What You See In The Mirror - Body Dysmorphic Disorder

What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder is a mental health condition related to body image.

Those suffering from BDD spend time worrying about perceived flaws in their appearance to such an extent that it has a detrimental impact on their mental health and general quality of life.

For example, concerns around appearance may make a person anxious to go out in public or see other people. BDD can therefore negatively impact work life and relationships with other people.

A person can develop BDD at any age, albeit it is most common in teenagers and young adults. It varies in severity from person to person and from day to day.

Suffering from BDD in no way means a person is vain. BDD is a mental health condition in which a person is overly critical and oversensitive to their perceived flaws. These flaws are often unnoticeable to others.

Whilst scientists have not yet determined the exact cause of BDD, it is thought it may be associated with genetics (you are more likely to develop it if you have a relative a mental health disorder), a chemical imbalance in the brain, or have previously had a traumatic experience (e.g. abused as child or bullied at school).

Some people with BDD also have another mental health condition, such as obsessive-compulsive disorder (OCD), generalised anxiety disorder (GAD) or an eating disorder.

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What are the symptoms and how is it diagnosed?

Frustratingly, many people who are suffering with BDD refrain from reaching out for help because they are worried about being judged as vain. This means there is often a long period between self-diagnosing BDD and seeking support.

BDD is characterised by obsessively self-criticsing aspects of appearance, flaws that cannot be seen by others or appear very slight. This obsession can manifest itself in many ways such as;

  • Continual worrying about a specific area of the body e.g. the face
  • Continual comparison of your looks with those of others
  • Either avoiding looking at yourself or alternatively continually looking at yourself in the mirror
  • Making a concerted effort to conceal the perceived flaws (e.g. combing hair, applying make-up)

If you have BDD, these obsessional behaviours cause emotional distress and have a significant impact on your ability to carry on with your day-to-day life including work, social life and relationships.

BDD can lead to a loss of confidence and feelings of shame which in turn lead feelings of depression and anxiety. These may manifest themselves in eating disorders, alcohol and drug abuse, self harm and suicidal thoughts.

BDD can also result in a person feeling the need to undertake unnecessary medical procedures, such as cosmetic surgery.

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What are the treatments for BDD?

The treatment alternatives for BDD are similar in nature to other mental health disorders. The two main treatments are cognitive behaviour therapy (CBT) and anti-depressants.

CBT aims to change the way a person thinks about their appearance. It aims to make a person less self-depreciating by learning what triggers the symptoms.

The standard anti-depressants offered are selective serotonin reuptake inhibitors (SSRIs). The most common SSRI offered is called fluoxetine. SSRIs can take up to 12 weeks before any improvement in symptoms is noticed and they may be taken for several months to fully alleviate the symptoms.

Other avenues that can help with BDD include attending support groups, (useful for meeting people in similar situations), practising mindfulness exercises, getting together with friends or family, and relaxation and breathing exercises (often effective at relieving stress and anxiety).

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If you have any follow-up questions don't hesitate to contact us at help@manbehindthemirror.co.uk

Written by Mike Firth, GP and Medical Director

This article is for informational purposes only and is not a substitute for professional medical advice or diagnosis. Always talk to your doctor about the risks and benefits of any treatment.