Model Tess Holliday is opening up about her mental health struggles.
“My body dysmorphia has been really trying me lately and when photos from previous years pop up while I’m scrolling through my phone, it causes me to spiral a bit,” Holliday, 36, began a recent Instagram post.
“Then I have to check myself & ask: ‘Why are you really sad?’ Because I like how I looked there — but I was also in the throws of my most disordered eating, in an abusive relationship, and so deeply unhappy,” she wrote. “Now, my body is different but my heart is fuller.”
Holliday included two photos of herself that were taken in an exercise studio.
"My happy place w @soraconnor, working out and trying to stay present in my body without self-doubt or self-judgment," she shared.
People with body dysmorphic disorder (BDD) are preoccupied with their physical appearance and focus on perceived flaws, according to Dr. Katharine Phillips, a professor of psychiatry at Weill Cornell Medicine in New York City.
“These preoccupations trigger repetitive behaviors or rituals — things like constantly checking mirrors,” Phillips told TODAY Health. “For example, you might spend an excessive amount of time applying and reapplying makeup, or picking at your face."
Phillips noted that the preoccupations cause clinically significant distress or inference in day-to-day functioning. On average, these behaviors consume 8 hours a day.
“Impairment can include poor concentration, missing work or not going to class because you think you look ugly and you don’t want people to see you,” she explained.
BDD currently affects 2 to 3% of the population, making it more common than anorexia nervosa or obsessive compulsive disorder (OCD), Phillips said.
“It’s easy to confuse BDD with vanity, it’s easy to dismiss it,” Phillips said. “But BDD is one of the more severe psychiatric conditions and associated with very high rates of suicidality.”
The disorder is typically treated with serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy, a mental health treatment that teaches skills and focuses on changing problematic thoughts and behaviors.
Experts including Phillips, the author of “Understanding Body Dysmorphic Disorder: An Essential Guide,” do not recommend cosmetic treatment.
“All the good research data that we have indicates that these procedures virtually never help and they cam make BDD worse,” Phillips said. “And that makes sense because people with BDD have a distorted view of how they look.”
Earlier this year, Holliday announced that she was receiving treatment for anorexia.
"Any type of eating disorder can affect any person at any size,” Chelsea Kronengold, associate director of communications at the National Eating Disorders Association (NEDA) previously told TODAY. “Many, many people struggle with atypical anorexia. It’s just as serious as anorexia.”
If you're struggling with an eating disorder and need help, information or resources, visit the NEDA website or call 1-800-931-2237.