“I couldn’t see any of the features I fixate on,” 她告诉CNN. “The mask is covering my nose and my jaw, 我当时就像, '哇. My hair is really nice today.”
Ordinarily, Darr said, a glimpse of her reflection sends her spiraling into dysmorphic thoughts.
但现在, for her and for others struggling with body dysmorphia, wearing masks is making everyday life more bearable.
It’s an extreme that can drive some to extremes
BDD is a psychiatric illness in which people are preoccupied with perceived physical flaws to the extent that it impacts daily functioning
— one BDD sufferer among the five to 10 million in the US
— those flaws relate to her chin and nose
“A jaw that cuts glass,” 她说, is what she wants. And she compulsively performs body checks to manipulate her face to this end.
“I’m taking my thumbs and I’m drawing them against my jaw to try and make it look different,” 她说.
Darr’s body checking — whether with her thumbs or in the mirror — is one compulsion among many. Others with body dysmorphia may pick their skin or seek cosmetic surgeries. In severe cases, sufferers might perform self surgeries and amputations.
博士. Eda Gorbis has worked with BDD patients since the 1990s and acts as director of the Westwood Institute for Anxiety Disorders, 公司
She said she has seen patients with over 100 plastic procedures in tow.
“It’s a very severe medical illness,” 她说. “The feedback from the eyes and into the brain is not properly processed. They do not see the forest for the trees, so they over-focus on the detail.”
Masks help sufferers camouflage themselves – to an extent
For people like Darr, with fixations on her face, masks can ease some of these compulsive symptoms.
“Masks make it easier. This entire year with mask-wearing has been great,” 她说. “It shields both other people from my mysterious ugliness, and myself.”
Gorbis has noticed that many of her patients are relieved by the widespread usage of masks.
She said the pandemic has supported a pre-existing tendency in BDD patients to isolate themselves and hide their features.
“Without the pandemic, they camouflage themselves,” Gorbis told CNN. “They don’t venture out. 所以, staying at home for them now is great, and wearing a mask is fantastic.”
但, Gorbis said, it’s not a long-term solution. Points of fixation for BDD patients are not actually fixed.
“It’s like hypochondriasis,” 她说. “With hypochondriasis, [the obsession] moves from organ to organ — ‘It’s my appendix, it’s my heart, it’s my stomach.’ With BDD, it’s the body part.”
But it’s one step toward self-acceptance for some
Eli, a 23-year-old trans man, asked not to be identified by his full name for privacy concerns.
He said he understands that masks are not the sole solution to his problems.
But suffering from both BDD and gender dysphoria
, he said that they help him
, 和别的, better affirm his gender identity
Now more than ever, people are correctly gendering him in public spaces.
“I went into a grocery store in a mask and baggy clothes, and someone tapped me on the shoulder and said ‘Excuse me, sir,'” 他告诉CNN. “I don’t even remember what they said. All I remember is that they called me ‘sir.'”
Unable to take testosterone, Eli said both gender dysphoria and BDD make him fixate on his face.
“I have very soft features and a very soft jaw line,” 他说. “When I wear a mask, it hides my jawline and I feel a lot more confident.”
He said that BDD adds another layer of difficulty when it comes to self-acceptance as a trans person, especially in regards to coming out.
“I fought myself over it for years,” 他说. “I’ve come out four different times over the course of my life, and then push myself back into the closet.”
Being properly gendered helps, 虽然 — and the way masks facilitate this makes them a “safety blanket,” 他说, while he works toward self-acceptance.
BDD, 然而, is notoriously hard to treat
A large piece of BDD treatment though
, Gorbis said
, is not camouflaging
— it’s 接触
To this end, Gorbis developed “crooked mirrors” to externalize and exaggerate patients’ distortions. In treatment, she has her patients face their worst fears — that they are ugly, and that yes, everyone notices.
“It is so they habituate to the idea that they can be ugly and still acceptable,” 她说. “Because the brain is going to keep giving them that feedback, that ‘You’re ugly.'”
Exposure can help BDD patients live with this feedback loop, 她说, while other patients find relief in cognitive behavioral therapy, medication or a combination of treatment methods.
仍然, 她说, many BDD sufferers never even find themselves in treatment
— a dangerous fact
, given the severity of the illness
一个 2007 研究 found that around
80% of people with BDD experience suicidal ideation at some point in their lifetime
. About one in four or more have attempted suicide
The majority of these people cite BDD symptoms as the primary reason for their suicidality.
Hurdles to recovery are lodged in the very nature of BDD as an illness that benefits from shame and secrecy.
But for those who do enter treatment, chances are good.
一个 2011 研究 showed that with enough time
, BDD patients frequently make full recoveries and rarely relapse
— signaling a horizon beyond the exhaustion for people like Darr
No one knows what a post-pandemic world holds
It’s anyone’s guess what happens when mask mandates expire.
Darr and Eli both said they would continue to wear masks if they believed they wouldn’t be judged post-pandemic — but Darr has a more permanent plan.
一天, 她说, she will use her savings for plastic surgery.
She’s aware of the experts that say plastic surgery will only transfer obsessions to another body part, or not be satisfying.
“I know those are possible factors,” 她说. “I just want them to know that it’s exhausting. It’s exhausting.”
然而, with some doctors’ offices temporarily closed due to the pandemic, cosmetic procedures may be harder to get — and Gorbis said that this may “defer the desire” for surgeries.
She said the only permanent fix to an illness so deft and disruptive is committed treatment.
除此以外, BDD sufferers are left with little relief — except, 目前, a pandemic-induced mask mandate.