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How Do I Help My Hypochondriac Sister-in-Law?

Question:

My sister in law is starving for attention. She has resorted to abusing drugs to make herself sick. She had always been super healthy, thin, and high energy. However, she was also a little homely,(sorry, but it goes with the story), and my brother loved her before and still does, regardless of what she looked like.

When their children grew older and needed her less,(she has always been a stay at home mom), she started getting cosmetic procedures. She has had three nose jobs, a tummy tuck, chin implants, eyelid surgery, cheek sculpting and more bottom than I can count. She has also had her teeth capped. So far, fine. If it makes her feel prettier and they can afford it, why not?

The problem is that she wouldn’t stop there. After she ran out of surgeries to have, she started literally traveling around the world to get doctors to give her drugs to make her more beautiful and youthful. She now has an injection pump attached to her delivering a cocktail of HGH, cortisol, and Synthroid. Synthroid for a 5’2″ woman who weighs less than 100 pounds! She claims this is for some mysterious illness that doesn’t even have a name yet, but I am sure it is because she is obsessed with her looks.

She will mope around for days or weeks, not cooking or taking care of the house, and wearing pjs 24 hours a day. When there’s an occasion where she will “appear in public” it’s like she is a completely different person. She gets dressed up in extremely expensive clothes, high spiked heels, lots of makeup, etc, and she’s full of energy running around kissing everyone, saying hello and being the center of attention.

I don’t think this is normal. I think she’s either depressed or delusional, but I don’t know how to tell my brother.

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Answer:

Homeliness is in the “eye of the beholder.” It is very subjective and can even be a projection of an individual’s self esteem rather than the other way around. In other words, what you are feeling or seeing as “homely” is really the sense of what she feels about herself. It’s common that an individual can be made to feel what another close person may feel. However, my guess is that your sister-in-law does have a problem. She may be dealing with something called “Body Dysmorphic Disorder,(BDD).” According to the Mayo Clinic:

BDD is a “type of mental illness in which you can’t stop thinking about a flaw with your appearance–a flaw that is either real or imagined.”

People with BDD intensely obsess over their appearance. An important aspect of this obsessing is that the individual seeks out multiple cosmetic surgeries in order to “fix” the self perceived flaws. One of the problems is that the person never feels satisfied and feels compelled to go on to the next surgery. The bottom line is that an addiction to surgery develops, much like other types of addiction.

You can learn more about this disorder by going to this URL at the Mayo Clinic:

http://www.mayoclinic.com/health/body-dysmorphic-disorder/DS00559

Your sister-in-law is an adult and, in my opinion, it makes sense for you to speak to her about this problem but include the fact that you feel worried about her and that she must be experiencing a lot of emotional pain to go through all of this surgery.. Don’t get your hopes up about any results. She may simply dismiss what you are saying. But, as the old saying goes, “Nothing ventured, nothing gained.” Just be careful to be gentle with her and her feelings. This is a very sensitive issue.

If she is willing to listen then she should know that help is available. Cognitive Behavioral Therapy along with with anti depressant medications are commonly used to help people with BDD.

Best of Luck

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