HOW TO SUCCESSFULLY TREAT BDD WITH MEDICATION: WHAT GETS BETTER WITH AN SRI? CONCERN WITH MORE NOTICEABLE APPEARANCE PROBLEMS
HOW TO SUCCESSFULLY TREAT BDD WITH MEDICATION: WHAT GETS BETTER WITH AN SRI? CONCERN WITH MORE NOTICEABLE APPEARANCE PROBLEMS Sometimes the SRIs decrease an obsessional preoccupation with a noticeable aspect of appearance, such as obesity. Some people whose appearance problem wouldn’t qualify for BDD (because the defect is obvious) may become less preoccupied with and less upset by these problems when treated with an SRI. For example, some people who are quite overweight become less consumed by their weight obsessions—they’re still not happy with their weight, but they’re no longer obsessed with it. Both their BDD-related concern and their concern with a more noticeable appearance problem diminish.*Insight was assessed with the Brown Assessment of Beliefs Scale (BABS), a scale developed by Dr. Jane Eisen of Brown Medical School, myself, and Drs. Doug Beer, Katherine Atala, Steven Rasmussen, and Lee Baer. This scale has been shown to be a reliable and valid measure of insight (degree of delusionality).In a way, this observation makes sense. The medication can’t distinguish between a slight appearance problem (i.e., BDD) and one that’s more noticeable. The medication doesn’t have eyes! The SRIs probably work by decreasing excessive, obsessional thinking, regardless of what someone actually looks like. This issue requires more research and goes beyond BDD. It raises the question of whether accident victims or people with congenital deformities who are overly preoccupied with and distressed by very noticeable defects might benefit from SRI treatment. Might they become less consumed by their concern—less preoccupied, less distressed, and better able to function? It’s possible.*253\204\8*
