Body Dysmorphic Disorder

People with body dysmorphic disorder (BDD) are not simply self-conscious about how they look. They are concerned with an aspect of their appearance to the point of preoccupation, unable to imagine that their “flaw” is the result of a mental disorder. The results can be devastating, leading to disrupted lives, wasted hours each day, or even suicide. Frighteningly, BDD is also under-diagnosed. Read on to learn more about this common disorder, its symptoms and treatments.

Definition

Body dysmorphic disorder (BDD), also known as dysmorphophobia or dysmorphic syndrome, is a mental illness involving anxiety and an obsessive concern over an imagined or minor defect in one’s appearance.

Signs & Symptoms of Body Dysmorphic Disorder

The primary symptom of BDD is a preoccupation with a perceived imperfection so distressing that it interferes with normal life.[1] People with BDD will focus on the imperfection (which may in fact be slight or non-existent) for hours each day and insist they look horrible because of it.[2] As a result, they may feel unloveable and fear rejection by others.[2] They may avoid social situations because of the perceived flaw.[1] Some even drop out of school or leave work because of the disorder.[2]

BDD can result in repetitive or compulsive behaviors aimed at examining, hiding, or improving the supposed defect. Some of these signs of body dysmorphic disorder include:

  • excessive grooming
  • looking in mirrors frequently or not at all
  • skin touching or picking
  • hiding or distracting from the area (for example, with baggy clothes)
  • seeking reassurance from others about the supposed flaw
  • researching or seeking out cosmetic surgery — although this generally fails to “fix” the problem[1,2]

Causes of Body Dysmorphic Disorder

A combination of genetic and environmental factors are believed to contribute to the development of BDD.[1] BDD usually begins in early adolescence and often occurs alongside or results in other disorders including depression, social phobia, or obsessive compulsive disorder (OCD).[2]

Effects of Body Dysmorphic Disorder

BDD can have a terrible effect on an individual’s quality of life. People with BDD often lose hours each day preoccupied with their imagined flaw.[2] They may become housebound as a result of their concerns.[2] Even when they are able to leave the house, productivity at work or school is reduced and they may avoid recreational social interactions.[2] Individuals with BDD commonly seek out unnecessary cosmetic surgery or dermatological treatments, although these procedures rarely make them feel better.[2]

Treatment for Body Dysmorphic Disorder

Cognitive-behavioral therapy (CBT) and medication are commonly used to treat BDD.[1,2] Therapy focuses on challenging the patient’s incorrect beliefs about his or her appearance and creating new, true patterns of thought about the perceived defect. It also involves helping the patient reduce behaviors associated with BDD such as checking the mirror.[2] A therapist may also introduce exposure therapy in which the patient enters social situations while exposing the so-called defect. Serotonin reuptake inhibitors (SRIs) are the medication of choice for BDD.[2]

References

  1. Body Dysmorphic Disorder (BDD). Anxiety and Depression Association of America. Retrieved from: http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd
  2. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414653/

By C. J. Newton, MA, Counseling.info Editor

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