"Young males face a unique and distinct set of circumstances that can pave the way for steroid misuse and abuse."

A guide for Teens in High School and young adults in College

COMPLETE GUIDE 2019: Muscle Dysmorphia and Steroid Abuse Prevention Among Young Males in High School and Universities

"Younger males experience a unique and distinct set of cultural circumstances and expectations that render them psychologically vulnerable to steroid abuse."

The scientific reason young males abuse illegal steroids - Muscle dysmorphia (MD)

Definition: Muscle dysmorphia (MD) is a type of body dysmorphic disorder (BDD). It is characterized in the American Psychological Association’s (APA) Diagnostic and Statistical Manual (DSM-V) by an obsessive and clinically diagnosable negative perception of one’s appearance, specifically a malignant preoccupation with building muscle mass.

MD was once labeled “reverse anorexia” in previous editions of the DSM, but was reclassified in 1993. It is still sometimes referred to as “bigorexia”. Muscle dysmorphia is similar to other types of body dysmorphic disorder in its manifestation through negative body image and the obsessive of some (in this case muscle size); however, symptoms are often more intense, and often include an even stronger avoidance of social activities and interaction.

Recent data from the body dysmorphia education and advocacy organization Mirror-Mirror indicates that approximately 10 percent of bodybuilders suffer from BDD, but that it also affects between one and three percent of males. One of the more malignant and dysfunctional means through which muscle dysmorphia sufferers is through the excessive use of steroids to build muscle. According to data from the National Institute on Drug Abuse (NIDA), steroid misuse is associated with muscle dysmorphia, a behavioral disorder in which men think that they look small and weak, even if they are large and muscular.

The reality is that younger males experience a unique and distinct set of cultural circumstances and expectations that render them psychologically vulnerable to these conditions. Understanding the relationship between these two conditions, their impact on health and quality of life and how to treat them is key to improving care outcomes.

Symptoms of Co-Occurring Muscle Dysmorphia and Steroid Abuse

One of the unfortunate realities of simultaneous MD and steroid abuse is that the latter often informs that former. It’s very often not until individuals present with symptoms of steroid abuse that their underlying body dysmorphia is finally discovered.

Some of the primary symptoms of both conditions include, but are not limited to:

  • Preoccupation with Body Image and Obsessive Pursuit of Muscle Mass
  • Intense and Persistent Fear of Weight Loss
  • Excessive and Dangerous Level of Physical Exercise
  • Neglecting Other Areas of Life in the Pursuit of Getting Bigger
  • Going on Weird and Strange Diets to Gain Muscle Mass
  • Excessive and Unhealthy Use of Dietary Supplements
  • Intense Fear of Body Exposure in Social Situations

Data from Touro University’s College of Pharmacy indicates a strong correlation between sexual abuse and the development of steroid addiction in young males.

Preventing Co-Occurring Steroid Abuse and MD in Younger Adult Males

While this dual-diagnosis disorder is experienced by both male and female sufferers, it overwhelmingly affects men over women. Data from Harvard University indicates that a majority of Americans who misuse anabolic steroids are male non-athlete weightlifters in their 20s or 30s. Issues of self-confidence, self-image and other types of traumatic experience are primary incubators for these conditions. Young males face a unique and distinct set of circumstances that can pave the way for steroid misuse and abuse. Expectations of masculinity which are often exemplified through exaggeratedly large muscle has created a culture of obsessive pursuit of getting bigger. Conventional paradigms that strength and physical vitality are displayed through incredibly large muscle mass are a common, and often destructive, system of thinking.

Diagnosing and Addressing Muscle Dysmorphia

It’s important to realize that muscle dysmorphia and all other types of body dysmorphic disorder go far beyond an exercise in vanity. If left unaddressed sufferers are rendered increasingly vulnerable to serious emotional and physical health issues, including but not limited to self-harm, suicide, severe overexertion of the body in order to meet unrealistic expectations of physical fitness, steroid abuse and more. A commonly cited study from Brown University indicates that as much as 80 percent of individuals living with muscle Dysmorphia and other types of body dysmorphic disorder experience suicidal ideations regularly throughout their lives.

In an effort to avoid muscle dysmorphia escalating to these urgent and critical heights, it’s critical that those at risk, as well as their loved ones, are diligent in identifying the signs and symptoms. Once muscle dysmorphia is diagnosed, patients should undergo customized and targeted behavioral care from an experienced, qualified mental health professional who specializes in body dysmorphic disorders.

While each muscle dysmorphia patient’s treatment regiments will vary, some of the more common modalities included in treatment include:

  • Nutritional Therapy
  • Cognitive Behavioral Therapy
  • Pharmacological Intervention
  • Fitness Therapy
  • Group Dynamics
  • One-on-One Counseling

The University of Virginia reports that effective treatment for body dysmorphia typically focuses on healthy eating habits, medication, the reinforcement of healthy self-image and various other core factors.

Some of the most common medications used to treat muscle dysmorphia and other types of body dysmorphic disorder include the SSRI class of antidepressant medications, including:

  • Citalopram (Celexa)
  • Escitalopram (Lexapro) 
  • Fluoxetine (Prozac)
  • Fluvoxamine (Luvox)
  • Fluvoxamine CR (Luvox CR)
  • Paroxetine (Paxil)
  • Paroxetine CR (Paxil CR)
  • Sertraline (Zoloft)

These medications, as well as all other types of prescriptions, should only be taken under the guidance of a prescribing physician.

What do steroids look like?

Steroids can come in tablet, capsule or liquid form, as well as gels, creams and patches.

Are Your Young Male Students Addicted to Steroids?

Modern fitness and “gym culture” has blurred the lines between controlled and excessive use of pharmacological aids to build muscle mass. Young American men who seek to quickly emulate athletes, bodybuilders and pop culture figures are especially vulnerable to this cycle of steroid misuse. The most common types of steroids young men take to build muscle mass are called anabolic steroids (testosterone, androstenedione, stanozolol, nandrolone, methandrosteolone).


Effective Treatment of Muscle Dysmorphia-Related Steroid Abuse

When muscle dysmorphia rises to the level of steroid abuse and addiction, it is officially what is classified as a dual-diagnosis or co-occurring disorder. Co-occurring disorders are characterized by the simultaneous existence of a substance use disorder and mental health issue (anxiety, depression, bipolar disorder, etc.). People start abusing when they suffer from muscle dysmorphia out of a pathologic preoccupation with muscle development.

Effective treatment of any type of co-occurring disorder must address the physiological dependency issues and inherent behavioral health origins that led to and sustained the substance, which includes:

  • Medically Supervised Detoxification and Withdrawal Management - Detox is the process by which substance use disorder sufferers are able to purge the toxins that have accumulated in their systems as a result of prolonged and untreated drug use. The process generally yields at least mild to moderate withdrawal symptoms, which, in the case of steroids, can include weakness, fatigue, decreased appetite, weight loss, nausea, vomiting, diarrhea, abdominal pain, severe bouts of aggression (“roid rage”), paranoia, and more. Steroid withdrawal can very often lead to violence. Steroid withdrawal symptoms can last anywhere from several days to two weeks.
  • Behavioral Rehabilitation (Rehab) – Behavioral rehab helps sufferers of co-occurring muscle dysmorphia and steroid abuse develop coping mechanisms minimize relapse while exploring the root causes and sustaining factors of the steroid abuse. This is critical to identifying toxic and negative thought patterns that can influence the onset muscle dysmorphia. There are multiple age and gender-specific treatment resources for young adult males suffering from co-occurring MD and steroid abuse.

After the initial treatment process, embedded lifestyle changes, such as ongoing behavioral therapy, nutritional counseling and, in some cases, pharmacological intervention, are necessary to maintaining progress in recovery from these conditions.

Long-Term Impact of Steroid Abuse

The National Institute on Drug Abuse reports multiple physical and psychological effects of steroid abuse, including but not limited to:

  • High Blood Pressure
  • Blood Clots
  • Heart Attacks
  • Stroke
  • Artery Damage
  • Decreased Sperm Production
  • Enlarged Breasts
  • Shrinking of the Testicles
  • Male-Pattern Baldness
  • esticular Cancer
  • Hepatitis
  • Liver
  • Peliosis Hepatis
  • Tumors
  • Musculoskeletal System
  • Short Stature (Specific to Adolescents)
  • Tendon Injury
  • Aggression
  • Mania
  • Delusions
  • Skin
  • Severe Acne and Cysts
  • Oily Scalp and Skin
  • Abscess at Injection Site
  • Jaundice

Get the Help You Need Today

If you or someone you care about has developed these conditions related to steroid misuse, it’s time to seek proper help immediately.

Muscle dysmorphia and steroid abuse can be life-threatening and easily derail long-term health and quality of life. There is a world of difference between a stringent fitness regimen and an obsessive preoccupation with gaining as much muscle as possible (and putting yourself through unthinkable physical and psychological rigors to make it happen). Don’t let negative self-image and unrealistic body expectation stop you from achieving peace of mind and lasting mental health. There are multiple resources to help you or your loved one overcome this co-occurring disorder for good so you can live the life you deserve.

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