend has that disorder and she has really low self-esteem, and she told my sister once that she would change her eye color if it was ever possible,” said Salma Jabri, a 15-year-old at Hinsdale Central High School, just outside Chicago. “My sister’s friend also has had two nose jobs in the past year.”

Teens may become anorexic or suffer somatic delusion, among a list of obsessively bad behaviors, as the condition takes over their lives. BDD should not be taken lightly because of the trouble it can cause teens at a formative age, notes the Anxiety Disorders Association of America in Maryland.

According to the Mayo Clinic in Minnesota, the ailment, also called “imagined ugliness,” is a mental illness in which teens can't stop thinking about flaws -- either minor or imaginary -- in their appearance. Low self-esteem, depression, social isolation, suicidal thoughts, paranoia, phobia, body odor concerns and desires for implants or other cosmetic surgery are among the behavioral problems that may surface as a result.

Alex Kyi, a 15-year-old sophomore at Jones College Preparatory High School in Chicago, said he had taken some action because of being ashamed of his looks, noting “when I’m around attractive people, I feel as if my looks don’t matter. I’d rather get surgery to make myself look better.”

The clinic also reported that body dysmorphic disorder usually starts in adolescence, affecting both genders equally. The condition affects about 1 percent of the U.S. population and as many as 10 percent of those seeking dermatology or cosmetic treatments may do so because of the ailment.

A study found that 24 percent of those with BDD also had obsessive compulsive disorder, according to the Obsessive Compulsive Disorder Center (OCD) of Los Angeles.

Some people might say that Michael Jackson showed symptoms and their consequences. The pop singer, who died in 2009, went through a series of treatments to lighten his skin and surgeries to fixed perceived facial flaws in the 1980s and ‘90s. Later, he became somewhat of a hermit at his ranch in California and often wore a surgeon’s mask in public.

Very few celebrities with BDD have discussed the topic publicly, Dr. Jamie Feusner, a psychiatrist at the University of California, Los Angeles, told a CNN reporter this year. He and his colleagues have treated celebrities at UCLA, but keep the names confidential.

Despite popular perceptions, BDD is not sending masses of adolescents between the ages of 13 and 19 for some nick and tuck at doctors’ offices. The American Society of Plastic Surgeons reported that age bracket accounted for 2 percent of the 12.5 million cosmetic procedures in 2009. The most common procedures for teens were laser hair removal, nose reshaping, laser treatment of leg veins and laser skin resurfacing.

So the disorder mainly manifests itself in how teens behave and their grooming.

“I worry about my looks when I’m around others that look better than me,” said Robbie Hawkins, a junior at Marian Catholic High School in Chicago Heights, “so I constantly adjust my wardrobe and other things to make myself look better.”

Seventeen magazine noted that teens spend about $9 billion annually on cosmetics and skin products, and a Magazine Publishers of America marketing profile found that clothing topped a list of items that teens -- a $112 billion spending sector in 2003 -- bought or planned to buy with their own money.

"The problem is really on the inside, it's not what they really look like," Sabine Wilhelm, director of the BDD Clinic and Research Unit at Massachusetts General Hospital, said in the CNN report.

Researchers point to possible triggers of BDD, including brain chemicals called neurotransmitters that are linked to a person’s mood, genetic traits in the family tree and environmental conditions such as peer pressure and other social influences.

Theresa Murphy, 15, said teens might feel as though they have symptoms of the disorder and acknowledged she sometimes stray in that direction. “I like the way I look most of the time, but sometimes I feel as if I need makeup to make myself look better,” said the sophomore at Thornwood High School in the Chicago suburb of South Holland.