Body dysmorphic disorder (BDD) is where an individual becomes particularly self-conscious and believes that they have a problem with the appearance of a specific feature of their body. They become pre-occupied with their perceived issue and therefore this is all they can think about.
Another term still used to reference to BDD is 'dysmorphophobia', whilst the media sometimes refer to it as 'imagined ugliness syndrome', which is a particularly unhelpful term as sufferers really see themselves as ugly.
BDD is more common in people with a history of depression and social phobia, with mild disorder more common in women and young teenagers. It has been suggested that up to 1% of the population is affected by BDD.
What are the symptoms of body dysmorphic disorder?-
People who suffer from BDD may spend several hours each day thinking about their appearance and what they believe is wrong with it. They are very self-conscious, and may have a picture in their mind of the impression they give which no-one else can see, and a feeling of shame that others do not experience. Common characteristics of someone with BDD include:
- Asking for constant reassurance about their image
- Repeatedly checking their appearance in front of mirrors
- Picking at their skin to make it smooth
- Cutting or styling their hair until they think it is perfect
Many people are concerned with some aspect of their appearance. To be diagnosed with BDD can be very distressing and have a serious effect on your life. This can lead to avoidance of social and public situations and hiding the part of your body that you are not happy. This can include wearing heavy make-up, brushing your hair in a particular way or wearing loose clothes.
With the most severe cases, BDD can affect your ability to work or study as well as impact on your social and family life. Many sufferers are single or divorced, suggesting that they find it difficult to form relationships. Some sufferers may be housebound, in hospital or in severe cases, attempt suicide.
What are the causes of BDD?-
From what little research there is, causes are thought to be psychological and biological. BDD may have a genetic influence, and it usually develops in the teens – a time when people are generally most sensitive about their appearance. They may have endured negative experiences like being teased or bullied. They will have developed a low self-esteem, may fear being alone and isolated and begin judging themselves by their appearance.
What are the most common areas of the body involved in BDD?-
People who suffer from BDD may think that there is something wrong with any part of their body, including their breasts or genitals. However, most sufferers are concerned with one or more aspects of their face. The most common concerns are with the nose, the hair, the skin, the eyes, the chin, the lips, or the overall body build. Sufferers may complain of a lack of symmetry, feel that something is too big or too small, or that it's out of proportion to the rest of their body.
What treatments are available?-
There has been limited research on the treatment of BDD. Two treatments that have been shown to work include cognitive behavioural therapy (CBT) and antidepressant medication.
Contacting your GP is often the easiest way to get help and further treatment. He or she may refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment. If you're worried about talking to your GP, consider writing down your concerns and questions. You can:
- Take a friend or family member
- See another doctor in the practice
- Join a new GP practice
The type of professional support offered will depend on the services that are available in your area and the arrangements that your primary care trust (PCT) have with other health authorities or private providers. Treatment for BDD is also available privately through the Priory.
Cognitive behaviour therapy for BDD-
Cognitive behaviour therapy (CBT) can help those suffering from BDD. This treatment is based on a structured programme of self help, helping you learn to change the way you think and act. During therapy, you will learn different ways of thinking about your problem and to refocus your attention away from yourself. You would learn to confront your fears and stop your rituals, such as checking mirrors and grooming yourself more than normal.
Certain types of prescribed antidepressants called selective serotonin reuptake inhibitors (SSRIs) have been shown to be helpful in the treatment of BDD.
Getting your life back on track - long term recovery-
Treatment works effectively for many sufferers. However, some sufferers may feel reasonably well for a time then go back to old behaviour, while others remain chronically ill. Although there is no research on medication combined with therapy, if you have more severe symptoms then you are more likely to recover from BDD by combining the two.