Body Dysmorphic Disorder

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) causes people to believe that parts of their body look ugly. People with BDD spend hours focused on what they think is wrong with their looks. Many times a day, they do things to check, fix, cover up, or ask others about their looks. They focus on flaws that seem minor to others.

What Are the Signs & Symptoms of Body Dysmorphic Disorder?

People with BDD:

Focus to extreme on their looks. With BDD, people find it hard to stop thinking about the parts of their looks they dislike. They focus on specific things — like a pimple on their skin, or the shape or looks of their nose, eyes, lips, ears, or hands.

Feel upset about their looks. People with BDD feel worried, stressed, and anxious about their looks almost all the time.

Check or fix their looks. With BDD, a people feel the strong need to check their looks over and over. For example, they check their looks in a mirror, ask others how they look, or "fix" their looks many times a day.

Try not to be seen. Some people with BDD feel so bad about their looks they don't want to be seen. They may stay home, keep to themselves, or use makeup, hats, or clothes to cover up. Some people with BDD avoid looking in mirrors because it is so stressful.

Have a false image of their looks. People with BDD don't see their body as it really is, or as others see it. The flaws they focus on are things that others can hardly notice. They feel sure they look ugly, even though it's not true.

How Is Body Dysmorphic Disorder Diagnosed?

A trained mental health therapist who understands BDD can diagnose it. They ask questions and listen carefully to the answers to know if a person has BDD or another disorder.

How Is Body Dysmorphic Disorder Treated?

BDD can be treated with:

• Cognitive behavioral therapy (CBT). CBT is a type of talk therapy. It can help people with BDD learn that what they think affects how they feel. In CBT, people learn to notice their thoughts. They learn to challenge the thoughts that make them feel bad. They learn they can change the way they see their body. Slowly, and with lots of support, in CBT people learn to focus less on flaws. They learn to stop checking and fixing their looks.
• Medicine. Medicines that help serotonin work well are used to treat BDD. These are sometimes called SSRI medicines. SSRI medicines can help people obsess less about their looks and feel less distress. With less distress, they can make more progress in the CBT.

Most of the time, CBT therapy and medicine are used together to treat someone with BDD.

What Causes Body Dysmorphic Disorder?

There is still much to learn about the exact causes of BDD. But experts believe that these things play a role in causing BDD:

• Genes. BDD may be partly inherited. It tends to run in families.
• Serotonin. Serotonin is a normal and necessary chemical found in the brain. A poor supply of serotonin helps explain why BDD happens.
• Brain differences. Studies have shown that some areas of the brain look and work differently in people with BDD.

BDD is not caused by anything the person or their parent did. It is a mental health condition that needs treatment. BDD is not a person's fault.

What's It Like for Someone With Body Dysmorphic Disorder?

The thoughts and worries that are part of BDD take up a person's time and drain their energy. With BDD, a person never feels OK about how they look, no matter what others say. Because of BDD, they often miss out on being with friends, going to school or work, or doing normal activities. This can make them feel alone, sad, or depressed.

Some look for treatments or surgery they don't need, hoping to "fix" a flaw. But this doesn't relieve or improve BDD. It can be hard for the person to see that the problem with BDD is not the way they look. It's the false way BDD makes them see themselves.

What if I Have Body Dysmorphic Disorder?

If you think you might have BDD:

• Talk to a parent, therapist, doctor, or other adult you trust. Tell them what you're going through.
• Ask them to help you find a CBT therapist.
• Meet with a CBT therapist to find out if you have BDD.
• Keep all your appointments for therapy. It takes time and effort to change the way you see yourself.
• Be honest and open with your therapist. Let them know if you feel depressed.
• Let others give you support. It helps to know you're not alone.
• Be patient. It takes time and effort for CBT therapy and medicines to relieve BDD. Work hard in therapy and don't give up.

You also can visit online BDD sites for more information and support, such as:

• IOCDF
• BDD Foundation
• Online Body Dysmorphic Disorder Support Group