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Body dysmorphic disorder (BDD)

a mental health condition where individuals become excessively concerned with perceived flaws in their appearance
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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 unnoticeable to others. Despite this, individuals with BDD may spend hours each day engaged in behaviours aimed at fixing or hiding these flaws.

Common behaviours include excessive grooming, skin picking, mirror checking or seeking constant reassurance from others. The condition 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 and even suicidal thoughts. 

Common myths around body dysmorphic disorder

BDD is just about being overly concerned with appearance

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. 

Causes and impact of BDD

The causes of BDD are complex and likely involve a combination of genetic, environmental and psychological factors. Individuals with a family history of mental health disorders, or those who have experienced bullying, abuse or trauma related to their appearance, are at higher risk. Societal pressures, especially those emphasising physical appearance, can also contribute to the development of BDD. Additionally, neurobiological factors, such as differences in brain structure and function, may play a role in the condition. 

Social and cultural pressures play a significant role in BDD. Recent studies have deepened our understanding of the relationship between social media use and BDD. Social media, with its heavily edited and staged images and filters, promotes unrealistic beauty standards that reinforce negative self-perception. Constant exposure to idealised appearances increases body dissatisfaction, particularly in young people, making those with BDD more vulnerable to obsessive concerns. 

Living with BDD can be isolating and overwhelming. The relentless focus 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 or even eating disorders. The condition often leads to repetitive behaviours that take up significant time and energy, further impairing the individual’s ability to engage in daily activities or maintain 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. 

Recognising the signs of body dysmorphic disorder 

Recognising BDD early is crucial for effective treatment. Signs include: 

  • Spending excessive time worrying about appearance.
  • 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 or anxiety related to appearance.

If these behaviours are interfering with daily life, it’s important to seek help from your GP or a mental health professional. 

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 Behavioral Therapy (CBT): Helps challenge distorted thoughts and reduce compulsive behaviors through techniques like Exposure and Response Prevention (ERP). 
  • Medication (SSRIs): 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 with body dysmorphic disorder, including: 

Seek professional help: Cognitive Behavioural Therapy (CBT) is one of the most effective treatments for BDD. It helps individuals challenge and change the distorted beliefs about their appearance. 

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. 

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. 

Limiting social media exposure: Reducing engagement with heavily edited or appearance-focused content can lessen self-comparison and body dissatisfaction. 

Practice 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

There are multiple ways in which you can help others who have body dysmorphic disorder, which include:

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. 

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. 

Encourage healthy habits: Support your loved one in engaging in activities that promote wellbeing such as, exercise, healthy eating and stress management. 

Educate yourself: Understanding BDD can help you provide better support. Familiarise yourself with the condition so you can offer informed and compassionate assistance. 

support

Our Advice and Support Service is open Monday to Friday, 10am to 4pm (closed for lunch between 12.30pm and 1.30pm), where advisers can signpost you to local support that most fits your needs, including our Change Mental Health services. We offer initial advice on money worries and help to deal with emergencies.

Contact 0808 8010 515, email us at advice@changemh.org or fill out the enquiry form on the Advice and Support Service page.

Other support

Beat is a leading charity for eating disorder/body image support.

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. 

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