I think I have had BDD all my life - there has always been something I have been worried about. I remember obsessively looking at my fringe thinking I was going bald for about a year - looking in shop mirrors - and also having an obsession about brown marks on my teeth for a whole summer. My obsessions moved around my body, including my legs and chest but they never took over my life - until four years ago I suddenly noticed I had facial hair which was quite long and got very upset. I was away travelling and would look in mirrors in different angles at regular intervals during the day and then when I returned from travelling I tried different treatments to remove the hair and was very conscious about sitting in certain lights and people noticing it. This carried on even though my Mum said she couldn't see it. The treatments only worked temporarily and I became convinced they were making the hair worse and worse and worse until one day I decided I wouldn't look any more and would only think positive thoughts about my facial hair whenever it came up in my mind.

Amazingly I managed to avoid looking at my facial hair for about two years and if I ever did see it I would look away. I felt like I was lying to myself but it meant I could get on with my life. This was fine and seemed to work until my Mum bought me a magnetising mirror and I noticed that the skin on my cheeks had got looser and more wrinkly and was very upset that one of the treatments might have 'damaged my skin'. I was convinced my skin looked wrinkly if I looked down and remember sitting in a meeting at work for two hours with my jumper pulled up around my face! I became more and more upset about it until I started looking for a treatment to fix it and found 'microdermabrasion'. This magic treatment promised to smooth out my skin and get rid of wrinkles and the first treatment did seem to make my skin look smoother. But each treatment after that seemed to make it worse and worse even though I followed the instructions on how often to do it and how to look after my skin. I became more and more worried that I had now damaged my skin more and this is when my BDD got really bad.

I visited a dermatologist who said my skin was fine and completely undamaged by the microdermabrasion and previous hair removal treatment but although I felt better for a few hours I found this very hard to believe considering how bad it looked. He even said my skin was quite good for my age and another dermatologist has since said the same - and that I should see a psychiatrist! But this reassurance didn't help at all after the first few hours and subsequent constant reassurance from family and my boyfriend did nothing to make me feel any better - as there was no way my skin looked OK to me and I thought they must all have low standards or just being nice or just not be looking close enough. The more I looked at my skin the worse it looked and I became transfixed and increasingly horrified by how bad it was and how it was getting worse and worse.

I started piling on expensive anti-aging creams and when I saw some new lines by my eyes I started to worry that the positions I was sleeping in was making it worse and tried lots of different pillows and positions - some very uncomfortable! I got worse and worse to the point I would look in the mirror over and over again sometimes for hours on end and not be able to go out because I was so self-conscious and panicked. During one period I was so upset by how awful I looked I would hide under a pillow and cry and cry constantly. It became difficult to see friends who had 'good skin' and I looked at numerous magazines to see if I could find anyone with skin like mine - sometimes I could but I would usually only feel better for a short time or think they must have bad skin like mine. Nothing could make me feel any better for more than a few minutes - it felt like being in a nightmare I couldn't wake up from where my skin looked worse an worse. Sleep was my best escape although I would often dream about it. My poor parents got the brunt of it as I would phone them regularly completely distraught and inconsolable. My BDD was getting worse as I had too much time to look in the mirror and was becoming more and more devastated and depressed by how bad I looked. When I did eventually go back to work part-time it was very stressful and I found it very very difficult to concentrate whilst being sat under a strip light - my work output was pretty low! This went on for quite a few months and every day has been a huge effort just to get up and go out of the house with people looking at me. Tubes have been a nightmare and plane toilets caused me massive upsets - as well as really any mirror at all. I have spent hours upset or worrying about or looking at my skin - to the point where it became what I thought about most of the time. I found it very difficult to think how I would live with looking so bad and it getting worse the older I got. Although I was in a relationship that in some ways made it harder as someone was looking at me close up and seeing how awful my skin was and deeply unattractive. I could go on about how much it has affected my life but it is the most traumatic thing I have ever been through and makes divorce seem like a walk in the park!

I started CBT at the end of last year and have had 5 sessions. It is the most difficult thing I have ever done as I am having to give up habits that seem impossible to resist. I have done better at some than others and sometimes I have to start all over again when I slip into my old habits. To reduce my preoccupation I have to:

- not look in the mirror except for functional checks and not close up - very hard to do
- not look at other people's skin
- not ask for reassurance
- not look in magazines
- not engage with the thoughts I have and accept them as true - live with uncertainty whether they are true or not
- refocus my attention on other activities

Some days are better than others. When I don't stick to what the CBT therapist asks me to do I get worse. Overall I am better able to concentrate on other things. The very difficult thing is when I catch a bad view of myself and think I have been lying to myself or pretending I am OK when I look horrendous and I get very upset and am back at square one. Then I have to get up and try and start all over again. It seems very difficult to imagine fully recovering but the CBT therapist who specialises in BDD has a very high recovery rate and I know it is one step forward and two steps back. But one day at a time I will get there.

Louise