It appears that patients diagnosed with BDD have serotonin levels that are lower than normal, indicating a neurobiological role. Serotonin is a neurotransmitter which helps to transmit nerve impulses across the junctions between nerve cells. Low serotonin levels are also associated with depression and other mood disorders. BDD is considered to be a rare condition but it is believed that as much as 1% of the general population may be affected, with teenage girls more susceptible than other groups.
Given that low levels of serotonin are associated with BDD, the treatment is similar to that of depressive disorder and anxiety, usually involving the use of selective serotonin reuptake inhibitors (SSRIs), most commonly fluoxetine (Prozac) or sertraline (Zoloft). The doses required to be effective are often much higher than that used to treat depression, although there appears to be a high rate of positive responses to SSRIs among BDD patients. This supports the theory that this disorder has a neurobiological component related to serotonin levels in the body.
The omega-3 fatty acid EPA works by elevating serotonin levels in a similar way to that of SSRIs. Recent research has confirmed that pure EPA derived from fish oil is as effective as flexitime (Prozac) for the serotonin increase, also making it an effective treatment for the management of BDD, without associated side effects.
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"My living nightmare started when I hit puberty at the age of 13. My self esteem hit rock bottom after constant thoughts that I was a horrible person and that I was hideously unattractive. At worst, I would look in the mirror and see an 80 year old, balding woman with wrinkles staring back at me. These thoughts started to affect my social life considerably, since when I went out I was convinced that people were staring and thinking I was deformed. By the time I was 16, I had begun to experience suicidal thoughts, and was consequently prescribed Prozac and Seroxat by my GP, neither of which were effective. It wasn’t until April 2006 when I watched a TV documentary about BDD that I started to make sense of my thoughts. Everyone on the programme was really attractive and, most importantly, normal, and yet they were convinced they were so ugly no one would ever love them. It wasn’t long after that I was diagnosed with Body Dysmorphic Disorder (BDD). Two years ago I read about a woman with PMDD (premenstrual dysphoric disorder) – an extreme version of PMS – and how the supplement Vegepa helped her. I started taking Vegepa and now, 2 years on since my diagnosis, I can honestly say that it has been a massive help. I no longer feel that I am so ugly that I want to die, and the heavy spells of depression have lifted. When I look at myself I can see the little wrinkles and small laughter lines and think 'That's okay, they are meant to be there'. I know I’ll have BDD for the rest of my life, but now I’m the one in control and I’m finally learning to accept myself for who I am.”
Danielle Nulty, Staffs