Teach Me

Do I Have Body Dysmorphia?

We all have insecurities about ourselves. Whether it’s wishing we were thinner or had a smaller nose, there is always something we feel like we could tweak or change about ourselves.

But let’s face it: No one is perfect.

While having insecurities about body image is quite normal, they often don’t interfere with our daily life or ability to live normally. For people who have body dysmorphic disorder (BDD), however, these flaws perpetuate in their minds. They can spend hours a day, worrying, thinking and criticizing themselves, disturbing their work, social life and normal daily functioning.

“Body dysmorphia (BDD) is a preoccupation with a perceived flaw or an excessive preoccupation with a small anomaly that causes significant distress or impairment,” said Gagandeep Singh, MD, a psychiatrist at Banner Behavioral Health Hospital. “For example, you might find yourself constantly checking and examining parts of your body or your perceived defects in the mirror or window. You may even avoid social situations, work or school because of it."

When should you be concerned you might have BDD?  Dr. Singh explains what you should know about this mental health disorder.

Signs and symptoms of BDD

BDD is not about vanity. It is a mental disorder that affects both men and women and is often closely linked with other mental health disorders, like obsessive compulsive disorder (OCD).

Usually you have a poor self-image – seeing yourself as deformed, hideous or ugly – while others see you as normal and even attractive. You can become obsessed with any body part.

In addition to spending an inordinate amount of time fixated on your appearance, other symptoms of body dysmorphic disorder might include:

  • Repetitively seeking medical tests and reconstructive surgery or cosmetic procedures
  • Avoiding mirrors and windows
  • Extreme behaviors such as excessive grooming and skin picking
  • Comparing your body parts to others
  • Socially isolating yourself from others because of your body part
  • Repeatedly asking others for their opinions about appearance

Prevalence and causes

“From the standpoint of epidemiology, we don’t know fully,” Dr. Singh said. “Likely there are some biological and environmental underpinnings as well as unconscious displacement or psychological factors.”

Bullying and teasing may also create or help lead to feelings of shame and fear.

How is body dysmorphic disorder diagnosed?

The good news is that BDD is diagnosable, treatable and can be improved and managed with proper attention, lifestyle changes and professional support. To be diagnosed with BDD, you must present with the following symptoms, according to the Diagnostic and Statistical Manual of Mental Disorders DSM-5.

  • Appearance preoccupation
  • Repetitive behaviors
  • Clinical significance
  • Differentiation from an eating disorder

How is body dysmorphic disorder treated?

“By the time I see these types of patients, people with BDD, they have been referred from another specialty, such as a primary care doctor or plastic surgery office,” Dr. Singh said. “My first concern is always making sure they are safe, that they haven’t given up hope and don’t have suicidal thoughts or want to hurt themselves. Then I’m looking at what is going on in association with it, such as depression, anxiety or substance abuse.”

Treatment of BDD usually involves a combination of treatments and may change over time. It could include the following:

  • Psychotherapy with a focus on cognitive behavioral therapy (CBT) can help you work through cognitive distortion/negative thinking and change unhealthy behaviors.
  • Medication, such as selective serotonin reuptake inhibitors (SSRIs), can help reduce obsessive thought patterns and behaviors.
  • Lifestyle changes, such as eating healthy, sticking with prescribed therapy and medicine, avoiding drugs and alcohol and exercising regularly, can help take care of yourself.

There is hope

If you or a family member are wrestling with BDD, there is hope. Reach out to your physician or a behavioral health specialist to find out how to get started on the road to recovery.

Visit bannerhealth.com to find a mental health professional who can help.

Other useful articles:

Behavioral Health Depression Anxiety