More commonly, people try to cope with BDD by using alcohol or drugs. The intent is to decrease the preoccupation, dull the emotional pain, and lessen anxiety and self-consciousness in social situations. The percentage of people with BDD who’ve had a problem with alcohol or drugs is high: 20% of the people in my first BDD series, and 43% of the second series, had an alcohol problem (abuse or dependence) at some time in their life. Seventeen percent of the first series, and 34% of the second series, had a drug problem (abuse or dependence) at some point in their life. You may recall that the Minnesota study I previously mentioned found that 26% of people who were hospitalized on a psychiatric unit with a substance use disorder (drugs or alcohol) had BDD.
A very high percentage—70%—of people with BDD who have an alcohol or drug problem (abuse or dependence) say that BDD contributed to their drug or alcohol problem. In 26%, BDD is the main reason or a major reason for their drug or alcohol use. In 27%, it’s somewhat of a reason, and in 17% it’s a minor reason. Only 30% say that their drug or alcohol problem is unrelated to BDD.
BDD was the main cause of Adam’s alcohol and drug problem. He’d had a serious problem with alcohol and drugs for many years, and he’d been in and out of more than 30 detoxification and rehabilitation programs. “You might not believe this,” he said to me, “but my alcohol and drug abuse problems were totally and completely due to my appearance problem. A lot of counselors have told me that’s just an excuse, but I think they’re wrong. It was a crazy way I tried to block the pain of my obsessions, and it never worked. I tried to numb myself to my perception of my body, but it didn’t change. It actually made the pain over my appearance worries worse.”