Body dysmorphic disorder (BDD) involves persistent preoccupation with perceived appearance flaws that others see as slight or do not notice, together with repetitive behaviors or mental acts and significant distress or impairment. It can affect people of any gender and often begins in adolescence.
Insight varies: some people recognize their appearance concerns may be exaggerated, while others feel certain that the perceived defect is real. Reassurance alone often does not resolve the distress.
If this sounds like you or someone around you, do not be quick to label yourself as crazy or self-obsessed. BDD is a real psychiatric issue, and treatment is available to recover from it. Keep reading to learn more about the disorder and how to deal with BDD in the best possible way.
Body Dysmorphic Disorder (BDD) refers to a psychological condition where an individual becomes preoccupied with their self-image, particularly with a minor or imagined defect in their physical appearance. As a part of this disorder, you may become obsessed with any part of the body like skin, hair, face, stomach, and chest.
BDD is closely related to obsessive-compulsive disorder (OCD) due to similarities in neurobiology, symptoms, treatment responses, and comorbidities.
BDD can affect social life, study and work. Shame and fear of being judged can make seeking help difficult, and depression or anxiety may also be present.
Some common symptoms of BDD include:
- Avoiding mirrors or constantly checking yourself in the mirror
- Constantly exercising
- Picking at your skin with tweezers or fingers
- Trying to conceal your “flawed” body part through makeup, scarf, or hat
- Constantly comparing yourself with others
- Not believing others when they say you look fine
- Always asking other people whether you look OK
- Social withdrawal or isolation
- Refusing to leave the house, especially during the daytime
- Going for unnecessary plastic surgeries
- Consulting with multiple doctors about your appearance
- Feeling depressed, ashamed, or anxious
- Suicidal thoughts
BDD can improve with appropriate treatment. Supportive measures can help coping but do not replace assessment and BDD-specific treatment.
Avoid Self-Isolation
Stay connected with trusted people. Discuss avoidance and reassurance-seeking with a therapist so that support does not unintentionally reinforce compulsive behaviors.
Seek Help from a Nutritionist
Balanced nutrition supports health, but particular foods do not prevent or treat BDD or eating disorders. Seek assessment for restriction, bingeing, purging or significant weight concerns; a qualified dietitian may help as part of a treatment team.
Exercise Regularly
Activity may support well-being, but compulsive exercise can be part of BDD or an eating disorder. Discuss exercise driven by appearance distress with a clinician before increasing it. A gym trainer alone cannot treat this problem.
Practice Meditation
Mindfulness or relaxation may help some people cope. They are optional supports, not a cure for BDD; discuss them with a therapist if they increase rumination or distress.
Maintain a Journal
Journaling is an excellent way to express emotions and thoughts without acting on them. It allows you to release the increasing stress level without indulging in risky behaviors.
Get Professional Help
Seek a clinician familiar with BDD. Effective care is often provided as an outpatient; residential rehabilitation is not automatically necessary.
Tell a GP or mental health clinician about appearance concerns, repetitive behaviors and their effect on daily life. Assessment can distinguish BDD from eating disorders and other conditions and guide suitable treatment.
Treatment depends on severity and preference. BDD-focused cognitive behavioral therapy (CBT), including exposure and response prevention (ERP), is recommended. An SSRI may be appropriate, with combined treatment often used for more severe impairment.
Psychotherapy
CBT addresses appearance beliefs, distress, avoidance and repetitive behaviors. It helps people practice different responses to concerns rather than simply replacing negative thoughts with positive ones.
ERP is part of CBT for BDD whether or not OCD is also present. With a therapist, people gradually approach agreed situations while reducing rituals such as checking, camouflage and reassurance-seeking.
Medication
SSRIs can reduce symptoms for some people. Their use does not establish that BDD is caused by a simple chemical imbalance. A prescriber should discuss benefits, side effects, monitoring and the time needed to assess response.
Medication and dose changes require a prescriber. Intensive or inpatient care may be needed for serious safety risks or severe impairment that cannot be managed as an outpatient.
To overcome body dysmorphia and get the most out of your treatment, follow the tips mentioned below:
- Do not skip any therapy session, even if you do not wish to engage in a conversation
- Learn as much as you can about your disorder and how it affects your daily life and health
- Take any prescribed medication as directed, and do not stop or alter the dose without consulting a doctor. You may develop withdrawal symptoms if you abruptly discontinue the medication or re-acquire the symptoms of BDD
- Avoid seeking solace in drugs or alcohol as they may interact with your medications
- Look out for common triggers and pay attention to warning signs so you can learn to overcome them with the help of your therapist.
BDD can be associated with self-harm or suicidal thoughts. Seek urgent help if these occur. If someone may act on suicidal thoughts or cannot stay safe, call local emergency services or go to an emergency department. In the UK call 999 or 112; Samaritans also provides emotional support on 116 123.
Treatment can help, although progress and support needs vary. A GP, qualified mental health professional or appropriate NHS service can arrange assessment. Choose a provider experienced in evidence-based BDD treatment.
