Body Dysmorphia (BDD)
What is Body Dysmorphia?
Body Dysmorphia – or Body Dysmorphic Disorder (BDD) – is an anxiety disorder that is specific to the individuals body image. It is a mental health condition where a person spends an excessive of time concentrating and worrying about flaws that they see when they look at themselves, in particular in their appearance. These flaws that they see in their appearance are often not noticed by anyone else but themselves. If a flaw is noticeable then it usually is a normal flaw, for example hair loss, however the individual will see it as prominent and will focus heavily on this.
BDD is not age or gender specific, however it is most common in teenagers and young adults. It can often can start affecting a person when they are around the age of 12 or 13, where they will start developing mild symptoms of BDD, with nearly two thirds of BDD sufferers experiencing the beginning of the disorder before they turn 18 years of age.
Statistically, BDD affects around 40% of males and 60% of females, with males becoming obsessive over hair loss, body build and their genitals. Females that suffer from BDD will become obsessive over the way their body looks, such as breast size, bum size and their stomach. To try to overcome these flaws, females are more likely to check their appearance in mirrors excessively, and change their clothes frequently; whereas males may focus on weight lifting to excessive amounts.
- Checking mirrors constantly or avoiding mirrors
- Trying to hide the ‘flawed’ area with heavy make-up
- Wearing clothes that disguise body shape
- Constantly seeking reassurance about appearance
- Obsessive exercise to target ‘flawed’/specific areas (e.g. excessive weight lifting in men who suffer from muscle dysmorphia)
- Weighing themselves constantly
- Comparing themselves to models/celebrities/other people
- Seeking to have cosmetic/medical treatment
- Social anxiety/avoidance – this can be caused by the individual becoming fearful of being rejected or ridiculed because of the flaws that they see. This can be misdiagnosed as social anxiety disorder
An individual suffering from BDD may start to show compulsive behaviour, demonstrating repetitive actions to fix the ‘problem’, hide it and find reassurance from peers about the body part that they see as flawed.
This type of repetitive compulsive behaviour can become very time consuming for the individual, taking up to 3 – 8 hours a day. Even when they gain the reassurance that they are seeking it can be short lived for that person. This causes friction within their everyday lives, as well as in relationships.
What causes body dysmorphia?
The cause of BDD is not exactly known, however there are certain things it can be associated with.
- Genetics – if a family member is known to suffer from BDD, OCD or depression, it can be linked to developing BDD
- Chemical imbalance in the brain
- Past traumatic experience – if an individual has suffered from bullying, or abuse as a child, they may be more likely to develop BDD later in life.
- Other mental health conditions – some people who suffer from BDD may also suffer from OCD, anxiety disorder or an eating disorder
- Feeling isolated or lonely – a person may feel a need to look a certain way to maintain friendships and personal relationships. This can lead to excessive self-focus, seeking reassurance and comparing themselves to others constantly
- A change or breakdown in relationships
If you believe that you or someone you know are suffering from BDD, a good place to start is by contacting your GP. They will be able to do an assessment and suggest the best treatment. Whilst more research is needed into which treatment is best, at the moment, NICE guidelines recommend specific BDD Cognitive Behaviour Therapy (CBT) if it is causing the individual mild functional impairment.
If BDD starts to cause the individual moderate impairments, then there is a choice of either CBT treatment or SSRI medications, or if they are showing more severe impairment, a combination of CBT treatment and SSRI medication is recommended. If none of these treatments work then it is recommended by NICE that you access specialist services that are specific for BDD.
Advice for family and Friends
Having a person that is suffering from BDD can cause upset and confusion for family, friends and partners. You may spend hours trying to reason with the person when it does not have a lasting effect. It is important to remember that they are not behaving this way to annoy you; it is not ‘bad’ behaviour. It is a disorder that can affect anyone, at anytime in their life. Do not blame yourself, nor them for their behaviour – it is nobody’s fault, even if BDD is genetically linked within your family.
Encourage them to seek help. This could be through therapy, medication or self help forms. This includes giving them the encouragement to continue their treatment, especially when they start hitting barriers and start to find it difficult. Give them praise, even for the smallest steps or improvements (e.g. for not looking in the mirror as often).
Family, friends and partners should not participate in the BDD behaviour. This also means not adapting what you do to accommodate the individuals worries. Try to encourage a normal lifestyle as much as possible.