Body Dysmorphic Disorder: Information, Symptoms, Treatment and More

Body Dysmorphic Disorder (BDD), also known as Body Dysmorphia, is a mental health condition that is characterised by an individual having intense worries about supposed faults in their appearance.

While these faults aren’t noticeable to others, they cause extreme distress to the individual with BDD. Thoughts and worries regarding the fault can become intrusive, leading to significant anguish.

BDD is considered to be an Obsessive-Compulsive spectrum disorder. While BDD is a difficult condition to live with, treatment is available, which can lead to a better quality of life.

What are the symptoms of Body Dysmorphic Disorder?

The symptoms of BDD can range from person to person. As with similar conditions, they will typically have obsessions and compulsions.

Primarily, an individual with BDD will obsessively worry about a perceived fault in their physical appearance. It is normal for compulsive behaviours to develop – normally in reaction to the perceived fault, such as attempting to ‘normalise’ their appearance.

Signs and symptoms

• Will often worry extensively about a certain area of the body – such as face, skin, hair, thighs or stomach
• Spend significant time trying to correct the supposed flaw
• Intense distress due to perceived flaw
• Low mood
• Excessive rumination
• Repetitively checking appearance in mirror, or avoiding mirrors completely
• Comparing one’s appearance to that of others
• Avoiding certain situations to avoid anxiety over appearance
• Feelings of loneliness
• Symptoms of eating disorders
• Possible self-harm
• Suicidal ideation

In terms of the Obsessive-Compulsive spectrum, it is common for someone with BDD to obsess over their supposed flaw. They may have an urge to cover up their supposed flaw, or do something to change their appearance. This will lead to the action being done – the compulsion.

BDD is often associated with suicidal ideation – such is the distress that is caused by the perceived flaw. There is also a significant crossover between BDD and Eating Disorders, although they are separate conditions.

BDD affects both men and women. The condition can affect someone at any age in their life. BDD can interfere with multiple areas of life, especially socially. An individual may not wish to see others, due to fear of their appearance.

What are the causes of Body Dysmorphic Disorder?

It appears that there are many risk factors for Body Dysmorphic Disorder. It is highly likely that a range of factors contribute to the onset of the condition.

The condition normally first appears in childhood or when a person goes through puberty [1]. With their body changing significantly at this point, appearance can be scrutinised.

Personality traits like low self-esteem, perfectionism, or a lack of confidence can make someone more vulnerable to developing BDD.

Research has also found that past or childhood trauma also appears to be a potential cause or aggravating factor [2]. This could be maltreatment from a caregiver, emotional abuse, being the victim of bullying, or any other traumatic experience.

Other research suggests that there may be a genetic component to BDD. For example, one twin study found a heritability rate of 43% [3]. Having a family member who has had BDD, or a different mental health condition, makes someone more vulnerable to developing BDD.

Rates of BDD are believed to have skyrocketed in recent years, which has been associated with the rise of social media. Social media can present a false image of what a person looks like – leading to many people comparing themselves to others in a negative way.

The use of social media has certainly led to more cases of BDD. Research shows that excessive social media use is associated with a higher level of body dissatisfaction [4].

BDD can also appear alongside other mental health conditions like eating disorders, anxiety, or depression.

As seen above, many people are vulnerable to developing the condition – with a range of potential causes. In some cases, BDD may appear without a clear cause.

Diagnosis of Body Dysmorphic Disorder

It is important to see a Doctor or mental health professional if someone believes they are suffering from Body Dysmorphic Disorder. Those experiencing suicidal thoughts are especially implored to seek treatment.

At an appointment, a Doctor will aim to gain a thorough understanding of the symptoms that the patient has.

They will ask a range of questions, normally based around how the symptoms affect the life of an individual – along with questions any possible thoughts of suicide or self-harm.

In terms of the actual symptoms, for BDD to be diagnosed, a patient will generally need to meet the following criteria:  

• The individual obsesses over at least one non-existent (or slight) flaw(s) in their physical appearance.
• The individual will be preoccupied with this flaw, and spend a lot of time thinking about it.
• This obsession causes distress in multiple areas of life, and typically stops the individual from doing everything they hope to.
• The condition isn’t better explained by an eating disorder – especially in cases that involve excessive or minimal weight. The criteria for an eating disorder is given precedence over BDD.
• An alternative mental health condition hasn’t caused the symptoms.

Muscle Dysmorphia is a sub-type of BDD, and can be diagnosed too using the above criteria. This refers to when an individual is preoccupied with thoughts that their body is build is either too small or insufficiently muscular. This particular form of BDD is heavily linked to substance abuse.

BDD is unfortunately often misdiagnosed, either as Depression, Obsessive-Compulsive Disorder, Social Anxiety Disorder or Social Phobia.

How is Body Dysmorphic Disorder treated?

BDD is a serious condition which can cause significant distress. There is heightened risk of suicidal ideation, as well as self-harm – underlining the risks involved.

Fortunately, treatment is available, and in many cases, will result in a much better quality of life – underpinned by fewer intrusive thoughts, or hopefully a total abolition of them. Treatment will normally involve:

Talking Therapy

Talking therapy is the most important part of treating Obsessive-Compulsive Disorders. A therapy like Cognitive-Behavioural Therapy is especially useful – due to its focus on the effect of thoughts. This is a key area in Obsessive-Compulsive spectrum disorders.

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

There are a range of other types of talking therapies available if needed. Therapy can provide a range of benefits. We have more information on our Therapy section.

Medication

For more moderate or severe cases of BDD, an individual may be prescribed medication. Antidepressants can help lessen harmful thoughts and help improve mood.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Summary

Seeking help for Body Dysmorphic Disorder is very important, it is a very challenging condition to live with.

Treatment is available and can help to improve the life of someone with the disorder. For further information, take a look around our website.

See Also

• Obsessive-Compulsive Spectrum Section
• What is the Prognosis for Obsessive-Compulsive Spectrum Disorders?
• Therapy Homepage
• Medicine Homepage