Body Dysmorphic Disorder (BDD), its Symptoms, and Why You Should Know About It

Whether you are male or female, and regardless of your age, you probably spend a significant portion of time in front of a mirror each day. Granted, some spend more time worrying about their appearance than others (namely teenagers, who are already going through hormonal and physical changes), but the fact of the matter is: we all do it. Appearance is a big part of our culture and Western civilization as a whole. The standard of “beauty” and “attractiveness” is constantly shoved in our faces with ads on TV, billboards, magazines, and newspapers. For males, a lean, tanned, and muscular figure is being portrayed as “ideal”. For females, an ever-shrinking, emaciated figure is depicted as “beautiful”.  These cultural ideals make it quite discouraging for those who are striving to attain them. Many of the male and female models we see in magazines are digitally-doctored with airbrushing and blemish-reducing techniques. And despite the fact that most of us are aware of this, we still compare ourselves to them and try to look like them. It is really no wonder that body image disturbances, bodily dissatisfaction, and a variety of eating disorders are on the rise. But what about the “silent sufferers” who struggle with body image concerns mentally, but do not meet the criteria of eating disorders like Anorexia Nervosa or Bulimia Nervosa? Are these people still sick? Do they still require treatment even though their illness is mental?

When people discuss mental illnesses like Schizophrenia, Bipolar Disorder, or Generalized Anxiety Disorder, it is typically understood what is being talked about. But what about the other psychological disorders that are perhaps not as easily recognized and understood? Body Dysmorphic Disorder (BDD) is not a very well-known diagnosis, yet it exceeds the prevalence rates of Schizophrenia, Bipolar Disorder Type I, and Generalized Anxiety Disorder (GAD) in the American adult population (Koran et al., 2008). Therefore, it is important to learn more about BDD and understand how it affects individuals who have it.

Body Dysmorphic Disorder (BDD) is sometimes referred to as “dysmorphophobia” or “imagined ugliness”. It is a chronic psychiatric condition that affects men and women equally, whereby a person cannot stop thinking about his/her appearance – particularly a flaw in his/her appearance, which is usually very minor or even imagined. The most common bodily “flaws” persons with BDD obsess over are skin imperfections, hair (either on the head or body hair), and facial features (such as the size and shape of the eyes, ears, or nose). Other common areas of focus for a person with BDD include the genitals, breast size (in females), legs/thighs, and muscle tone (particularly in males). To the sufferer, this “flaw” preoccupies their mind 24/7. They spend hours on end thinking and obsessing about it and how to alter their appearance in such a way that the flaw is no longer noticeable. Some even take drastic measures, such as having cosmetic procedures done. Others are so ashamed of their appearance that they become reclusive and stay indoors to avoid social contact with the outside world. As you can see, BDD adversely affects the quality of a person’s life.

BDD is a diagnosis that mental health professionals are seeing more and more of these days. While it is certainly normal to feel dissatisfied with your body and outward appearance from time to time, a constant obsession about your appearance is cause for concern. Your appearance should not cause you extreme anxiety and distress, and it should not occupy the majority of your daily thoughts. A diagnosis like BDD should not be taken lightly, as it can quite easily lead to more serious health problems such as suicidal ideation and a full-blown eating disorder.

Signs & Symptoms of Body Dysmorphic Disorder:

BDD is similar to Eating Disorders in that it involves body image disturbances and distortions. However, unlike Eating Disorders, persons with BDD are usually focused on one aspect of their body or appearance rather than their entire body. BDD is also quite similar to Obsessive-Compulsive Disorder (OCD), because it involves obsessive and intrusive thoughts about being “ugly”, and also involves compulsions such as ritualistic mirror-checking behavior. Other compulsive behavior a person with BDD might engage in include applying make-up constantly, skin-picking, excessive shaving or plucking, excessive exercising, and frequently asking others how they look. While these compulsions may provide short-term relief for a person with BDD, they actually only encourage and worsen the disorder, as they are short-lived.

The following are some signs and symptoms of BDD that can be applied to both males and females:

  • Being preoccupied with your appearance
  • Believing that you have some sort of physical flaw or abnormality in your appearance
  • Frequently asking others how you look for reassurance
  • Engaging in checking behavior such as checking your appearance in front of the mirror several times per day
  • Engaging in other compulsive behaviors such as skin picking, shaving/plucking, excessive grooming or excessive exercising with the belief that doing so will disguise your perceived flaws
  • Avoiding social interactions because of your perceived flaws
  • Having cosmetic procedures done to correct your perceived flaws and receiving little to no satisfaction from them


Complications of Body Dysmorphic Disorder:

As with all psychological disorders, there are complications associated with BDD. These can include (but are not limited to):

People with BDD may be afraid to seek treatment for their disorder, in fear that others will think they are just conceited or vain. Persons with this type of disorder already fear being judged by others, therefore telling someone about what they’re going through can be a very frightening thought for a person with BDD.

Treatment for Body Dysmorphic Disorder:

If you think that you can recover from BDD on your own, you are (unfortunately) mistaken. BDD is a very serious and chronic psychological disorder that can get much worse if left untreated. Therefore, BDD requires treatment from a professional counselor. If you are in the San Diego area and seeking counseling for Body Dysmorphic Disorder (BDD), please give my office a call today for a consultation.  The most common and most successful treatment option for BDD is Cognitive-Behavioral Therapy (CBT). CBT focuses on identifying and altering your problematic thought patterns and replacing them with more realistic ones. This type of therapy can be quite demanding, however, as it often includes “homework assignments” for you to complete in between therapy sessions. On the bright side, CBT has proven to be very successful in treating a wide array of psychological disorders, including BDD. In fact, it has been shown to be equally effective as medications such as anti-depressants. The notion behind CBT is that if we can change our thoughts, we can subsequently change our emotions/feelings and thus our behavior. During CBT sessions, you will also learn healthier coping mechanisms for the obsessions and compulsions that BDD gives you. With practice, you will eventually be able to employ these techniques on your own and finally live a life that is free of intrusive thoughts and ritualistic behaviors.

Overall, Body Dysmorphic Disorder (BDD) is a chronic, psychological disorder that is not very well-known by the general public. It is important that we all take the time to educate ourselves about this disorder, as its prevalence rates continue to rise and affect people of all ages, ethnicities and genders. BDD has the potential to be very dangerous if it is left untreated, and may manifest into a full-blown Eating Disorder. However, with treatment (such as CBT), it has been shown to drastically improve the quality of life for persons who have struggled with the debilitating effects of BDD. Please do not hesitate to contact my San Diego counseling office today at 858-481-0425 for a consultation!

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Copyright ©2012 Jan Rakoff. All Rights Reserved.

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