Modern Family’s Reid Ewing Shares His Struggle With Plastic Surgery Addiction

The actor spent hours dwelling on “flaws,” every single day. His social life was nonexistent.

“I’d sit alone in my apartment and take pictures of myself from every angle, analysing every feature,” The Modern Family actor writes in a column for The Huffington Post. “After a few years of doing this, one day I decided I had to get cosmetic surgery. ‘No one is allowed to be this ugly,’ I thought. ‘It’s unacceptable.’

In 2008 at age 19, he went under the knife for the first time for cheek implants, convinced he “would suddenly look like Brad Pitt.” Instead, he woke up screaming and crying from the pain. He had to wear a full facial mask for two weeks, spending most of that time locked away in a hotel room “doped up on hydrocodone.”

When he took off the mask and swelling receded, Ewing was shocked by the results. “The lower half of my cheeks were as hollow as a corpse’s…” he writes. He went back to his plastic surgeon, who refused to operate on him for six months, explaining that he would get used to his new facial structure.

In response, and unwilling to wait, he sought out another surgery for a chin implant at age 20. For the next two years, also while filming Modern Family, he would get several additional procedures with multiple doctors, along with cosmetic fillers and fat transfers – each one to fix an issue caused by the last.

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In 2012, “all the isolation, secrecy, depression, and self-hate became too much to bear,” he admits. “I vowed I would never get cosmetic surgery again even though I was still deeply insecure about my looks.”

It took months, but he finally got more comfortable with the gazes of others. He now realizes that his problems were never cosmetic. He has body dysmorphic disorder, coupled with a plastic surgery addiction.

“Of the four doctors who worked on me, not one had mental health screenings in place for their patients, except for asking if I had a history of depression, which I said I did, and that was that,” Ewing writes. “My history with eating disorders and the cases of obsessive compulsive disorder in my family never came up. None of the doctors suggested I consult a psychologist for what was clearly a psychological issue rather than a cosmetic one or warn me about the potential for addiction.”

Ewing points out that we rarely hear about cosmetic surgery in this particular light, from someone with his all-too-common perspective. “ Gambling with your looks, paired with all the pain meds doctors load you up on, make it a highly addictive experience,” he says. “It’s a problem that is rarely taken seriously because of the public shaming of those who have had work done.”

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According to counselor and psychologist Karla Ivankovich, PhD, an adjunct professor of psychology at the University of Illinois, Springfield, body dysmorphic disorder (BDD) is a condition “where the individual obsesses over flaws in appearance.”

Whether these flaws are minor and real, or simply perceived, Ivankovich says they tend to be accompanied by persistent and intrusive preoccupying thoughts with a typical onset in the late teenage years – just like Ewing. “These negative thoughts cause significant emotional distress and impact sufferers to the point that daily functioning is disrupted by managing their compulsions or the behaviors enacted to ‘minimise’ and hide their perceived imperfections,” she tells Yahoo Health.

Symptoms of BDD include preoccupation over specific facets of appearance, obsessive grooming to cover the perceived flaw, or extensively examining an area of the body deemed unattractive. Sometimes those who have the condition can experience short reprieves if they’re reassured about their appearance – but usually only for a time.

Ivankovich says that 2.4 per cent of adults suffer from BDD in the United States, with a roughly equal male-to-female ratio according to the DSM-V – but outside the country, those percentages fall to roughly 1.7 or 1.8 percent. She suggest that the inflated stats in the U.S. are due to the American culture of “rail thin beauty.”

BDD is also accompanied by a litany of other conditions, like major depressive disorder, eating disorders, OCD, substance abuse and social anxiety. “It all revolves around the perception that this flaw is so significant that it causes embarrassment, shame and humiliation,” Ivankovich says. “So someone with BDD will avoid social situations or do anything to cover it up.” Including plastic surgery, much like Ewing underwent.

Plastic surgery addiction often goes hand-in-hand with body dysmorphia. “About 7 to 8 percent of those who receive plastic surgery in the United States are diagnosed with BDD,” Ivankovich explains. “Outside of the U.S., most studies cite a prevalence rate of roughly 3 to 16 percent.”

Surgery rarely makes the BDD sufferer feel better about their appearance, though. “You are not ‘fixing’ a body part by way of surgery,” Ivankovich says. “Remember the criteria for the condition is that there is a slight imperfection or none at all as perceived by others – it is just what they fixate on. I liken this disorder to the hall of circus mirrors. Each way someone with BDD turns, they see a different perception – but all are out of touch with the reality of the situation.”

Ewing says he wishes he could have had more insight into his mental-health condition before going under the knife. “Plastic surgery is not always a bad thing. It often helps people who actually need it for serious cases,” he writes, “but it’s a horrible hobby, and it will eat away at you until you have lost all self-esteem and joy. I wish I could go back and undo all the surgeries.”

The actor urges anyone considering plastic surgery to think long and hard, and question the need. According to Ivankovich, if you are considering a procedure, a good doctor will administer a pre-surgical psychological screening, because those with BDD are rarely good candidates for surgery.

If you think you may have body dysmorphic disorder, see a psychologist or counselor. “The rates for suicidal notions and suicide attempts are high in this population, across the lifespan – from children to adolescents and adults,” Ivanovich explains. “Professional care is essential in addressing the underlying issues of anxiety and the obsessive-compulsions.”

Today, Ewing is one sufferer who seems to be in a better place, with a better perspective. “Now I can see that I was fine to begin with and didn’t need the surgeries after all,” he writes.

This article originally appeared on Yahoo Health