Body dysmorphic disorder (BDD) is a mental health condition where a person experiences heightened anxiety about at least one perceived flaw in their physical appearance. This flaw may or may not be observable to others.
Preoccupations can focus on any part of the body, but the most common areas are the skin, hair, and nose. These concerns are unwanted. They are usually difficult to resist or control, and on average occur three to eight hours per day. BDD affects about 2% of adults.
There is no one cause of BDD. But research suggests that exposure to bullying, critique of appearance and experiences of rejection have an influence. High rates of abuse and neglect during childhood have been associated with BDD. Also, the disorder is more likely to occur in individuals with relatives who have obsessive-compulsive disorder.
Individuals with BDD perform at least one body-focused repetitive behavior (BFRB) or mental act in response to the preoccupation.
Examples of repetitive behaviors or mental acts are:
- Hair pulling
- Skin picking, scratching, or carving
- Excessive grooming
- Mirror checking
- Nail biting
- Cheek biting
- Reassurance seeking
Warning Signs
- Spending excessive time in front of the mirror or purposely avoiding mirrors
- Going out of the way to avoid contact with others, especially large social gatherings
- Expressing hatred or disgust with their general physical appearance or specific body parts
- Expressing a strong desire to get cosmetic surgery
- Spending more money than the average person on grooming or makeup products
- Being hesitant to go out during the day
- Attempting to hide parts of their bodies using makeup, clothes, hats, scarves, etc.
- Lateness or anxiety in the morning
- Seeking reassurance about their physical appearance
- Making comparisons to others
- Withdrawing from previously enjoyed and/or valued activities
- Expressing thoughts of suicide and/or hopelessness about their situation
Individuals with BDD often seek out cosmetic treatments to address their perceived flaws. These treatments can vary from cosmetic surgery to things like skin smoothing treatments, which can be very expensive and rarely improve BDD symptoms. Individuals often report an increase in concerns about their appearance following cosmetic treatment.
Medication and cognitive behavioral therapy (CBT) may effectively reduce symptoms of BDD.
- Medication: Successful treatment may include the use of selective serotonin reuptake inhibitors (SSRIs). SSRI's are antidepressants that also help reduce obsessive thoughts and compulsive behaviors.
- Cognitive-behavioral therapy (CBT): Cognitive-behavioral therapy targets BDD-related thoughts and behavior patterns to reduce repetitive behaviors. Individuals first learn how their thinking patterns contribute to their symptoms. Then they learn how to change their thoughts so that symptoms are less likely to occur.
Major depressive disorder (clinical depression) often coexists with body dysmorphic disorder. Other common co-occurring illnesses include social anxiety disorder, obsessive-compulsive disorder, and substance-related disorders.
Anxiety and Depression Association of America
www.adaa.org
Body Dysmorphic Disorder Foundation
www.bddfoundation.org
The International OCD Foundation
bdd.iocdf.org
Treatment Finder: https://iocdf.org/find-help/
