Body dysmorphic disorder (BDD) is a mental disorder in which someone worries about a perceived physical defect or a minor flaw that others are not able to see. This condition results in people seeing themselves as “ugly”, so they avoid public exposure or undergo plastic surgery in order to improve their appearance.
A few characteristics of BDD are similar to those of eating disorders and obsessive-compulsive disorders. Body image is a concern with BDD, as with eating disorders. BDD is concerned about a specific part of the body, while an eating disorder is concerned about the weight and shape of the entire body.
People with obsessive-compulsive disorder (OCD) experience distressing recurring thoughts, fears, or images (obsessions) they may be unable to control. These thoughts produce anxiety (nervousness) which makes us feel obligated to perform certain rituals or routines (compulsions).
BDD is usually accompanied by self-indulgent behaviors, such as picking at the skin or constantly looking in a mirror. People with BDD eventually become so obsessed with their defect that they have a hard time functioning in their lives on a social, work and home level.
Men and women are equally affected by BDD, which is a chronic (long-term) disorder. It usually starts during the teenage years or in early adulthood.
BDD patients are often concerned with the following:
- Skin imperfections: Blemishes, scars and wrinkles are some examples.
- Hair: A person may lack hair or have hair on their head or body.
- Facial features: It can be related to the nose, but also any feature’s size or shape.
- Bodyweight: Weight or muscle tone may be the focus of those suffering from this disorder.
Additionally, penises, muscles, breasts, thighs and buttocks may need to be examined, as may odors.
What is the impact of body dysmorphic disorder (BDD) on people?
The following are some of the symptoms of body dysmorphic disorder:
- Self-describe as “ugly”
- Hours are spent pondering their perceived flaws
- Missing work or school because they do not want to be seen by others
- Keep family and friends at a distance
- Attempt to improve their appearance by getting plastic surgery (possibly multiple surgeries)
- Becoming emotionally distressed and engaging in harmful behavior
Are eating disorders and body dysmorphic disorder related?
Body dysmorphic disorder is not the only disorder that can affect people with this disorder. A person suffering from eating disorder, anxiety disorder, depression, or obsessive-compulsive disorder (OCD) may have any one of these disorders.
It is similar to eating disorders in some ways. An eating disorder and body dysmorphic disorder are both concerned with how they appear on the outside. People with eating disorders tend to focus on their weight and appearance. Anxiety about a particular body part is a sign of body dysmorphic disorder.
What are the symptoms of body dysmorphic disorder?
Body dysmorphic disorder symptoms are:
- Observing and picking at the skin, as well as trying to cover up or hide the perceived defective area repetitively and overtime
- Continually checking to make sure there is no visible defect
- Measure it or touch it repeatedly
- The inability to stop focusing on the perceived defect causes problems at work, school or in relationships
- Having a feeling of self-consciousness or feeling anxious when in public or around others
- Regular consultation with a medical specialist, such as a plastic surgeon or dermatologist, helps to improve their appearance
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What causes body dysmorphic disorder?
It is not known what causes BDD. There is a theory that the disorder involves an issue with the structure or function of some brain areas associated with processing body information. A biological basis for BDD is further evidenced by the fact that it is often associated with other mental illnesses, such as major depression and anxiety.
BDD can also be caused or triggered by:
- Childhood trauma or emotional conflict
- Low self-esteem
- Being criticized by parents or others for how you look
The societal pressures that are based on physical appearance also may have an impact on the development of BDD.
Both males and females are prone to body dysmorphic disorder, which usually begins in early adolescence.
Body dysmorphic disorder seems to be triggered or caused by certain factors, such as:
- Being a family member of someone with a body dysmorphic disorder or obsessive-compulsive disorder
- Children who were teased, neglected or abused as a child
- Perfectionism is one of these personality traits
- Beauty expectations or social pressures
- Anxiety or depression are other mental health conditions
How is BDD diagnosed?
It is often difficult to diagnose BDD because of its secrecy and shame. BDD is largely unrecognized by most experts.
In some cases, people with the disorder don’t want to share their concerns with their doctors because they are embarrassed. Consequently, the disorder may go undetected for years or never be diagnosed.
Doctors are often alerted when patients seek plastic surgery repeatedly to address the same or multiple perceived defects.
An honest history and an in-depth physical examination will likely be the first steps in diagnosing BDD. Psychiatrists and psychologists, who are specially trained to diagnose and treat mental illnesses, are often recommended to people with BDD by their doctors.
Psychiatrists and psychologists make diagnoses based on their observations of someone’s behavior and attitude.
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How to treat body dysmorphic disorder?
The following therapies are likely to be used for body dysmorphic disorder treatment:
- Psychotherapy: In cognitive therapy (cognitive therapy) and behavioral therapy (behavioral therapy), the individual focuses on changing the underlying beliefs and behaviors of the body dysmorphic disorder sufferer. This is achieved by correcting the false belief that the defect exists and minimizing compulsive behavior.
- Medication: There is good evidence that antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs) may improve body dysmorphic disorder, as are antipsychotic medicines such as olanzapine (Zyprexa), aripiprazole (Abilify), or pimozide (Orap) (either alone or in combination with an SSRI). The FDA has not approved any drug for the treatment of BDD.
- Group therapy and/or family therapy: Support from the family is crucial to the success of treatment. The signs and symptoms of body dysmorphic disorder should be recognized by family members.
SSRIs will not improve your BDD symptoms after 12 weeks of treatment if you have tried CBT and SSRIs. Another antidepressant called clomipramine may be prescribed instead.
The National OCD/BDD Service in London may refer you to a mental health clinic or hospital if you do not see any improvement in your symptoms.
Your BDD will probably be assessed in greater depth by these services.
The doctor may recommend more CBT or some other form of therapy, and he or she may also prescribe a different kind of antidepressant.
What are the complications of body dysmorphic disorder?
When someone with BDD becomes self-conscious in public, social isolation can become a problem. School and work can also be negatively affected by this.
BDD sufferers are at an increased risk for major depression, and the distress they experience puts them at risk for suicide. The disorder may also result in individuals undergoing many surgical procedures in an attempt to correct their perceived defect.
What is the outlook of BDD?
If a person with BDD receives treatment regularly and follows it, the outlook is positive. The long-term success of those who have strong support systems is also increased.
Is it possible to prevent body dysmorphic disorder?
BDD cannot be prevented. People might benefit from early treatment if they begin to exhibit symptoms. BDD can also be prevented or exacerbated by encouraging and teaching healthy attitudes about body image.
In addition, an environment that provides understanding and support might help reduce the symptoms and help the affected person better cope with the disorder.