Understanding Body Dysmorphic Disorder: Symptoms and Treatment

Many of us have a moment where we look in the mirror and feel unhappy with what we see. It's not uncommon to have unkind thoughts about our appearance. However, body dysmorphic disorder (BDD) takes these feelings to a level that can lead to clinically significant distress, expensive medical bills, severe depression and anxiety, or even self-harm and suicidal thoughts.

People with body dysmorphic disorder may focus on a perceived flaw to the point of undergoing cosmetic surgery multiple times, getting unnecessary and invasive cosmetic procedures that don't address their body dysmorphia, and may also be dealing with other severe conditions such as anorexia nervosa.

Let's take a closer look at body dysmorphic disorder: what it is, how to recognize body dysmorphia in ourselves or others, how it can impact mental health, and what kind of treatments are used for managing body dysmorphic disorder.

What is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is a mental health disorder characterized by a preoccupation with perceived defects or flaws in appearance, causing significant distress and impairment in daily life. It is a psychiatric condition defined in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).

Body dysmorphic disorder (BDD) is often comorbid with other psychiatric disorders, such as obsessive-compulsive disorder (OCD) and eating disorders.

It can affect anyone, usually beginning during the teen years or early adulthood, and affects slightly more women and people assigned female at birth than men and people assigned male at birth.

Causes and Risk Factors of Body Dysmorphic Disorder

The exact cause of BDD is still unknown, but it is thought to be a combination of environmental, psychological, and biological factors.

Environmental factors like bullying or teasing may contribute to feelings of inadequacy, shame, and fear of ridicule. Childhood abuse or trauma can also contribute.

Biological factors, such as genetics, may also play a role in the development of body dysmorphic disorder.

Family history and cultural expectations may also contribute to the development of BDD. The presence of other mental health disorders, such as obsessive-compulsive disorder, can also be a risk factor for developing body dysmorphic disorder.

Symptoms and Diagnosis of Body Dysmorphic Disorder (BDD)

Symptoms of body dysmorphic disorder include excessive concern about a perceived flaw in one’s appearance. This can look like focusing on:

• The look of your face, including complexion, structure, blemishes, or wrinkles
• Hair, including thinning or baldness
• Skin and the appearance of veins
• Breast size
• Muscle dysmorphia, which focuses on the size and shape of the muscles
• Genitalia (in cases of gender dysphoria)
• Compulsive behaviors, such as excessive grooming
• An obsession with physical appearance, often with a perceived defect

People with body dysmorphic disorder may spend hours each day worrying about their appearance in a way that causes significant impairment. A mental health professional will diagnose this disorder based on BDD symptoms and their impact on daily life. Other mental health disorders, such as obsessive-compulsive disorder, social anxiety, depression, and eating disorders, are common in people with body dysmorphic disorder.

Treatment and Management of Body Dysmorphia

Treatment for BDD typically involves a combination of talk therapy and medication.

Cognitive behavioral therapy (CBT) is an effective form of talk therapy used to treat body dysmorphic disorder. A therapist or other mental health professional will work collaboratively with the client to identify problematic thoughts and behaviors and offer strategies to shift them into healthier directions over time.

Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), are often prescribed to help manage symptoms. A mental health professional will work with the individual to develop a personalized treatment plan.

Complications and Mental Health Comorbidities of Body Dysmorphia

Body dysmorphic disorder can often lead to the development of another mental health condition. Severe depression, anxiety, and suicidal thoughts may occur if left untreated.

Muscle dysmorphia is a related condition that affects individuals who are excessively concerned about their muscle mass and body shape.

Other mental health disorders, such as OCD, social anxiety disorder, or an eating disorder, are also common comorbidities with body dysmorphic disorder and, if left untreated, can lead to severe complications.

Living with Body Dysmorphic Disorder

Living with body dysmorphic disorder can be difficult and may lead to social isolation, major depression, and suicidal thoughts if not addressed.

People with body dysmorphic disorder typically spend 3 to 8 hours per day thinking about a perceived flaw in their appearance.

Treatment for body dysmorphic disorder can be a long-term commitment, but with the right treatment and support, it is possible to manage symptoms and improve quality of life.

Seeking Help and Support for Body Dysmorphic Disorder

If symptoms worsen or new symptoms develop, contact a healthcare provider. If you experience suicidal thoughts or behaviors, seek immediate help through emergency services or a suicidal prevention helpline.

A mental health professional can provide a proper diagnosis and treatment plan for body dysmorphic disorder.

Prevention and Awareness of Body Dysmorphia

The most effective way to deal with BDD is to prevent body dysmorphic disorder in the first place. Avoid negative self-talk and focus on positive body image to help avoid BDD in your loved ones. If you have a child or teenager who is excessively concerned about their appearance, talk to a healthcare provider.

Early treatment can also help prevent body dysmorphic disorder from developing into a more severe BDD. If you notice that someone you love is overly focused on a perceived flaw, demonstrates repetitive behaviors, or has poor body image, talk to them about seeking help.

Prognosis and Outlook of Body Dysmorphic Disorder

Body dysmorphic disorder is a treatable condition. Body dysmorphic disorder treated with psychotherapy or a combination of therapy and medication is often successful, with 50-80% of people experiencing fewer or less severe symptoms with treatment.

Combining medication with psychotherapy is recommended, as psychotherapy can help develop coping strategies. Without treatment, BDD can disrupt daily life severely, and suicidal thoughts and self-harm are common among untreated individuals.

Mental Health Resources for Body Dysmorphic Disorder

Organizations like the National Alliance on Mental Illness (NAMI), or the American Psychiatric Association (APA), provide resources and support for individuals with mental health conditions, including body dysmorphic disorder.

The International OCD Foundation provides information and resources for individuals with OCD and related conditions, including body dysmorphic disorder.

Diagnosing and Treating Body Dysmorphic Disorder (BDD) in Brooklyn

If you suspect you may be experiencing symptoms of body dysmorphic disorder, like repetitive behaviors, obsession over a perceived flaw, or problems with body image that interfere with your enjoyment of life, it may be time to talk to a professional about getting body dysmorphic disorder diagnosed, and treating BDD.

At Williamsburg Therapy Group, our team of doctoral-level psychotherapists offers a number of evidence-based therapeutic approaches to talk therapy that offer the tools necessary for learning self-compassion, managing stress, and learning healthy coping skills to address body dysmorphic disorder, as well as any co-occurring mental health condition like obsessive-compulsive disorder.

If you, a family member, or someone you love is showing signs of body dysmorphic disorder, call our service coordinator to be matched with a therapist that can start BDD treatment, offering support and strategies to address the symptoms of body dysmorphic disorder, work on relapse prevention, identify any comorbid eating disorders or other mental health conditions, and in general improve mental health and well-being.