Disorder Victims See Monster in the Mirror

Feb. 1, 2005 -- -- Erika Pikor and Francey Laudsaw are both obsessed with looking in the mirror. But their preoccupation with the looking glass has nothing to do with vanity.

"Something's pulling me toward the mirror, you know. I don't want to stand in front of a mirror for three hours, but that's what I found myself doing," said Pikor, 22, a longtime sufferer of body dysmorphic disorder, or BDD.

Pikor is one of the approximately 5 million people who suffer with BDD in the United States. She and Laudsaw both say the disorder has had a significant impact on their quality of life.

"It's kinda like you want to know how ugly you are," Laudsaw, 19, said on ABC News' "Good Morning America." "It's an overwhelming anxiety. You just feel so ugly and so disgusting."

Roberto Olivardia, a clinical psychologist at McLean Hospital in Belmont, Mass., and co-author of "The Adonis Complex," says people with BDD see themselves differently than the rest of the world does.

"People with BDD look perfectly fine. They look rather average or above average in their appearance, but they see something that you and I don't see," said Olivardia, who runs a group for people with BDD at McLean.

Olivardia says that when people exhibit exaggerated responses -- such as social avoidance and extreme camouflaging -- to tiny scars or minor hair loss, a diagnosis of BDD may be in order.

Pikor says her preoccupation with her appearance became so severe that she even thought of taking her own life.

"I had said to my doctor, I said, 'Well, if I just don't wake up, then they'll, I'll be fine.' "

Pikor finally turned to a dramatic treatment approach called exposure therapy. She was forced to confront her fears daily by going out into public places and letting people look at her. Pikor was also required to make eye contact and to ask strangers on the street for directions or the time.

ABC News' Medical Editor, Dr. Timothy Johnson, says BDD therapists believe that the brain will somehow acclimate to the experiences, and that the all-consuming anxiety will decrease or even disappear completely.

While Pikor's family says her exposure therapy has improved her life, Laudsaw is still overwhelmed by BDD. Since she can't afford therapy, she communicates with others like herself online.

While BDD was first described in the medical world more than 100 years ago, it wasn't widely discussed until the 1980s. However, Johnson says BDD is still widely unrecognized and misdiagnosed.

Johnson says it's important that family members of people who suffer with image issues look out for extreme responses that could indicate BDD.

"They should watch for a child that doesn't want to be with other kids, that doesn't do normal social things. I think that's the big tipoff, and at the other end of the spectrum, a child that is always in the bathroom looking in the mirror, those are clues, obviously, even at age 5, that something is wrong," Johnson said.

For more information on body dysmorphic disorder, go to www.mclean.harvard.edu

"Good Morning America" would like to thank the Connect With Kids network and their program "Mirror Mirror" for their help on this story. For more information go to www.connectwithkids.com