Hello,
Welcome to Healthcare Magic and thanks for your query.

I do understand that you are going through a terrible time with this problem. I know how difficult it can be to live with these thoughts and how much of social, occupational and day-to-day dysfunction this can cause, because I have seen patients with the same problem suffer. And believe me, with appropriate treatment they have been able to overcome this problem. So, please be assured that I am taking your symptoms very seriously and will surely guide you in the right way.

Now, first of all, you are in a state of extreme mental stress, so much so that you are having suicidal thougts. So, the first step is to seek help for this. Only if you are stable and stay positive, you will be able to undergo proper treatment and improve.

Secondly, the symptoms which you are having are indicative of a delusional disorder, more specifically called an Olfactory Reference Syndrome. This condition is caused due to certain neurochemical inbalances in the brain. Now, please don't misunderstand that i am implying that your symptoms are not real or imaginary. Rather, what I'm saying is that your symptoms are indeed very genuine and serious, but the underlying cause is not a skin problem or a bodily dysfunction, but due to these chemical disturbances in your brain.

There are effective medication available which will set right these neurochemical imbalances, but you have to continue them for a long period. In addition, you will also need counselling / psychotherapy to handle your stress and depressive symptoms also.

So, I would strongly advise you to consult a psychiatist urgently, for a detailed evaluation and further management. Also, please keep talking to someome close to you, so that you can offload your emotional burden and feel more supported.

Wish you all the best...

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Hello again and thanks for writing in.

Well, in this disorder, the problem is not just a simple paranoia or guilt that other people may find you smelling bad. The pathological roots are much deeper, where the person actually "percieves" that he / she is indeed smelling bad and many people do report strongly that they can actually smell the bad odour emanating from their body. That is why I had mentioned that you should not misunderstand that I am simply implying that you are just 'paranoid' or 'over-reacting' or 'unecessarily feeling guilty'. No... this problem is more complex than that. Normally, the nose picks up raw sensations of smell which are then interpreted by the brain as a particular smell. So, if there is a disturbance in your brain causing it to misinterpret the smell sensations as 'foul', then you are indeed going to be smelling a foul odour. So, your symptoms are real, you find yourself smelling bad and have often actually smelt the foul body odour. But this is because your brain's perception itself is faulty or altered, due to the chemical imbalances in the brain and this altered perception is what is causing you to have this firm, unshakeable belief that you are smelling bad. So, please remember, it's not your fault and you are not simply 'imagining it' or 'over-reacting'

I would advise you to first have a detailed evaluation by a psychiatrist. This evaluation would also include a physical examination and a medical screening to rule out any possible medical conditions. So, please don't worry that just because you go to a psychiatrist, you will be labelled as a "psychiatric patient" and none of your symptoms would be taken seriously. More importantly, since this problem is causing you extreme distress and depression and because you have become socially withdrawn and have suicidal thoughts also, it is essential that you seek a psychiatric consultation at the earliest. Please take the help of someone close, who can support you and guide you through these tough times.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist

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