Body Dysmorphic Disorder (BDD) is when someone is preoccupied with a defect in their appearance. This defect is either minor or imagined and causes great distress to the person. BDD might be linked to or cause complications such as eating disorders, anxiety disorders, obsessive compulsive disorder, and low self-esteem. The issues of self esteem, the continual thoughts about one’s appearance, and the need to complete specific actions to decrease negative body image are a few examples how BDD relates to eating disorders.
The perceived flaws involved in BDD can occur in many forms. The most common are those involving the nose, and skin and hair of the face. People even go so far as to opt for cosmetic surgery to fix the so called flaw. However, most patients often remain dissatisfied or feel that the surgeon did a poor job, or simply turn their attention to another area of the body. People with BDD can obsess over more than one defect at a time and can also switch which areas of their body they find repulsive. Other common issues with the body include moles or freckles, acne, breast size, muscle size, and genitalia. Those with BDD cannot be convinced that the defect is actually nonexistent or slight.
Several common symptoms demonstrate Body Dysmorphic Disorder:
- Ritualistic behaviors such as spending long amounts of time grooming
- Checking mirrors frequently or avoiding them
- Repetitively questioning and seeking reassurance that the defect is actually fine
- Withdrawal from social situations
- Problems in interpersonal relationships
- Continually checking for defects through touching
- Believing that others are always scrutinizing your appearance negatively
- Attempting to hide perceived flaws by wearing excessive makeup or clothing
- Undergoing numerous cosmetic procedures but remaining unsatisfied
- Picking at skin
- Comparing the self to others
Among these symptoms, people can also spend multiple hours each day thinking and obsessing about the flaw. It interrupts their lives and can lead to poor work performance and decline in the quality or number of relationships. When people become so ashamed of their appearance, they avoid work altogether and remain at home. Those with BDD are more prone to depression and are at a greater risk of suicide.
The disorder often goes undiagnosed or is diagnosed incorrectly due to a couple main reasons. First, its causes are not entirely known. BDD might be linked to a variety of factors including genetics, brain chemicals, and the environment. Second, because of it parallels with other problems like OCD and eating disorders, it is more difficult to make completely accurate diagnoses. Physical exams, laboratory tests, and psychological evaluations all help to determine if BDD is present. However, people are often hesitant to openly discuss their issues of BDD with doctors because they feel ashamed. Once diagnosed, treatment for Body Dysmorphic Disorder can come in the form of different medications and psychotherapy.