THE ALIEN WITHIN: A STORY OF DISCONNECTION

| June 3, 2024

Imagine Growing up with an intense desire to amputate your limb because you feel it doesn't belong to you. This is the daily struggle of individuals suffering from a condition called Body Integrity Identity Disorder (BIID), it is a rare condition in which persons typically report an intense desire either to be paralyzed or to have one or more of their healthy limbs amputated [1], although the condition is not included in the Diagnostic and Statistical Manual of Mental Disorders IV, It is classified as a 'Disorder of bodily distress or bodily experience' in the ICD 11 [2]. The disorder is characterized by a persistent and strong desire to become significantly physically disabled, such as a major limb amputee, paraplegic, or blind [1]. This desire usually develops during early adolescence and is accompanied by ongoing discomfort or intense feelings of inappropriateness towards one's current non-disabled body. 

Because it is a rare disorder, BIID is not commonly known to neurologists, psychiatrists, and surgeons due to limited research [3]. This issue is further compounded by the fact that individuals with BIID tend to avoid healthcare. Instead, they often resort to pretending they are disabled or carrying out self-amputation to fulfill their desires [1]. BIID is often associated with symptoms of stress, depression, mood disorders, and anxiety which makes it a serious health concern [4][5]. 

Several studies suggest that individuals who have Body Integrity Identity Disorder (BIID) typically develop the condition in early childhood [1]. They report a desire for body modification in order to feel complete or satisfied within themselves. While somatic and severe psychiatric co-morbidity is uncommon, individuals with BIID may experience depressive symptoms and mood disorders due to the distress caused by the disorder [5]. Surgery has shown to be helpful for those who undergo amputation, and these individuals tend to score lower on disability scales compared to those with BIID who do not undergo body modification [1].

BIID is an uncommon, rarely studied, and very private illness where a severe mismatch between an individual's mental and physical body image has a profound impact on their life. BIID can cause people to self-inflict mutations and cause them to have a strong desire to amputate a major limb or severe the spinal cord in order to become paralyzed. For those who are impacted, BIID desires are a necessary part of living and are not the outcome of severe physical or mental illness. It is necessary to conduct additional research to determine the cause of this condition. BIID is something that doctors should be aware of when they see a patient who desires unusual body modifications. It is imperative that this desire be discussed carefully. Currently, there is no other effective management strategy available except surgery.