I was 12 when I started wearing make-up, and downloaded Instagram.
From that day, my life changed for the worse.
Social media – and its scores of picture-perfect celebrities and influencers – made me feel as if I was different. That I didn’t fit in with my friends.
That I looked ugly and disfigured.
Everyone online had cute, button noses, full lips, and large eyes. I didn’t feel like I had that.
Caking on layers upon layers of make-up everyday helped me change that feeling of being ugly and different. It helped with the bad thoughts – but my obsession with it spiralled out of control.
And the more access I had to social media, and its endless advertising of make-up, the worse it became.
Looking back, the signs of body dysmorphic disorder (BDD) were there, but I was young and hadn’t even considered it.
I didn’t know BDD was a mental health condition that made you obsessively worry about your appearance, I thought it was just me who was disgusted at how I looked.
I thought I was just ugly.
At first, make-up was fun to use, and experiment with through tutorials online – but it soon became a chore. It became overwhelming as it took over two hours to do each day, but it felt essential.
Soon, I didn’t let anyone see me without make-up on – not even my parents. At home, I’d run to the bathroom with a towel over my head so no-one would see my face.
Aged 13, I began to draw contour lines on my nose with eyeliner and fake tan to try and change its appearance. I hated my nose, and thought it was too big – I wished it was smaller like I thought everyone else’s was.
I even bought into scams online, using pocket money to buy all sorts of fad ‘nose shaping’ creams. I thought there could be a miracle product to erase my ugliness, but nothing worked.
Wearing make-up felt like it was something I had to do to fit in. If anything, it did the exact opposite as it was so obvious I wore make-up, when all my friends didn’t. I was more of a target for bullies, which only made my self-esteem worse.
It embarrassed me as I soon became known as ‘the girl with s**t on her face’ at school – now, no one remembers me for being anything or anyone else, or even remembers me at all.
Content warning: descriptions of self-surgery
It soon became clear to my parents what I was doing when they caught a glimpse of my face, and when they encouraged me to wipe the make-up and tan off, I knew I needed to do something more permanent. More drastic. I wouldn’t let their worries stop me.
I began scratching lines into my nose with scissors, razors and tattoo needles I’d managed to buy easily – at very little cost, with no proof of ID needed – online.
Back then, I never really saw it as ‘self surgery’ – but I was desperate, and told myself it was what I needed to do to look normal.
While I did this, I frantically emailed plastic surgeons across the country, asking what their age limit was for a nose job – I was 15.
My attendance at school wavered, and I eventually stopped going altogether – losing touch with my friends. I couldn’t bear anyone looking at me, at my face. I was so ashamed of what I looked like and how people would tolerate my ugliness.
I refused to leave my room, and my parents – though they tried everything I could to make me better, and to get help – couldn’t get through to me.
At one point, my mum ended up sliding meals under the door in my room, with the lights turned off, so I could have dinner like my family were downstairs.
One night, I googled: ‘Why am I so ugly?’ and came across BDD, but I didn’t believe there could be a real reason why I felt so ugly, other than the fact that I was.
I couldn’t have been more wrong.
I was under the care of my local CAMHS – Child and Adolescent Mental Heath Service – by now for school refusal, but out of desperation my parents then went private. In August 2019, I was diagnosed officially with BDD – the so-called ‘bully in my head’.
I didn’t believe the diagnosis at first, but it turned out that the way I’d felt the way I did for so long was psychological, and down to my mental health – not my physical appearance.
Despite weekly CBT for BDD sessions I continued to get worse and in June 2020, I was referred to the OCD/BDD adolescent team at the South London Maudsley.
I had an assessment at the Maudsley NHS Trust in January 2021 to determine what kind of care and help I needed to get better.
My parents and I sat with a psychiatrist and two psychologists on a video call, and answered a lot of questions about me, my mental health and the impact it was having on my family. My recovery journey really started then.
Now, aged 18, I still have ongoing therapy and I’m on antidepressants that help manage bad thoughts and high anxiety. I also wear very little make-up, too – I’ve come so far.
I have a strict hygiene routine though, and shower twice a day to help me with negative thoughts. It’s my way of coping, and I’m seeking therapy for it.
On the outside, it may seem to people that I look well – but on the inside, it’s a different story.
The bad thoughts about my body are still there, but I can manage them. I know it’s an ongoing recovery – but one I can control, at my own pace.
My relationship with my parents has gone from strength to strength, too, and I don’t hide anything from them anymore. I even went to Alton Towers with my dad and brother for the first time, without covering my face with make-up and hiding my face.
As for social media, I have a love-hate (mostly hate) relationship with it.
I deleted Instagram for a year after advice from my therapist, but re-downloaded it. While it contributed to making me very sick in the first place, it has also help me make contact with old friends.
There’s lots of accounts and content that I know might be triggering for me, but ultimately I like using it as a way to stay in touch with them.
It’s sad the effect that social media has had on me, though – and I’m sure, many other teenage girls, or just people in general, have been influenced negatively by social media.
Now, I feel healthier, and look it, too – without self-sabotage getting in the way. I’m learning how to be OK with myself, and it’s something I’m extremely proud of.
A brand new Pears Maudsley Centre for Children and Young People is set to open; clinicians and academics from the King’s Maudsley Partnership will aim to speed up the diagnosis and treatment of disorders like Avella’s.
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