Social media intensifies body dysmorphic disorder; specialists call for looking after mental health

• Specialists warn that psychological treatment for body dysmorphia is key given the impact of social media on mental health.

Scrolling through social media looks like an everyday, harmless activity. For some people, however, constant exposure to edited photographs, filters and unrealistic beauty standards can become the trigger for an obsessive concern with their appearance. In these cases, seeking psychological treatment for body dysmorphia can be the first step towards recovering emotional wellbeing.

That constant exposure matters all the more in a country where social media is part of daily life. In the Dominican Republic, 68.3% of the population — around 7.89 million people — is present on these platforms, according to figures from the Centro de Análisis y Estudio de la Comunicación (CAESCO).

The Digital Audiences Observatory for Central America and the Dominican Republic also notes that 33.9% of users spend more than three hours a day on social media. In that context, understanding how prolonged exposure to content centred on physical appearance can affect mental health is increasingly important.

“Social media can feed some of the negative beliefs that people with body dysmorphic disorder develop about themselves. When those ideas start to interfere with daily life, it is important to seek professional help,” explains Ashwini Nadkarni, a psychiatrist at Mass General Brigham who sees patients at Brigham and Women’s Hospital.

What is body dysmorphic disorder?

Body dysmorphic disorder goes well beyond feeling unhappy about some physical feature. It is characterised by excessive concern with flaws that, in many cases, are minimal or do not even exist for anyone else. According to the International OCD Foundation, the condition currently affects between 1.7% and 2.9% of the general population.

People living with this disorder may spend between three and eight hours a day in front of the mirror, trying to hide a feature of their body, constantly checking their appearance or performing repetitive behaviours to ease their anxiety.

That preoccupation ends up affecting different areas of their lives. They often struggle at school, at work or in their personal relationships, and avoid social activities for fear of being judged.

How social media affects body image

Social media does not cause body dysmorphic disorder on its own, but it can intensify negative thoughts in those who are already more vulnerable.

Constant comparison with other people is one of the main factors. While most users compare aspects of their lives with what they see online, those with this disorder tend to read those differences as confirmation that their appearance falls short.

“Social comparison is a process by which we assess our appearance by measuring ourselves against other people. In those with body dysmorphic disorder, that comparison can reinforce a negative view of themselves,” explains Dr Nadkarni.

Added to that is the use of filters and editing tools that show idealised versions of the face and body. Over time, those images shift the perception of what counts as “normal” and can make real appearances seem less acceptable.

Negative comments on social media are also a risk. Even when they are not aimed directly at someone, messages that mock physical appearance can reinforce the fear of being judged and encourage symptoms of anxiety, depression and body dysmorphia.

How to look after your mental health around social media

Reducing the impact of social media does not mean giving it up altogether, but developing a more conscious relationship with the content you consume. Dr Nadkarni recommends:

•             Reviewing the accounts you follow from time to time and unfollowing those that stir insecurity or self-criticism.

•             Setting times for using social media and gradually cutting down on exposure.

•             Using the time away from the platforms for activities that support wellbeing, such as spending time with other people, taking up a hobby or exercising.

•             Questioning negative thoughts about your own appearance and replacing them with more realistic readings.

Psychological treatment for body dysmorphia

When concern about appearance begins to interfere with work, school, personal relationships or daily activities, it is advisable to seek psychological treatment.

The treatment with the strongest scientific backing combines cognitive behavioural therapy with medication known as selective serotonin reuptake inhibitors, which help regulate mood.

Therapy can also include gradual exposure exercises to help the person face the situations they avoid for fear of being judged, slowly reducing the anxiety tied to their body image.

“Many people hesitate to seek help, but evidence-based treatments are highly effective. A timely diagnosis allows us to step in before the disorder significantly affects quality of life,” says the psychiatrist from Mass General Brigham, an academic health system that treats patients from all over the world for complex conditions.

What is more, when symptoms persist or other related disorders are suspected, specialised care in mental health and eating disorders within a multidisciplinary team makes it possible to offer a comprehensive assessment and a treatment tailored to each patient.

The perfect image does not exist

Social media will remain part of everyday life, but learning to use it consciously can reduce its impact on self-esteem.

Recognising when concern about appearance stops being a common insecurity and becomes a mental health problem is essential to acting in time. Seeking psychological treatment for body dysmorphia not only helps reduce symptoms, it also allows people to regain confidence, build a better relationship with their own image and improve their quality of life.