Many people spend time feeling unhappy with certain parts of their bodies. Preoccupation with appearance is sometimes made worse by certain industries like the fashion and make-up industries that play on these insecurities. To some extent, it is normal to care about one’s appearance. However, for some people, the preoccupation comes to dominate their lives and they develop body dysmorphic disorder (BDD or  body dysmorphia).

When happiness about one’s appearance becomes a primary desire — something that one spends most of their time doing — it can become a mental health issue. When someone experiences BDD, they have a flaw (usually perceived but sometimes real) that they obsessively focus on. Their focus may preoccupy so much of their time that it begins to negatively impact other parts of their life, like their job and friendships.

The field of psychiatry uses The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-V) to guide treatment.

  • Criteria to be diagnosed with BDD:

    According to the DSM-V, a person must meet the following criteria to be diagnosed with BDD:

    • They must be preoccupied with one or more perceived defects or flaws in physical appearance. Other people either cannot see this flaw or consider it slight or minor.
    • The individual has performed repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking or reassurance seeking) or mental acts (e.g., comparing his or her appearance with that of others) in response to the appearance concerns
    • The preoccupation causes clinically significant distress or impairment in social, occupational or other areas of functioning
    • In individuals whose symptoms meet diagnostic criteria for an eating disorder, the appearance preoccupation is not better explained by concerns with body fat or weight

BDD is a disorder of perception. It is also an obsessive-compulsive type disorder — it is not an eating disorder.

So what does a drug like meth do to this condition? Meth or methamphetamine is a powerful stimulant that can worsen the symptoms of BDD. Unfortunately, some of the effects of meth use are those that a person with BDD believes will help them: weight loss and appetite suppression.

Does Meth Use Cause BDD?

No, meth does not cause BDD, but it can make symptoms worse if a person already has it. Body dysmorphic disorder’s causes are mostly considered to be genetic, with some possible environmental causes.

  • Symptoms & effects of meth use can include the following:

    • Anxiety
    • Bursts of elevated mood and euphoria
    • Emotional swings
    • Hallucinations
    • High energy levels
    • Insomnia (trouble sleeping)
    • Irritability
    • Lethargy and introversion
    • Loss of appetite
    • Paranoia
    • Short attention span

At lower doses, meth will increase energy levels, decrease appetite, and improve attention span. These effects may seem appealing for a person with BDD. Meth may initially help the person with BDD focus on factors besides their condition, while also making them lose weight. They may feel skinnier and be less worried about their appearance.

Over time, a person begins to build a tolerance to the drug and will take more and more. With enough use, they may become dependent and experience symptoms of withdrawal without it.

Are BDD Symptoms Amplified by Methamphetamine Use?

Yes, methamphetamine use can amplify or worsen anxiety, paranoia and obsessive thinking, all common body dysmorphic disorder symptoms. Those who develop severe meth addictions may experience emotional swings, trouble sleeping and hallucinations (seeing or hearing things that are not there).

At higher doses, meth abuse will severely worsen the condition.

In addition to worsening symptoms of the primary condition of BDD, this person may now have a methamphetamine addiction. If they stop taking the drug, they will experience symptoms of withdrawal.

Other Effects & Symptoms of Meth Use

Symptoms of meth use can cause significant distress for people with BDD. A person with both BDD and a substance use disorder has a dual diagnosis. Dual diagnosis treatment is more complex than treatment for BDD or methamphetamine addiction alone. A clinician must be trained in managing the complexities of both conditions at the same time.

In addition, someone with co-occurring disorders is often in significant distress. The condition they were originally hoping to treat, BDD, is even worse, and now they are addicted to meth. Not only are the symptoms of their condition worse, but they experience methamphetamine withdrawal.

  • Common symptoms on meth withdrawal:

    • Anxiety
    • Hunger
    • Hypersomnia (oversleeping)
    • Intense drug cravings
    • Psychosis (uncomfortable and uncontrollable thoughts)
    • Severe depression
    • Weight gain

Some of the symptoms of withdrawal mimic the symptoms of BDD or will worsen them, namely hunger, weight gain and anxiety.

Finding Treatment for BDD & Substance Abuse

The cornerstone of body dysmorphic disorder treatment is cognitive-behavioral therapy (CBT). CBT is a therapy technique that helps a person retrain their thinking to have more realistic goals. For BDD, CBT helps a person recognize that their compulsive thinking is causing them more harm than good.

To treat the substance use disorder associated with methamphetamine, a person enters a treatment program that may be inpatient or outpatient, depending on the severity of the addiction. Inpatient treatment takes place in a live-in facility and is intended for more severe cases with multiple setback episodes. Outpatient treatment is a form of treatment where the person commutes from their home and they can still participate in work and school obligations.