BDD Attacks
What is a BDD attack?
Techniques to Cope
Suicide Help

This section has been broken down into the following categories for easier navigation:

1. What is a BDD attack?
2. What can trigger a BDD attack?
3. Situations
4. Behaviors of other people
5. How to find the root of your BDD attacks
6. Example attack scenario and how to battle it
7. What does a person with BDD think during a BDD attack?
8. How does it feel to have a BDD attack?
9. What is the most common outcome of a BDD attack?


What is a BDD attack?
Most BDDers have good days and bad days. On a good day, a BDDer can function somewhat normally and not worry constantly about his appearance, although rituals will persist throughout the day. Or, they may feel unattractive, but it won't interfere with functioning. A bad day usually starts with a BDD episode, which consists of negative self-talk and self-doubts. This can easily escalate into a BDD attack, which is denoted by a sudden feeling of impending doom, self-hatred, hopelessness, isolation, and often, thoughts of suicide. BDD attacks usually pass after several minutes to hours, but it's a very terrifying time for a BDDer, and also for family and friends of the victim. A BDD attack can take place anywhere, but very often occurs in front of a secluded bathroom mirror. During this time, BDDers are usually dangerously isolated in their own minds, not allowing others' input to have any affect on their thinking.

But, probably the worst thing that these people can do, is act as if they don't need you--They have better things to do, more people to meet. The problem is, very often, people with these disorders have a hard time showing real love and acceptance to others. They pull you in, but then keep you at a distance. Such behaviors are very difficult for a BDDer, who needs unconditional acceptance.

How to Find the Root of Your BDD Attacks
I find that it's good to keep a BDD journal, and jot down your thoughts and chart how extreme your feelings of BDD are at that particular time. After some time, you'll notice that a pattern forms, and certain situations are much more likely to cause an attack than others. Once you find what these situations are, you can make the choice of avoiding them if they are unbeneficial to you, or trying to face them, but with a new understanding. You can use Cognitive Behavioral Therapy skills to help find your way through situations that would normally cause an attack.

Example Attack Scenario and How to Battle it
I'll now explain an example of what might cause a BDD attack, and how to tackle the problem: I find out that my boyfriend has to go on a big business trip, and that he is not going to invite me. This reminds me of the time that my mother went out and got a fulltime job, and told me that she did that so she wouldn't have to be around me anymore. During those days, I was all alone and very afraid, and believed that this rejection would prevent me from getting help if I was in a dangerous situation. I assume that my boyfriend is also making his job his first priority so that he doesn't have to be around me anymore. I fear that I will be all alone again, which causes me to become very afraid, and then the BDD attack begins.

As you can see, the attack is actually nothing out of the ordinary. It's exactly how a person should act if they've formed beliefs that you've seen above! Most people would know that having a loved one go on a business meeting is not rejection. But circumstances from a BDDer's past have given them certain beliefs, and if they think they might become true, they panic! The ideal way to handle this example situation would be to address your fears with your boyfriend. Tell him how you feel and why you are scared. Let him reassure you that he is not leaving you, but is just going on a business meeting. Perhaps you can make a compromise so that you will feel included and accepted. For instance, you can ask that he calls you from his meeting at a certain time to let him know he's thinking of you. After he leaves for the meeting, it is important to use positive self-talk on yourself and question all negative thoughts that come to mind. If you panic, and start telling yourself that you are all alone because you are ugly and unloved, just remind yourself that your boyfriend is at a meeting. He's most likely at this meeting so that he can earn money to help support your activities when he's with you. To top it all off, every moment he's away is a moment closer to his return.

If you still have a feeling that he's gone because he hates you, and he's going to abandon you, then remind yourself that it's ok if he did leave you! You're a human that's capable for caring for yourself! Use the time you have alone to learn how to become independent and care for yourself. Know that things are never hopeless, and even if things don't work out with the person you're with, things can work out with other people in the future.

What does a person with BDD think during a BDD attack?
When a person with BDD experiences a full-blown BDD attack, they think several things. Often, so many things, that their thoughts begin to contradict one another and they don't even know what they're thinking anymore! Usually, when I'm going through a BDD attack, I feel very alone, as if I'm in a bubble separated from society. I feel like I stand out like a sore thumb, yet nobody sees me. I feel as if everyone around me should get away, because they may become infected by me…the very essence of me…yet, I need them. I have to sacrifice my happiness, and keep them away from me, so that they will be free of this horrible being. I feel that the only reason anyone would be around me is to chalk it up on their resume as a good deed. I feel that the people that are around me deserve more, and shouldn't waste their precious life on a horrible, disgusting, deformed, nobody! I start thinking about how there are so many better people in the world that could make the most important people in my life much happier. I think how if only I'd been born slightly different in some way, that this pain inside…this rejection…would go away! I think that there MUST be something physically wrong with me if I've had to go through the situations I've lived through. I think that if I had just been slightly prettier, maybe my mom would have loved me. Maybe my boyfriend would be more proud of me. My sisters would have hung out with me. My dad would still be alive. I start thinking about all the times that I was rejected. I try to prove to myself that I'm unaccepted, and remember all events that provide evidence for this belief. I feel as if I can trust nobody, and often feel that suicide is the only way of handling this immense pain. I need help from outsiders, but cannot accept it. I feel as if nobody is truly there for me, like they are all traitors that will turn their back on me if I open up to them. To put it in a single word, once all the initial panic subsides, I feel alone.

How does it feel to have a BDD attack?
The worst feeling imaginable. Think of getting dumped, losing a job, learning that a friend just died, and having your house burglarized all in one day, and then finding out additionally that you are going to surely live to be 112 years old and this day will be relived over and over again like in the movie Groundhogs Day with Bill Murray. Well, multiply that by a few times, and perhaps that would be similar to the feeling of a severe BDD attack. The feelings that come to mind during a BDD attack are those of anger, hopelessness, despair. Now that I think of it, it's very similar to the feeling of having someone close to you dying, and knowing that you can't accept the fact that they are gone forever, but being told to live with it anyhow. Add to that the feeling of someone taking your rights away, but not being able to fight back. You just have to let someone beat you, demoralize you, tell you what to do, and you have to be a slave, and do what they say, and not protect yourself. If I were to describe a scene of how BDD would feel, it would be an actual situation that I've seen one time. Imagine looking into the window of a restaurant, full of lively, cheerful people, vibrant colors, bright lights, uplifting music, wonderful aromas, and plenty of interaction. People are having fun, telling stories, just relishing in the joy of being together. Now imagine a door that leads to an old, dusty back room that is dark with no lights on…perhaps only one last ray of sunshine peeks through the window and is falling on a corner of the room. Nothing is in there except an old wooden table, and the colors you see are only tones of brown and grey. You are sitting at that table, all alone. You can hear everything going on next to you. You can see people walking by the window in front of you. But you don't possess the key to get through the door and be part of the celebration. The main room of the restaurant is the world, full of people. The little side room represents the dungeon that people with BDD are eternally trapped in. The world, with all its joy and happiness and acceptance seems so close, yet so impossible to join without that missing key. We have come to believe that this key of acceptance is beauty (or a better voice, more talent, etc).

What is the most common outcome of a BDD attack?
Most BDD attacks last for a few minutes to several hours. Some can even last a few days, but usually, sleep will help the attack pass (although, don't expect it to be a good night's sleep!). During most attacks, the BDDer will separate themselves from all other people, and will either stand statically at one mirror, or will run from one reflective surface to the next, trying to see if their appearance will change. They might start looking in magazines or on TV, comparing themselves to others. They are in a state of complete panic. This panic will escalate, and most people with BDD will start thinking of suicidal thoughts at this time. The suicidal thoughts will usually persist throughout the day, increasing little by little, until they can convince themselves to calm down and get some sleep or let the attack pass on its own. Usually, after a night of sleeping, a BDDer will wake up, wondering if their face has changed over night. Sometimes, they'll be happy to see that their deformity from the day before was entirely imagined! At other times, they'll think they are still deformed, but not to the extent they were the day before. The most important thing for a BDDer to remember is that these attacks will eventually pass, even though it seems they will last forever while they are occurring! If you know someone with BDD, please be careful not to do or say hurtful things at these times, as the thoughts of suicide are not intended to bring attention to themselves! Trust me, they are serious. The pain is so intense, they would easily take their own lives. Most of them only opt to live because they fear they might make someone sad by killing themselves, and don't want to bring this pain upon anyone. The last person they are thinking about is themselves.