Roy Suryo
Charlotte’s journey began in her early teens, a period marked by an intense and consuming hatred for her own reflection. The mirror, a commonplace object for most, became a source of profound distress for her. Her days were dictated by a relentless pursuit of an unattainable perfection. "I’d wake up at 5.30am to put my makeup on even though the school bus wasn’t until 8.30am," she recounts, her voice tinged with the memory of that overwhelming anxiety. This wasn’t a casual morning routine; it was a compulsive ritual. "I’d be compulsively applying it, taking it off, reapplying it, taking it off again – trying to get it as symmetrical and perfect as possible." This obsessive behaviour began to erode her social life, leading to increasing isolation. The college campus became a place she could only navigate for the necessity of sitting exams, the prospect of social interaction too daunting to bear. Even significant milestones like the school prom were avoided, the thought of having her photograph taken a terrifying ordeal.
This profound distress eventually led to a diagnosis of Body Dysmorphic Disorder (BDD). While the term "body dysmorphia" is often casually used on social media to describe general dissatisfaction with one’s body, BDD, as explained by Viren Swami, professor of social psychology at Anglia Ruskin University, is a more severe condition. It’s when persistent anxiety about one’s appearance starts to significantly interfere with daily life. Swami elaborates on the BBC’s "Complex" podcast that BDD involves an obsession with a specific aspect of one’s appearance that, while appearing normal to others, feels deeply flawed and wrong to the individual experiencing it. Key characteristics of BDD include significant emotional distress, prolonged periods of rumination on perceived flaws, and a feeling of being unable to control these intrusive thoughts about appearance. This often manifests in repetitive behaviours, such as excessive mirror checking or frequently touching the perceived "flawed" body part. "Their entire world narrows down around this aspect of their body and everything else kind of fades away," Swami observes, painting a vivid picture of the all-consuming nature of the disorder. While body dissatisfaction is statistically more prevalent among women, Swami notes that BDD does not show a clear gender divide, affecting individuals across the spectrum.
Charlotte’s path to recovery began with seeking help through her local mental health service, which eventually led to her admission to an anxiety disorder residential unit in London. It was during this inpatient treatment that she discovered the therapeutic power of creative expression. "I did occupational therapy when I was in in-patient treatment, like art and pottery and songwriting, and that’s how I got back into music," she shares. This therapeutic engagement provided an outlet for her deeply ingrained perfectionism. "It helped me channel my perfectionism, taking it out of the dark and into the light and dissipating that shame." Upon her discharge, Charlotte felt a strong urge to share her experiences, hoping to offer a beacon of hope to others who might be struggling.
Professor Swami emphasizes the importance of seeking professional help, advising individuals experiencing BDD symptoms to first consult their GP. For those who suspect a loved one might be suffering from BDD, Swami stresses the critical need for patience and empathy. He highlights that individuals with BDD often repeatedly seek reassurance about their perceived flaws. "Rather than shutting down these conversations and getting angry or frustrated about it, recognise BDD is a mental health condition that doesn’t just go away on its own and without professional help it can often get worse."
Tilly Kaye’s experience with BDD also began in her early teens, leaving her with profound feelings of self-loathing. "I felt like I wanted to apologise to the people who had walked past me for how ugly I was," she confesses. The simple act of looking in a public mirror became an impossibility. Her discomfort extended to her clothing choices, leading her to avoid anything tight-fitting. Even attending social events like festivals and parties became an "excruciating" experience, as the anticipation would trigger a "negative spiral that I couldn’t recover from in time for the event." Initially, Tilly mistook her struggles for low self-esteem and general depression. "I didn’t have the awareness to notice the connection between the different sorts of experiences that were actually all to do with my appearance," she explains. The onset of her university studies in fashion design, a field inherently focused on appearance and aesthetics, exacerbated her BDD symptoms. The constant comparison to those in the industry fueled dark and distressing thoughts about her own appearance, reinforcing feelings of unworthiness.
Over the years, Tilly sought therapy from various practitioners, but none specialized in body image issues. A turning point came when she began working with an NHS psychotherapist who identified her condition as BDD. Tilly then found further support through a BDD Foundation support group and engaged with a private therapist to manage her symptoms. She strongly recommends that individuals experiencing BDD symptoms research the condition thoroughly before discussing their concerns with a doctor. "This could mean people are able to ask for the right help with more confidence," she adds, highlighting the empowerment that comes with informed self-advocacy.
Today, Tilly has cultivated a greater sense of control over her thoughts. "If I’m looking in the mirror trying to get ready and I don’t like what I see, if I even feel that sense of panic coming over me, I can just put a stop to it straight away," she says, her voice firm with newfound resilience. She recognizes the crucial distinction between her internal perception and external reality. "How I see myself, depending on those different days and moods, isn’t how other people see me, they just see me as Tilly." This shift in perspective has led to a profound transformation in her mindset. "I found this joy in my life again, and for the first time since childhood I felt love towards myself."
Charlotte echoes this sentiment of hope and recovery. "I feel so fulfilled and so happy and so peaceful and I really do love my life now and I never thought I would get here." She wants to convey a powerful message to anyone struggling: "there is hope out there, you can recover."
If you, or someone you know, have been affected by issues in the story, please visit BBC Action Line to find information on organisations that can help.
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