Can shrooms and LSD be used to treat body dysmorophic disorder?

Dear Curious and Dysmorphic, 

Learning more about how to alleviate symptoms of body dysmorphic disorder is the first step to tackling it. Body dysmorphic disorder (also known as BDD) is an obsessive-compulsive disorder (OCD) in which a person is bombarded by intrusive worries about a perceived or highly exaggerated flaw in their appearance. Individuals with BDD are often preoccupied with thoughts about being defective or unattractive. They may imagine that they have a physical flaw, or they may worry excessively about a slight physical abnormality and feel shame and embarrassment. BDD may result from a combination of biochemical, genetic, and environmental factors. It’s also not uncommon for people with BDD to struggle with eating disorders, other types of OCD, self-harm, or thoughts of suicide. 

Both lysergic acid diethylamide (LSD) and magic mushrooms, are categorized as hallucinogenic drugs, also commonly known as psychedelics, making your connection between the two understandable. While there’s a growing body of research on how psychedelic drugs like LSD and mushrooms affect BDD and other mental illnesses, there's not enough out there to clearly determine a relationship. Since 2014, there’s been a growing interest in studying the effects of LSD and mushrooms on mental illnesses like addiction, depression, anxiety, and post-traumatic stress syndrome (PTSD). While hallucinogens were heavily stigmatized throughout the latter half of the 20th century, more people are now aware of their possible benefit in medical settings. The current standard for treating symptoms of BDD include being prescribed medications containing selective serotonin reuptake inhibitors (SSRIs) in combination with cognitive-behavioral therapy (CBT), although tricyclic antidepressants may also be prescribed. 

As psychedelics can activate serotonin receptors, it’s possible that they may be able to help people overcome obsessive thought patterns. Some research has demonstrated that psilocybin found in magic mushrooms improves cognitive flexibility, meaning that participants could shift more easily between tasks and mindsets. Psychedelics may also be able to create neural connections in the brain, allowing people to relay and integrate information in new ways. This means that, when coupled with psychotherapy, the substances could allow people to control the intrusive thoughts that drive their BDD symptoms. 

That being said, it’s not clear how permanent these changes are, as few studies have followed participants for long enough to observe any long-term changes or side effects. This is the case with many studies involving hallucinogens and BDD: while participants may report reduced symptoms and improved body image after taking the drugs, it’s unknown how long this relief lasts. 

Bad trips, as you’ve mentioned, are also a concern when using psychedelics. These experiences are often characterized by terrifying thoughts, feelings of despair, as well as a fear of losing control and death. The following short-term effects may occur after using psychedelics with or without experiencing a bad trip: 

• Extreme changes in behavior and mood; person may sit or recline in a trance-like state 
• Chills, irregular breathing, sweating, trembling hands 
• Changes in sense of light, hearing, touch, smell, and time 
• Nausea, especially in the first two hours 
• Increase in blood pressure, heart rate, and blood sugar 
• Fatigue the next day 

Curious and dysmorphic or not, it's worth mentioning that although psilocybin and LSD are found naturally in some types of mushrooms and are not typically addictive, they are still illegal in the United States. If you feel that BDD is affecting your life to the point where you’re considering using hallucinogens, you may consider discussing your concerns with a health care provider or mental health professional. They can help suggest treatment options for what you may be experiencing. 

Wishing you some relief,