Facial dysmorphia is a mental health condition where the sufferer has a warped perception of the appearance of their face. The sufferer may perceive their face to be abnormally large or small, lopsided, or a strange shape. In some cases, the sufferer perceives that other people have replaced their face with a mask.
Facial dysmorphia is also known as body dysmorphic disorder (BDD), body dysmorphia, facial dysmorphic disorder (FD), and dysmorphophobia.
Symptoms of facial dysmorphia
The main symptom of this condition is a distorted view of the appearance of one’s face. This may manifest as perceiving the face as being too big or too small; lopsided; having an unusual shape, such as a crooked nose; or some other abnormality.
In some cases, the sufferer may feel that their face has been replaced with a mask, or that it is otherwise unreal. This can lead to excessive touching of the face, feeling the skin to make sure it is real and still there. In extreme cases, a person may refuse to leave their home, or go outdoors.
The secondary symptoms of facial dysmorphia
The symptoms of this condition are often severe enough to significantly interfere with the sufferer’s life and ability to function properly. With treatment, they can be alleviated, however.
It is not uncommon for people with facial dysmorphia to become depressed, due to the isolation and alienation they may experience.
Symptoms of this condition tend to be made worse when the person with facial dysmorphia looks in a mirror, is observed by others, or sees photographs of themselves.
Experts are not certain what causes facial dysmorphia; however, there are several different theories about its causes.
A first theory
One theory is that the person’s brain does not process their image of themselves correctly, which leads to them perceiving their face differently than it appears.
A second theory
Another theory proposes that sufferers have either an abnormality in the way they perceive visual information or abnormalities in how the part of the brain responsible for perception works.
A third theory
A third theory is that the condition is caused by a chemical imbalance in the brain, such as low levels of serotonin. This may affect how the sufferer perceives their face. The effects of facial dysmorphia can be so severe and distressing that it may interfere with the sufferer’s ability to function properly and carry out everyday tasks.
Body dysmorphic disorder (BDD)
Some researchers believe that the condition is a type of body dysmorphic disorder (BDD). As BDD may also cause sufferers to be overly concerned about their other appearance, many people currently diagnosed with facial dysmorphia could feasibly instead have BDD. However, there are different treatments available for the two conditions. People diagnosed with BDD are more likely to be concerned about an excessive number of body parts, and this concern is often accompanied by compulsive behavior, such as skin picking.
The main treatment for facial dysmorphia is psychotherapy. This aims to help the sufferer learn how to cope with their condition and may include cognitive-behavioral therapy (CBT).
Serotonin reuptake inhibitors (SSRIs) and Tricyclic antidepressants
A doctor may prescribe medication to help with the symptoms of this condition. These include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, which are commonly used in the treatment of depression. If a person’s facial dysmorphia is severe they may be referred to a hospital or specialist unit for further treatment.
The long-term prognosis of the facial dysmorphia is good with successful psychiatric treatment, although there are cases in which it can persist for life.
The condition will not improve if the person continues to see a mirror as distorted or abnormal. This can be described as mirror phobia and may require behavioral therapy to overcome.
People with facial dysmorphia need to avoid too much time spent in front of a mirror, as this will only make the symptoms worse. Instead, they should gradually spend more time away from mirrors until their condition improves enough to do what they need to do without them.