What is Body Dysmorphic Disorder?



Body dysmorphic disorder (BDD) is an anxiety disorder related to body image.

You might be given a diagnosis of BDD if you:

  • Experience obsessive worries about one or more perceived flaws in your physical appearance, and the flaw cannot be seen by others or appears very slight

  • Develop compulsive behaviors and routines, such as excessive use of mirrors or picking your skin, to deal with the worries you have about the way you look.

If you have BDD, these attractions and behaviors cause emotional discomfort and have a significant impact on your ability to carry on with your day-to-day life.

BDD can vary in severity from person to person and from day-to-day. For some of us, matters around appearance may make it difficult to go out in public or see other people. This can have an impact on our work life and relationships with other people.


"It varies day-to-day. It can sit quietly or it can be completely debilitating."


BDD may also cause other problems, such as:

  • feelings of shame, guilt, or loneliness

  • isolating yourself to avoid situations that cause you anxiety or discomfort

  • misuse of alcohol/other drugs

  • eating disorders

  • self-harm

  • suicidal thoughts



Symptoms


People with BDD see themselves differently from how others see them. Although everyone's experience of BDD is unique, there are some common signs:

If you have BDD, you experience intrusive, negative thoughts about one specific area of your body, or several areas of your body, which you think are:

  • out of proportion

  • too big or too small

  • disfigured

  • lacking symmetry.

These thoughts cause you significant anxiety, and you will often spend several hours a day thinking about the area or areas of concern.

BDD can affect any area of the body, but common areas of anxiety include your skin, hair, nose, chin, lips, or genitals.


If you have BDD, at some point during the course of your obsessions you develop compulsive behaviors and routines to deal with the anxiety you feel about your appearance.

You may spend hours each day carrying out these behaviors to try to reduce your anxiety. The behaviors may briefly lessen your worries, or they may make you feel worse.

Common compulsive behaviors include:

  • obsessively checking your appearance in mirrors, or avoiding mirrors completely

  • using heavy make-up to try to hide the area you're concerned about

  • changing your posture or wearing heavy clothes to disguise your shape

  • seeking constant reassurance about your appearance

  • exercising excessively, often targeted at the area you're concerned about

  • frequent body checking with your fingers

  • picking your skin to make it smooth

  • excessive use of tanning products

  • frequent weighing

  • brushing or styling your hair obsessively

  • constantly comparing yourself with models in magazines or people in the street

  • seeking cosmetic surgery or having other types of medical treatment to change the area of concern



Causes

No one knows exactly what causes BDD. However, recent research suggests that there are a number of different risk factors that could mean you are more likely to experience BDD, such as:

  • abuse or bullying

  • low self-esteem

  • fear of being alone or isolated

  • perfectionism or competing with others

  • genetics

  • depression, anxiety, or OCD



Treatment

If you think you may have BDD, going to your GP is a great place to start. Your GP can administer an assessment and diagnosis, and help you obtain appropriate treatment. If you are diagnosed with BDD, your GP should offer you treatment options according to the National Institute of Health and Care Excellence (NICE) guidelines. What you are advised may depend on the severity of your symptoms, but ideally, you should be given CBT before you are designated any medication.

The NICE guidelines on the treatment of BDD recommend:

  • cognitive-behavioral therapy – with self-help materials such as books or computer programs, via telephone, or via a series of sessions with a therapist in a one-to-one or group setting

  • medication – either on its own or combined with CBT

  • specialist services for BDD, if other treatments do not work

Source: https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/about-bdd/

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