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A SPECTRUM OF SEVERITY: MILD BDD
But most people with BDD don’t get into serious accidents or act in self-destructive ways. Like Sarah, those with milder BDD live relatively normal lives. They work, see friends, date, and raise families. I treat college students who get good grades and graduate, homemakers who successfully juggle raising children and running a home, accountants who meet their deadlines, and doctors who give their patients superb care. Many people with this disorder are productive; some are very high achievers. All of them suffer, but they manage, sometimes well.
A psychiatrist colleague of mine wondered if one of her patients had BDD but thought it unlikely because he was functioning so well. This colleague had treated several other people with BDD whose symptoms had severely impaired their functioning and she consequently thought that all people with BDD had extreme difficulties with work, socializing, and other aspects of life. But it turned out that the patient in question, who was a college professor, did in fact have BDD. He managed to perform well at work because of the effort he made to stay focused on his work and to keep his symptoms from interfering. The professor, however, viewed his functioning as less than optimal. He hadn’t applied for a job he’d wanted because he feared he’d be turned down because of his “awful” appearance. And he’d refused a promotion that would require more work because his preoccupations were so taxing. “Even though I’m very high functioning and successful,” he explained, “I’m not working up to my capacity, although no one would ever know it.”
*20/204/8*