Understanding Body Dysmorphic Disorder: Symptoms, Risks, and Treatment Options

By: Suzanne Feinstein, PhD

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Most of us have stood in front of the mirror, intensely focused on a specific issue that we’d like to change. However, for someone with body dysmorphic disorder (BDD), this scrutiny is a constant, daily reality. 

Individuals who suffer from BDD have a distorted self image, and spend an unnatural amount of time worrying about flaws in their appearance. Most of the time, the imperfections they see as major are unnoticeable to others. 

Research shows that BDD affects about one in every 100 people, including an equal proportion of men and women. In this article, we’re taking a closer look at this condition and sharing some of the most common symptoms, risk factors, and treatment options. 

What Is Body Dysmorphic Disorder?

Also called body dysmorphia, BDD is a mental health condition characterized by an inability to stop thinking about one or more perceived defects in one’s appearance. While these flaws might be overly obvious to the individual, they’re usually invisible or only minor to others. 

Often, people who suffer from BDD are so embarrassed or ashamed about their appearance that they avoid social situations altogether. Instead of engaging in healthy routines and daily activities, they turn their focus almost entirely inward. They may check the mirror repeatedly, seek verbal reassurance on their looks, and engage in laborious grooming efforts. 

In many cases, these tasks consume a large portion of their day. In addition to worrying about the physical defects they believe they have, individuals with BDD are also stricken by intense bouts of anxiety over the way their repetitive behaviors disrupt their lives and impact their ability to function. 

To enhance their appearance and build their confidence, they may apply copious amounts of cosmetics or topical products. Sometimes, they’ll even undergo surgical procedures to correct the issues they see. While these steps might temporarily alleviate their stress, the anxiety will almost always return, leaving the individual to search for yet another way to find relief. 

Symptoms of Body Dysmorphic Disorder

Are you concerned that you or someone you know may suffer from this condition? If so, it helps to know the key signs. Some of the most common symptoms of BDD include:

  • Worrying excessively about a specific part of your body (especially your face)
  • Strongly believing that you have a physical flaw that makes you unattractive or deformed
  • Constantly comparing your appearance to others 
  • Believing that others take special notice of your appearance or mock you about it behind your back
  • Looking at yourself in the mirror excessively or avoiding mirrors altogether
  • Engaging in behaviors intended to hide or fix the perceived flaw (e.g. grooming or skin picking)
  • Trying to hide flaws through clothing, styling, or cosmetics
  • Frequently seeking reassurance and positive affirmation about your appearance from others
  • Avoiding social situations where they fear others will judge your appearance 

Left untreated, the symptoms of BDD can affect every aspect of a person’s daily life. Their preoccupation with their appearance can lead to excessive, intrusive thoughts, as well as repetitive, time-consuming behaviors. This can impact their work, social interactions, and personal relationships. 

In most cases, people with BDD will excessively focus on one or more parts of their bodies. While this part may change over time, some of the most common features to scrutinize include:

  • Face (nose shape/size, complexion, acne, wrinkles, blemishes)
  • Skin and veins
  • Hair (appearance, color, texture, thinning, baldness)
  • Breast size
  • Muscle size/tone
  • Genitalia

Thought patterns in individuals affected with BDD can vary. Some people may recognize that their thought patterns are excessive or untrue, while others are completely convinced that their beliefs are valid. The more certain they feel that their negative body image aligns with reality, the more distress they’re likely to experience in their lives. 

Risk Factors for BDD

Typically, the symptoms of BDD begin to develop in the early teenage years. While anyone can develop this condition, certain risk factors can increase an individual’s likelihood of developing or triggering it. These include: 

  • Being related (by blood) to someone who also suffers from BDD or obsessive-compulsive disorder (OCD)
  • Having a perfectionist personality
  • Having a chemical imbalance in the brain
  • Going through a negative life experience in childhood (e.g. bullying, neglect, or abuse)
  • Feeling especially vulnerable to societal pressures and expectations 
  • Suffering from a co-occurring mental health condition, such as anxiety or depression 

There is no definite cause of BDD, though the above factors can put someone at a higher risk of it. In some cases, people with BDD may also suffer from OCD, generalized anxiety disorder, or an eating disorder. 

Treatment for BDD

A mental health professional can perform a psychological evaluation to determine if an individual is suffering from BDD. In addition to this evaluation, the diagnosis will also be based on the person’s history (personal, family, and social) as well as the signs and symptoms they’re exhibiting.

Upon diagnosis, treatment for BDD often includes a combination of cognitive behavioral therapy (CBT) and medication, including selective serotonin reuptake inhibitors (SSRIs).

Through CBT, people with BDD can understand how their negative thoughts and behaviors negatively impact their lives. They’ll also learn how to challenge their perception of their body image and engage in other, more affirming thought patterns. In time, they will discover healthy ways to manage their self-critiquing urges, gradually reducing the amount of time they spend checking the mirror, seeking reassurance, or avoiding others. 

Do You Suffer From a Distorted Self Image?

Sometimes, symptoms of body dysmorphic disorder are clear, both to the sufferer and those in their close circle. Other times, it can be harder to discern the signs. Someone might seem to be functioning normally but inwardly suffer from a distorted self image that impedes their daily life. 

If the symptoms of BDD reflect your inner struggle, you’re not alone, and there are treatments that can help you reclaim your quality of life. With the right approach, you can break free of the constant cycle of self-analysis, judgment, and fear. 

At Advanced Behavioral Health, we specialize in treating a range of mental health conditions, including body dysmorphia. To learn more about our services, contact us to schedule an appointment!

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