Body dysmorphic disorder (BDD) is a mental health disorder when someone has an obsession that an aspect of their body or appearance is severely flawed. They believe that it needs to be hidden or altered – and will take exceptional measures to hide or attempt to fix it.
These flaws they “see” are most often imagined and other people cannot usually see anything wrong. If there is actually any flaw, in the mind of someone with BDD it is drastically exaggerated.
Also sometimes called body dysmorphia or dysmorphophobia, BDD causes great distress to anyone suffering from it. They may spend days on end only stressing and thinking about the flaw or flaws they believe they have.
Their thoughts about it can be totally intrusive and stop them from living normal daily life. This clearly has a negative impact on them and can badly affect those around them as well.
Someone suffering from BDD is more likely to turn to excessive drinking and/or using drugs or a behavioral addiction in an attempt to change their negative feelings. They are more likely as well to suffer from stress, anxiety, or depression.
Who does BDD affect?
Physician Enrico Morselli reported in the 1880s a disorder in people that he called dysmorphophobia. He was using it to describe a condition he had observed in some people who felt they were ugly even when there was nothing about their appearance that was unattractive.
A hundred years later the American Psychiatric Association (APA) recognized the disorder in its Diagnostic and Statistical Manual of Mental Disorders (DSM). The term body dysmorphic disorder was first used in this book in 1987.
BDD is classified as an obsessive-compulsive disorder (OCD) that’s estimated to affect five million to 10 million people in the US. Usually, it starts during the teenage years and affects both males and females.
BDD subtype “muscle dysmorphia” – a preoccupation that one’s body is not muscular enough and too skinny – affects mostly males. Sometimes muscle dysmorphia is known as “megarexia”, “bigorexia” or “reverse anorexia”.
What are the signs of BDD?
Having BDD does not indicate that someone is vain. But it usually has a devastating effect on the person with BDD.
For instance, some have delusions that other people are subtly pointing out or noticing their flaws without saying anything directly. BDD’s severity can change, but when it is intense it can mean avoidance of work, college, and socializing.
Someone with BDD can focus on any aspect of themselves. Most commonly it is the face, hair, and/or skin.
BDD symptoms include:
- Repeatedly and obsessively checking appearance.
- Frequently comparing themselves (or a part of themselves) with other people.
- Continually seeking verbal reassurances.
- Constantly choosing and/or changing outfits or such as brushing hair, cleaning teeth and putting on make-up in an attempt to cover “flaws”.
- Looking in mirrors a lot. Or going to great lengths to completely avoid seeing their reflection.
- Picking at skin to “smooth” it. This can create lesions that make it worse.
- Poor focus and motivation due to not being able to stop compulsively thinking about attempting to fix the “flaw”.
- Self-harm and even suicidal thoughts.
As with most mental health disorders, BDD’s cause is complex and likely because of multiple factors, including psychological, social, and cultural aspects. It can be the result of trauma, toxic shame, or some form of a “failure of love”, frequently experienced in childhood.
Many people suffering from BDD seek dermatological treatment or cosmetic surgery. Most often these do not help to resolve their condition, certainly not in the long term.
Due to the person with BDD feeling flawed, it can be extremely difficult for people to seek help for BDD. But seeking help from an expert in this type of disorder is vital because symptoms probably will not go away on their own – and will most often get progressively worse.
However, with treatment, they can start to improve straightaway. Cognitive-behavioral therapy (CBT) has helped people with mild BDD.
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