BDD (body dysmorphic disorder)

In this condition a person has a distorted perception of how they look. The individual typically spends an excessive amount of time worrying about their appearance and how others view them.

What is it?

BDD is an anxiety disorder that can have a huge impact on daily life. An individual with BDD worries obsessively about how they look. They often focus on a specific aspect of their body, for example, viewing a barely visible scar as a major flaw or seeing their nose as abnormal, and are convinced that others view the “flaw” in the same way. The person may spend a great deal of time concealing an aspect of their appearance, seeking medical treatment for the part of the body believed to be defective, and/or diet or exercise excessively. BDD affects about 1 in every 50
people in the US, can occur in all age groups, and is seen in males and females in equal numbers. It is more common in people with a history of depression or social anxiety disorder ,and it often occurs alongside OCD (pp.56–57) or generalized anxiety disorder (GAD, ). BDD may be due to brain chemistry or genetics, and past experiences may play a role in triggering its development. In assessment, the doctor asks the person about their symptoms and how they affect them and may refer them to a mental health specialist for further treatment.

Breaking the cycle

LOW MOOD The perceived constant social threat leads to chronic anxiety and depression.

EFFORTS TO CHANGE APPEARANCESafety behaviors or social avoidance prevail. The person may apply excessive makeup or use clothing to conceal the perceived defective attribute; seek cosmetic surgery; use extreme diet and exercise to change body shape; and avoid social situations, thus increasing feelings of isolation.

TRIGGER Seeing their reflection, misinterpreting body language, or someone’s passing comment can start the cycle.

AUTOMATIC THOUGHTS Negative thoughts dominate, for example, “I am defective and defective people are worthless, so I am worthless.”

TREATMENT

❯ Cognitive behavioral therapy to identify self-appraisal related to the problem body part and weaken the beliefs that maintain it.

❯ Antidepressants and antianxiety medication alongside therapy.