What is Body Dysmorphic Disorder (BDD)?
Body Dysmorphic Disorder (BDD) is a mental illness relating to perceived body defects which are not visible to other people. This disorder causes sufferers to spend hours pondering on some body part or feature they think is less than perfect.
No matter how much reassurance individuals with this disorder are given that they look fine they don’t believe it. Their persistent negative thoughts can have a huge impact on their quality of life.
Body dysmorphic disorder (BDD) makes people introspective and they may hide from family or any social situations. Absenteeism from school or work is also common as they fear people will notice their shortcomings.
People with BDD see themselves in a different light to others. They feel that some part of their body is: disfigured in some way, out of proportion, too large or too small or not symmetrical.
The prevailing symptoms of this disorder are:
Constantly checking appearance in mirrors or avoiding them altogether is one of the traits displayed by people with this disorder. They want reassurance that their perceived defect has not worsened or will avoid looking at it altogether. Those that do look in the mirror can spend hours gazing at themselves causing anxiety and distress. (1)
Hiding behind a camouflage is common with body dysmorphic disorder.
The use of makeup, sunglasses, hats, wigs or hairstyles can disguise facial flaws or baldness. Clothing will also be adapted to cover up what may be thought to be a less than perfect body shape. Excessive use of tanning products is a sign of someone wanting to cover up fair skin. (2)
No matter what body part causes concern reassurance will be sought that it is not different from other peoples.
Comparing the size of their hips or shape of their nose to other peoples will be the norm. In some instances this can be counterproductive as people may see themselves as less and less attractive.
However, models in magazines are constantly viewed as being perfect in comparison with their appearance. Whilst it sounds unreasonable, it’s also unavoidable. (3)
We all like to look our best, making sure our face is washed and hair is brushed is perfectly normal. However, for the person with body dysmorphic disorder (BDD) grooming will often be excessive. They will want to see every hair is in place repeatedly and can also wash their faces often. (4)
It is normal for people at some point in their life to pick at their skin. In BDD this behaviour becomes obsessive and compulsive.
The urge to pick at what are thought to be flaws in the skin is overwhelming. This can cause harm, especially when people use sharp objects like needles, razors or knives to carry out this habit. (5)
Some people may see themselves as weak and puny when in fact they are normal or quite muscular. In order to achieve the body they ‘think’ they want, they will exercise to the extreme.
In the case of men, this can include bodybuilding and taking drastic measures like using anabolic steroids to promote muscles. Diet and exercise could literally take over their lives to the detriment of every other aspect. (6)
Examining the area visualised as defective with fingers and hands becomes a regular thing. People will also touch the rest of their body to make sure nothing has changed. (7)
There are parts of our body that we would all like to change, yet we learn to live what we have and accept it.
However, people with body dysmorphic disorder (BDD) are likely to seek out aesthetic surgery to correct what they see as flaws. Often they will not be satisfied with the results and a pattern of persistent cosmetic surgery will emerge. (8)
Seeking reassurance about our appearance from time to time is something we all do. In BDD this reassurance is often not believed and looked for over and over again. (9)
There are no specific stages for this condition. The symptoms of this common and sometimes severe condition are used to guide clinicians when diagnosing the disorder.
BDD generally begins in late teenage years but milder symptoms can be seen as young as 12 years.
Body dysmorphic disorder can affect both men and women. Their perceived “ugliness,” can make them feel ashamed of themselves. They have a fear of rejection because of their appearance and are likely to feel anxious in social settings.
They can lead solitary lives having few friends and avoiding close personal relationships. They also fear that people may see them as vain for worrying so much about how they look.
Furthermore, it can lead to the development of eating disorders or possible suicidal tendencies. (10)
There are three criteria which are displayed by people with this condition, these are: (11)
A preoccupation with what is imagined as a defect in the way they look. There may be a minor physical flaw of some sort but their view of it will be disproportionate.
The obsession with their appearance causes significant distress and anxiety. They may not be socially functional or able to hold down a job. It also has a severe impact on everyday life.
There is no other mental illness that can account for their behavior. For example anorexia nervosa is an indication of not being happy about body shape and size.
Body Dysmorphic Disorder (BDD) by Proxy
It is worth mentioning that this disorder can also manifest as preoccupation with a perceived physical flaw in another person. This will usually be a partner, a child or someone close, it can even be more than one person.
Someone with this disorder by proxy will display similar symptoms like comparing the person to others. They will spend hours obsessing over whether that person will be accepted by others. Likewise they may feel they won’t be accepted by association. (12)
There are two types of treatment available to help people cope with this disorder. They are:
Cognitive Behavioral Therapy (CBT)
One way of describing this disorder could be that you can’t see the fire for the smoke. You become so obsessed by your flaws that you can’t see them objectively. You become self focused on your impression of yourself and think everyone sees you that way.
This can lead to conflict about your appearance between you and those who are close to you. You become self-conscious and socializing is nigh on impossible.
CBT will aim to help you focus your attention away from yourself. The aspects of this therapy include your thoughts, memories and images of yourself (cognition). Then also the symptoms you display like checking mirrors, grooming and camouflage (behavior).
CBT helps you understand the problem and examine the root cause. The focus will be on helping you face your fears and retrain your habitual practices. They will also try to deal with your obsession and the distress it causes so you can get your life back. (13)
The medication of choice for this disorder are known as serotonin reuptake inhibitors or SSRIs. They are a type of antidepressant and are able to reduce obsessional and compulsive behavior.
These types of medication have little or no side effects and are not habit forming. (14)
What is body dysmorphic disorder (BDD)? Body Dysmorphic Disorder (BDD) is a mental illness relating to perceived body defects which are not visible to other people. People will spend hours thinking some body part or feature is less than perfect.
What are the signs of body dysmorphic disorder (BDD)? People with this disorder feel that a part of their body is: disfigured in some way, out of proportion, too large or too small or not symmetrical. They will spend hours obsessing over the way they think they look. They may try and disguise their perceived flaws and can seek to change them with cosmetic surgery.
How do you develop body dysmorphic disorder (BDD)? The causes of BDD are not clear and there are several factors which can contribute to its development. These include genetics, malfunctions in the brain and life experiences. Childhood traumas like bullying, abuse and peer pressure can play a part. (15)
How are you diagnosed for body dysmorphic disorder (BDD)? Diagnosis revolves around the symptoms you exhibit and how you feel about your appearance. Any other mental illnesses will be ruled out.
What is the best treatment for body dysmorphic disorder? Treatments for this condition consist of therapy and/or medication. Your health professional will discuss options with you to decide the best course of treatment.
What are the long term complications of body dysmorphic disorder? This condition can leave you feeling low or anxious, consequently other mental illnesses can coexist with it. (16)
Is body dysmorphic disorder (BDD) considered a disability? Whilst this disorder is a mental illness it is not classed as a disability.
Is there a cure for body dysmorphic disorder (BDD)? There is no cure for this condition but treatments can help manage and reduce the symptoms.
Is body dysmorphic disorder (BDD) life threatening? This disorder is not life threatening in itself but there is a high suicide rate associated with it. (17)
Body Dysmorphic Disorder (BDD) is a mental illness which leaves people obsessing about bodily features seen as less than perfect.
This condition can be severe and have a major impact on quality of life. It affects both sexes and can start in your early teens, although sometimes it can take years to become an issue.
Fortunately there are treatments available in the form of both therapy and medication which can help manage and control symptoms.