Body dysmorphic disorder (BDD)
Body dysmorphic disorder (BDD), sometimes known as body dysmorphia, is characterised by an obsessive focus on perceived imperfections in one’s physical appearance. These perceived flaws are often minor or completely invisible to others. Despite this, individuals with BDD may spend hours each day trying to fix or hide these flaws.
Common behaviours in BDD include excessive grooming, skin picking, mirror checking or seeking constant reassurance from others. It often starts in adolescence, but it can affect people of all ages and genders. It can cause significant distress, affecting daily life, body image, social interactions and overall wellbeing. Without treatment, BDD can lead to severe anxiety, depression, self-harm and even suicidal thoughts.
Common myths around BDD
People with BDD are vain or just obsessed with their looks.
BDD is not simply about vanity. It is a serious mental health condition that can cause profound emotional distress and interfere with daily functioning.
BDD only affects women
BDD affects people of all genders. Men may focus on different aspects of their appearance, such as body size or muscle definition but they are equally susceptible to the condition.
Cosmetic surgery will fix BDD
Surgery rarely addresses the underlying psychological issues of BDD and can sometimes worsen symptoms. The problem lies in distorted self-perception, not the physical features themselves.
What causes BDD?
The causes of BDD are complex and involve a combination of genetic, environmental and psychological factors. Studies show that having a family history of mental health conditions, experience of bullying, abuse or trauma related to their appearance, can mean a higher risk of BDD. Societal pressures, especially those emphasising physical appearance, can also contribute to the development of BDD. Additionally, differences in brain structure and function, may play a role.
Social and cultural pressures play a significant role in BDD. Recent studies have indicated how social media use and BDD are deeply intertwined. Certain types of social media posts promote unrealistic beauty standards that reinforce negative self-image. Repeatedly seeing idealised and edited appearances online increases body dissatisfaction, making those with BDD more vulnerable to obsessive thoughts about their appearance, particularly in young people.
How can BDD impact your life?
Living with BDD can be isolating and overwhelming. Constantly focusing on perceived flaws can lead to social withdrawal, avoiding activities or even missing work or school. Many people with BDD feel ashamed and misunderstood, which can exacerbate feelings of anxiety, depression and eating disorders. The condition often leads to repetitive behaviours that take up significant time and energy, further impairing daily activities and relationships.
BDD is strongly associated with suicidal thoughts and behaviours. Studies show that people living with BDD are at a significantly higher risk of suicide, with rates up to 45 times higher than the general population.
Noticing the signs of BDD
Recognising BDD early is crucial for effective treatment.
Signs include:
- Spending excessive time worrying about appearance or body image.
- Engaging in repetitive behaviours like checking mirrors, grooming or picking at skin.
- Avoiding social situations or taking extreme measures to hide perceived flaws.
- Experiencing significant distress and anxiety related to appearance.
If these behaviours are interfering with daily life, it’s important to seek help from a mental health professional. You can find support at the bottom of this page.
Gender differences in BDD
BDD can affect people of all genders and while certain patterns are more commonly observed in men or women, these experiences are not exclusive. Anyone can experience concerns related to weight, look or muscle definition.
BDD in women:
- Women with BDD commonly fixate on facial features, skin, weight or hair.
- There is a strong link between BDD and eating disorders, as body dissatisfaction can lead to disordered eating behaviours.
BDD in men:
- Men are more likely to experience muscle dysmorphia, a form of BDD where they become obsessed with their muscle size and feel they are not muscular or lean enough.
- Steroid use and excessive gym workouts are more common in men with muscle dysmorphia.
Treatment for BDD
BDD is treatable, and early intervention can significantly improve outcomes. Common treatment options include:
- Cognitive Behavioural Therapy (CBT): Talking therapies, like CBT, helps challenge distorted thoughts and reduce compulsive behaviours.
- Medication: Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can help reduce obsessive thoughts and anxiety associated with BDD.
- Support groups & peer support: Connecting with others facing similar struggles can reduce isolation and provide coping strategies.
How to support yourself with BDD
There are multiple ways in which you can help yourself, including:
1. Seek professional help
Therapy and other professional support can help you manage BDD by addressing distorted thoughts, reducing compulsive behaviours and improving overall wellbeing.
2. Limit mirror checking
Try to reduce the amount of time spent checking your appearance in the mirror. Setting specific limits can help reduce compulsive behaviour and associated anxiety.
3. Engage in positive activities
Focus on activities that make you feel good about yourself and take the focus away from your appearance. Engaging in hobbies, socialising or volunteering can improve your self-esteem and overall wellbeing.
4. Limiting social media exposure
Reducing engagement with heavily edited or appearance-focused content can lessen self-comparison and body dissatisfaction. Read more about how your technology use can affect your mental health here.
5. Practise mindfulness or grounding techniques
Mindfulness and grounding techniques can help you manage the distressing thoughts and feelings associated with BDD. By focusing on the present moment and accepting yourself as you are, you can reduce the power of negative thoughts.
How to support others with BDD
Talking about BDD can be hard. There are multiple ways in which you can help others who have BDD, which include:
1. Be Supportive
If someone you know is struggling with BDD, offer support without judgement. Listen to their concerns and encourage them to seek professional help.
2. Avoid appearance-focused comments
Refrain from making comments about their appearance, whether positive or negative. Instead, focus on their strengths and qualities that have nothing to do with looks.
3. Encourage healthy habits
Support your loved one in engaging in activities that promote wellbeing such as, exercise, healthy eating and stress management.
4. Educate yourself
Understanding BDD can help you provide better support. Familiarise yourself with the condition so you can offer informed and compassionate assistance.
contact
Our National Advice and Support Service can help you and people you care for with mental health concerns and money worries.
We can link and signpost you to relevant local and national support, including our own Change Mental Health services, as well supporting with debt, grants and benefits.
The service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm to 1.30pm). Contact 0808 8010 515, email advice@changemh.org or fill in the form on the service webpage.
For full details about the service, visit the National Advice and Support Service webpage.
Other support
Beat is a leading charity for eating disorder support. Contact their helpline on 0808 801 0432 (Monday – Friday, 3pm – 8pm), use their webchat or send an email.
SupportED or NEEDS are Scottish charities that offer various forms of support, including peer support groups, befriending and support for carers of people diagnosed with eating/body image issues.
CarED hosts tutorials for people and offers an online database of services within Scotland.
