What Is Body Dysmorphic Disorder?

Most of us can think of one thing about our appearance that we’d like to change, such as our hair, height, or nose shape. Someone with body dysmorphic disorder (BDD), however, obsesses about a flaw in their appearance (whether real or perceived) to the point where it negatively affects their day-to-day life. These thoughts may keep them from work, school, and social activities.

BDD often begins developing around age 12, and it affects about 2.5 percent of men and 2.2 percent of women in the United States.

Signs of BDD

In people with BDD, negative thoughts about one’s appearance can last for hours each day and be debilitating. Many people with BDD also have low self-esteem.

The following behaviors are common signs of BDD. These behaviors may also be compulsive:

Changing clothes
Picking at skin
Excessive exercise
Excessive grooming
Avoiding or seeking out mirrors
Comparing to others
Seeking reassurance about appearance
Believing others are mocking him or her
Hiding the flaw with makeup, clothing or body position
Seeking cosmetic surgery

If left untreated, BDD can increase a person’s risk of suicide. It may also lead to substance abuse, eating disorders and severe depression. Treatment can prevent physical and mental health complications.

Causes of BDD

The exact causes of BDD are unclear, but genetics and environment both play a role. Influencing factors could include family history, brain chemistry, and personality. BDD can also develop as a result of child abuse or neglect.

People who have BDD sometimes have another mental illness. They may have anxiety, depression and/or obsessive-compulsive disorder (OCD). Eating disorders and social anxiety are also common among people with BDD.

Treatment for BDD

People who have BDD may feel shame, which can prevent them from seeking medical help, but treatment is available. Cognitive behavioral therapy, exposure and response prevention, and antidepressants are common treatment methods.

Cognitive-behavioral therapy (CBT) helps people change negative thinking patterns. Family therapy is also important, especially for teens. Family members can identify the signs and triggers of the condition. A strong support team is essential to overcome BDD.

Another treatment is called exposure and response prevention. The therapist exposes the person with BDD to his or her triggers in a safe, controlled setting. For example, a patient might always wear makeup because she has obsessive thoughts about her skin. This therapy would involve gradually reducing cosmetic use.

Antidepressants can help control the obsessions of this condition. Anxiety medications are sometimes prescribed as well.

Other treatment and management tactics include:

Practicing self-care
Avoiding drugs and alcohol, which can make symptoms worse
Understanding and avoiding triggers of BDD
Talking with someone you trust about your symptoms
Joining a support group for those with BDD
Sticking to your treatment plan and therapy sessions.

Do you think you may have BDD? Are you worried about a loved one? Talk with your doctor. A trained mental health professional can diagnose this condition and help you find the best course of treatment.