What is BDD?

As humans, we each have our own unique perception of what our body looks like. Despite what others think or tell us about our physical appearance, this internal body image is our guide to how we look and feel on any given day. This is normal and usually our own perceptions are not out of line with how others see us. For some however, their internal meters are distorted to the point that what is real and what they actually perceive are two very different things. Sufferers of this growing phenomenon are extremely critical of their physical appearance to the extent they are obsessed with a minor or even imagined defect, ultimately limiting their ability to function normally.

According to a 2005 article published in Psychosomatics, up to12 percent of patients seen by dermatologists, and up to15 percent of all patients seeking cosmetic surgery, suffer from Body Dysmorphic Disorder (BDD). To put this into perspective, in 2003 alone, over 8.3 million procedures where performed by plastic surgeons, dermatologists and otolaryngologists in the United States. While a great number of BDD sufferers focus on some aspect of their face such as their nose, ears, lips or general skin tone, many others are preoccupied with their hair, hips, feet, muscle size, breasts or genitalia for example. Sometimes an obsession can be more general, encompassing body shape, weight or overall attractiveness. Whatever the complaint, BDD is a serious disorder that often leads to social isolation and clinical depression and if left unchecked, sufferers turn to often dangerous and unnecessary surgical procedures aimed at fixing the exaggerated or imagined imperfection. Because shame and embarrassment keep so many BDD sufferers from seeking help, BBD also has one of the highest suicide rates among psychiatric disorders. BDD is treatable however, but because the symptoms increase over time, the sooner you seek help, the better chance you have for a successful recovery.

Covered Bridge in the Fall

Be not afraid of life. Believe that life is worth living, and your belief will help create the fact. - Henry James

What Are the Symptoms of BDD?

The first case of BDD was recorded in 1886. The American Psychiatric Association however didn't accept BDD as an actual disorder until 1987. Today, as the importance of physical beauty and superficial values grow, so do the reported cases of BDD. Admittedly, we all worry about our appearance from time to time, even obsessing once in a while, but true BDD sufferers take what is healthy concern to unrealistic and obsessive levels. Where most of us spend only a few minutes thinking about our looks, BDD sufferers spend at least an hour each day truly fixating on their imperfections. They constantly feel people are watching them, judging their defects and even laughing at them behind their backs. As a result, they are extremely anxious and self-conscious, often camouflaging their perceived flaws with make-up, baggy clothes, dark sunglasses and hats or in extreme cases, even masks.

People with BDD cannot pass a mirror without looking. Every reflective surface becomes an opportunity to obsess about their defects, often driving them to touch or even measure the flawed body part while incessantly comparing themselves to others. On the other hand, some become so disgusted with their appearance they cover all mirrors, refusing to even look at themselves. If you suffer from BDD, you know the rituals that often accompany this disorder. Personal grooming can take hours, shaving and or pulling every ill-placed hair or repeatedly washing because of supposed body odor for example. You need constant reassurances on how you look, which can be very frustrating for family and friends, usually resulting in few if any close relationships. Others rarely understand the intense emotional turmoil you endure. In extreme cases, BDD sufferers will ask surgeons to remove a completely healthy limb for instance and when their request goes unanswered, as it normally does, some will actually do it themselves in a desperate attempt to rid their body of the imagined defect.

There is no specific reason why someone develops BDD, although some people are at higher risk than others. As with many psychiatric disorders, BDD is believed to have a genetic component. As well, abnormal serotonin levels are thought to further contribute to the onset in most cases. BDD usually appears in early adolescence when young adults are most susceptible to peer pressure and media influence. Excessive teasing and attention placed on physical appearance may precipitate onset. Emotional trauma such as sexual abuse is also thought to be a factor in BDD. Psychologically, BDD sufferers have extremely low self-esteem and often find it painfully difficult to interact in social situations. As the condition progresses, many become housebound, quitting their jobs or school as they are no longer able to cope. The condition typically becomes chronic before symptoms are recognized because family and friends frequently mistake the classic obsessive behaviors of BDD as simply vain or attention seeking.

Getting Help: Body Image Issues

Often BDD is linked to other serious conditions such as depression, anorexia or bulimia and Obsessive Compulsive Disorder (OCD). If you suffer from BDD, you undoubtedly believe your imperfections are real, yet you may also have some sense that your concerns are not completely logical. Surgery is rarely the answer and in fact, usually makes the condition worse because until you address the underlying issues that cause you to feel imperfect, you will always find some physical defect to divert the real problem. BDD is a treatable psychological condition, but it will not go away on its own. The best prognosis for recovery includes both medical and physiological intervention. Counseling can teach you to manage your anxiety and increase your self- confidence so you can once again enjoy a healthy, fulfilling life.

Treatment for Body Dysmorphic Disorder (BDD)

Meeting with a counselor to discuss Body Dysmorphic Disorder gives you a place to talk freely about your concentrated focus on your appearance. The shame and embarrassment may strive to keep you silent, however it is important, even vital, you talk about it regularly while healing.

The underlying issues that cause you to perceive yourself so imperfectly and to focus on your appearance are the cause of your pain. The therapeutic relationship affords you a place to piece this together, to see where and why you crossed the line from a healthy concern of your body to one that consumes more and more time and attention from you, to see where you began falling prey to the idea that beauty is only external and you stopped liking yourself to this extreme. It is a place to regain your self-esteem, to learn to love yourself inside and out, redefine what beauty is as opposed to what we are constantly told by those with a financial interest in our dissatisfaction and to take personal inventory of what makes you valuable, what are your true goal and dreams, and what you really value and believe.

If you need a therapist to help you, we have a large selection of online therapists who are professional and licensed counselors, able to help you right where you are over the phone, via email, or webcam/messenger. If you prefer face to face counseling, please use our therapist directory and find a city close to you with a therapist who can meet your needs.


Find a Counselor or Therapist Now

Note: If you need help finding a therapist, please contact us