Phoenix Teen Counseling: What is Body Dysmorphic Disorder?

Everyone has days when they just don’t feel attractive.  Call it a bad hair day or a fat jeans day or whatever you want; it happens to all of us.  Now imagine feeling that way, all day, every day.  This is what it is like to have Body Dysmorphic Disorder (BDD).  BDD is an all-consuming preoccupation with some perceived flaw or defect in personal appearance.  People with Body Dysmorphic Disorder cannot turn off the voice in their head that is consistently criticizing how they look, making them feel unattractive, and damaging their self worth.

The unrelenting nature of Body Dysmorphic Disorder can lead to suicidal thoughts and behavior.  It can also lead to serial cosmetic surgery that is both unnecessary and does not offer relief. The all-consuming nature of this condition is elevates it to the level of a mental illness.  Everyone has a bad hair day once in awhile, but for people with BDD there are no good days.

Symptoms

Like other chronic anxiety disorders, Body Dysmorphic Disorder has a broad range of symptoms and those with the condition may experience all, some, or any combination of them.  Common symptoms include:

  • Preoccupation with physical appearance or any specific aspect of physical appearance
  • Spending significant amounts of time looking in the mirror
  • Belief that there is a deformity or defect that doesn’t exist
  • Avoidance of mirrors
  • Constant need for others to provide assurance on attractiveness
  • Serial cosmetic surgery
  • Unwillingness to have picture taken
  • Avoiding social situations
  • Wearing clothes or makeup specifically to cover perceived flaws

People with BDD can obsess over their appearance as a whole or any specific body part.  There are some areas of the body that are more commonly the object of the obsession including:

  • Skin/Complexion including obsessing over wrinkles or acne
  • Nose
  • Hair and Baldness
  • Breast Size and Genital
  • Muscle Size

It is not uncommon for the obsessive thoughts to shift from one body part to another over time as the disorder centers on obsessive thoughts rather than actual physical attributes.  In some cases, these thoughts can become so powerful that they result in delusional behavior.

Causes

There is nothing specific that is known to cause Body Dysmorphic Disorder.  Experts in the field agree that, similar to other mental illnesses, it may be caused by a combination of factors like chemical or structural differences in the brain, negative life experience relating to body image, and genetics.

Complications

Like any anxiety disorder, Body Dysmorphic Disorder can make it difficult to live life to the fullest and lead to other problems.  People with BDD may also experience Obsessive-compulsive Disorder (OCD), Depression, eating disorders, social phobia, and other anxiety disorders.  They may have to spend time in the hospital to treat their disorder and choose to undergo unnecessary medical procedures to fix the imagined flaws and defects.  They can become socially isolated, lack close personal relationships, and their disorder can make it difficult to go to work or attend school.    This disorder can also result in suicidal thoughts and tendencies.

Diagnosis and Treatment

Body Dysmorphic Disorder can be diagnosed by a doctor or mental health provider using a series of tests including a physical exam, blood tests, and a psychological evaluation.   However, BDD can be difficult to diagnose if the person with the disorder does not fully participate in any testing by sharing feelings and thoughts openly.   Diagnosis can also be complicated because BDD shares symptoms and traits with other mental illnesses which must be ruled out in order to get to the right diagnosis.   The diagnostic criteria for BDD include extreme preoccupation with some aspect of physical appearance that causes problems in other areas of life.

Treatment of BDD is most successful when the person with the disorder is engaged and willing to participate in the process.  BDD is commonly treated with cognitive behavioral therapy and may also include the use of medication.  In severe cases, hospitalization may be required in order to protect the wellbeing of the person with the condition.

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