13. Defining Psychological Disorders

When Minor Body Imperfections Lead to Suicide

“I think we probably noticed in his early teens that he became very conscious about aspects of his appearance…he began to brood over it quite a lot,” said Maria, as she called in to the talk radio program to describe her son Robert.

Maria described how Robert had begun to worry about his weight. A friend had commented that he had a “fat” stomach, and Robert began to cut down on eating. Then he began to worry that he wasn’t growing enough and devised an elaborate series of stretching techniques to help him get taller.

Robert scrutinized his face and body in the mirror for hours, finding a variety of imagined defects. He believed that his nose was crooked, and he was particularly concerned about a lump that he saw on it: “A small lump,” said his mother. “I should say it wasn’t very significant, but it was significant to him.”

Robert insisted that all his misery stemmed from this lump on his nose, that everybody noticed it. In his sophomore year of high school, he had cosmetic surgery to remove it.

Around this time, Robert had his first panic attack and began to worry that everybody could notice him sweating and blushing in public. He asked his parents for a $10,000 loan, which he said was for overseas study. He used the money for a procedure designed to reduce sweating and blushing. Then, dissatisfied with the results, he had the procedure reversed.

Robert was diagnosed with body dysmorphic disorder. His mother told the radio host, “At the time we were really happy because we thought that finally we actually knew what we were trying to fight and to be quite honest, I must admit I thought well it sounds pretty trivial.…things seemed to go quite well and he got a new girlfriend and he was getting excellent marks in his clinical work in hospital and he promised us that he wasn’t going to have any more surgery.”

However, a lighthearted comment from a friend about a noticeable vein in his forehead prompted a relapse. Robert had surgery to tie off the vein. When that didn’t solve all his problems as he had hoped, he attempted to have the procedure reversed but learned that it would require complicated microsurgery. He then used injections on himself to try opening the vein again, but he could never completely reverse the first surgery.

Robert committed suicide shortly afterward, in 2001 (Mitchell, 2002).