Ugly Duckling Syndrome

No one is entirely  happy with how  s/he looks. But  Ranbir was fixated,  and his need for  physical perfection  unknowingly made  him a social misfit

‘Many people dislike some aspect of their appearance. But for some individuals, normal appearance concerns turn into torturous obsessions. This relatively common, extremely distressing but often under-recognised and misdiagnosed condition is known as Body Dysmorphic Disorder (BDD),’ writes Dr Pulkit Sharma, in a study that he published in Journal of Personality in Clinical Studies. Dr Sharma is a clinical psychologist at New Delhi’s Vidyasagar Institute of Mental Health and Neurosciences.

In the last five years, he has had seven patients with symptoms of BDD. One of his patients spoke to Open about what it means to live with this condition.

Ranbir, 26, lives in Delhi and is from a well-to-do family. He has recently enrolled in an MBA programme—an achievement in itself, says his doctor. “After somehow finishing his graduation, he tried working at a few places but could not continue due to this problem,” says Dr Sharma.

His obsessive need to change the way he looks has affected his studies, his relationships and his health. Two plastic surgeries on his nose only took him closer to the brink. He contemplated suicide. Ranbir came across Dr Sharma’s article during a frantic, neverending, search for cosmetic remedies. He has been in psycho-therapy for five months now. He sees his doctor three times a week. As a child, says Dr Sharma, he preferred books and solitude to games with the boys: “Rather than giving him the space, his parents and others around him often made him feel like the odd one out.” In school, being teased by his classmates for his looks only exacerbated feelings of rejection. Dr Sharma adds: “Advertisements gave him the message that imperfect looks are undesirable and they need to be corrected in order to live life. This led to his indulgence in umpteen diets, exercises, beauty treatments and doctor shopping. Instead of improving his symptoms, it made him feel worse.”

Ranbir tells his story of living with BDD:

When I was 14, my friends teased me, saying that I had a flat, horrible nose. They said horrible things. My face, they said, was puffed up like that of a scarecrow. My nose, they sneered, looked like a knob. The more I told them to stop, the more they laughed and continued. And I thought no girl would like me. I also started feeling that I was very fat. I was 5 ft 5 inch and weighed 62 kg. I wasn’t muscular and thought I needed to build my body. It bothered me a lot. I decided to join a gym. I was 15. I started spending a lot of time working out. Seven days a week, two to three hours a day. My body would ache, but still I would do weight-training seven days a week. I suffered from serious muscle ruptures. But I found it impossible to give up training because I would feel very ugly if I didn’t work out.

A doctor I consulted told me to stop, but I could not. Going to the gym was like getting a daily dose of hope. The days I did not go, I felt horrible. The mental mess I found myself in was far greater torture than the physical pain.

Newspaper advertisements had a lot of influence on me. Especially the ones on nose surgery. Changing the shape of your nose, the ads promised, could change your life. I believed it. I believed it would make me feel good. And that everyone would start loving and accepting me. I felt that by changing my looks and working out, I would become happy. But nothing I did made me feel better.

I spend most of my day worrying about my looks, feeling sad and finding treatments for looks. I can’t work or have fun with friends. I can’t relax, can’t participate freely at family gatherings.

Earlier, I yearned for someone’s company. But now I keep to myself. When a girl approaches me, I clam up. I feel that she will find me ugly and reject me. I have never had a relationship. There were instances when someone tried to approach me, but I got scared and didn’t encourage it.

I have not been able to finish my studies or hold on to a job. When I go for an interview, I get the feeling everyone is staring at me because I’m ugly. I get very nervous. I cannot concentrate on anything. I was a very good student before this problem started.

When I look at myself in the mirror, I feel that my face and body are very ugly. I’m unhappy with my nose, the shape of my cheeks and my body. I feel exercise and surgery can make me look and feel better. I’ve tried beauty treatments, chemical peels, supplements, heavy exercise, even cosmetic surgery.

And even after many cosmetic treatments, including two nose surgeries, I feel horrible. I was 19 when I had my first surgery. My family thought it was the best way out to make me feel better about myself. I felt so too. The doctor told me success stories of how he had done plastic surgeries and transformed people’s lives. I believed this and went with the hope that this would make me happy and solve all my worries.

After the first operation, it took me six months to heal completely. I had stopped going to college. But that didn’t really matter to me. Working on this, after all, was top priority at the time.

In these six months, I felt worse. The doctor advised me to go for a second operation. He said the nose is difficult to change completely in some cases but assured me that a revision rhinoplasty (nose reconstruction surgery) could help. I wanted my nose to be like Hrithik Roshan’s—sharp.

I hated going out or being seen by others. This ruined my life. Studies, friends, family—I ignored them all. Changing the way I looked was my top priority. I’d spend eight hours a day on the internet, reading about ways to improve looks. The whole time that I was awake, I worried about being ugly. When all things failed, I thought of committing suicide. It was the dominant thought in my head. But I didn’t want to die sad. Therefore, I thought I would fight it out.

I’d trawl the web for everything from diets to face packs to cosmetic treatments to surgery. It was during one of those endless searches that I read Dr Pulkit Sharma’s article on Onlymyhealth.com.

This was around five months ago. Even though I felt that my problem was not psychological, this article touched a chord. I identified with the symptoms. Even though the article described what I was experiencing, I had difficulty accepting that it was all in my mind. I was dead sure my body was horrible, but thought, ‘Why not give therapy a shot?’ And so, reluctantly, I fixed an appointment with Dr Sharma.

My symptoms are still there. There are times, after undergoing therapy sessions, that I feel that the real problem is with my mind. And this has given me hope. Perhaps, with time, worries about my looks, this need to keep to myself and my inability to participate in social activities will go away as well. I am hopeful, right now.

Dr Sharma has shown me that these feelings could be related to my low self-esteem. Since childhood—though at that time I didn’t worry about my looks—I had a general feeling that I lacked something and that I needed to do something to change it. When I turned 14, social comments and media ads made me feel ugly. Now at times I think it’s just my mind. But I’m still not 100 per cent sure.

As told to Pallavi Polanki by the patient, whose name has been changed on request

appearanceBDDBody Dysmorphic Disorder