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 is quite normal, they often don’t interfere with our 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 an imagined defect 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 your imagined defect in the mirror or window. You may even avoid social situations and work 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
BDD is not about vanity. It is a mental disorder and is often closely linked with other mental health disorders.
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 BDD might include:
- Repetitively seeking medical tests and reconstructive surgery
- 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.
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
“By the time I see these types of patients, 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 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 can help you work through cognitive distortion/negative thinking and change unhealthy behaviors.
- Medication, such as selective serotonin reuptake inhibitors, can help reduce obsessive thoughts 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 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.