Body dysmorphic disorder (patient information)
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Editor-in-Chief: C. Michael Gibson, M.S.,M.D. [1] Phone:617-632-7753; Associate Editor-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
Overview
- Body dysmorphic disorder (BDD) is a mental illness. People who have this illness constantly worry about the way they look.
- BDD causes severe emotional distress. The preoccupation can be so extreme that the affected person has trouble functioning at work, school or in social situations. Any part of the body can be targeted.
What are the symptoms of Body dysmorphic disorder?
Symptoms can vary according to which body part (or parts) are targeted, but general symptoms of BDD include:
- Thinking about the perceived defect for hours every day
- Worrying about their failure to match the physical perfection of models and celebrities
- Distress about their preoccupation
- Constantly asking trusted loved ones for reassurance about their looks, but not believing the answer
- Constantly looking at their reflection or taking pains to avoid catching their reflection (for example, throwing away or covering up mirrors)
- Constant dieting and overexercising
- Grooming to excess (for example, shaving the same patch of skin over and over)
- Avoiding any situation they feel will call attention to their defect. In extreme cases, this can mean never leaving home
- Taking great pains to hide or camouflage the defect
- Squeezing or picking at skin blemishes for hours on end
- Wanting dermatological treatment or cosmetic surgery, even when professionals believe the treatment is unnecessary
- Repeat cosmetic surgery procedures, especially if the same body part is being improved with each procedure
- Depression and anxiety, including suicidal thoughts.
What causes Body dysmorphic disorder?
- About 1 - 2% of the population may have BDD, with men and women equally affected.
- BDD usually starts in the teenage years, when concern over physical appearance is common.
- The cause of BDD is unknown. Theories include:
- A person with BDD has a genetic tendency to develop this type of mental illness. The trigger may be the stress of adolescence.
- Particular drugs, such as ecstasy, may trigger onset in susceptible people.
- BDD could be caused by chemical imbalances in the brain.
- A person with low self-esteem who has impossible standards of perfection judges some part of their body as ugly. Over time, this behaviour becomes more and more compulsive.
- Western society’s narrow standards of beauty may trigger BDD in vulnerable people.
When to seek urgent medical care?
If you suspect you have BDD, see your doctor or a mental health professional.
Diagnosis
Diagnosis of BDD is difficult for many reasons, including:
- The person with BDD is more likely to seek help from dermatologists and cosmetic surgeons rather than psychologists and psychiatrists.
- The person with BDD is ashamed and doesn’t want to seek help from mental health professionals.
- This type of mental illness doesn’t get much publicity, so some health professionals may not even be aware that BDD exists.
- BDD is similar to many other conditions and misdiagnosis is possible.
Treatment options
There has been little research into the effectiveness of treatment for BDD. However, treatment that seems to help the most includes a combination of:
- Cognitive behaviour therapy (CBT) – training in how to change underlying attitudes in order to think and feel in different ways. This includes learning to tolerate the distress of ‘exposing’ their perceived defect to others.
Coping and management skills – training in how to cope with symptoms of anxiety.
- Medications including antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs). These drugs help reduce many BDD symptoms, including the compulsive thoughts, depression and anxiety.
- Generally, drugs are used in combination with psychotherapy.
- Some people with body dysmorphic disorder seek cosmetic surgery to ‘correct’ an actual or perceived physical flaw. Medical experts are divided on the ethics of what is sometimes called non-therapeutic mutilation or extreme body modification. Any medical or surgical procedure carries health risks. Unnecessary attempts to change one’s appearance through surgery may lead to dissatisfaction with the results and could worsen a person’s BBD.
Diseases with similar symptoms
- Agoraphobia
- Anorexia nervosa
- Hypochondriasis
- Obsessive compulsive disorder (OCD)
- Social phobia
- Trichotillomania
Where to find medical care for Body dysmorphic disorder?
Directions to Hospitals Treating Body dysmorphic disorder
Possible complications
Suicide rates among people with BDD are high.