Body Dysmorphic Disorder

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is a mental health condition that causes people to believe that parts of their body look ugly. People with BDD spend hours focused on what they think is wrong with their looks. Many times a day, they check, fix, cover up, or ask others about their looks. They focus on flaws that seem minor to others.

What Are the Signs & Symptoms of Body Dysmorphic Disorder?

People with body dysmorphic disorder:

Focus to extreme on their looks. With BDD, people find it hard to stop thinking about the parts of their looks they dislike. They focus on specific things — like a pimple on their skin, or the shape or looks of their nose, eyes, lips, ears, or hands.

Feel upset about their looks. People with BDD feel worried, stressed, and anxious about their looks almost all the time.

Check or fix their looks. With BDD, a people feel the strong need to check their looks over and over. For example, they check their looks in a mirror, ask others how they look, or "fix" their looks many times a day.

Try not to be seen. Some people with BDD feel so bad about their looks they don't want to be seen. They may stay home; keep to themselves; or use makeup, hats, or clothes to cover up. Some people with BDD avoid looking in mirrors because it is so stressful.

Have false ideas about their looks. People with BDD don't see their body as it really is, or as others see it. The flaws they focus on are things that others can hardly notice. They feel convinced they look ugly, even though it's not true.

What Causes Body Dysmorphic Disorder?

There is still much to learn about the exact causes of body dysmorphic disorder. But experts believe that these things play a role:

Genes. BDD may be partly inherited. It tends to run in families.

Serotonin. Serotonin is a normal and necessary chemical found in the brain. A low supply of serotonin helps explain why BDD happens.

Brain differences. Some areas of the brain look and work differently in people with BDD.

Body dysmorphic disorder is not caused by anything the person or their parent did. It is a mental health condition that needs treatment. BDD is not a person's fault.

How Is Body Dysmorphic Disorder Diagnosed?

A trained mental health therapist who understands body dysmorphic disorder can diagnose it. They ask questions and listen carefully to the answers to know if a person has BDD or another disorder.

How Is Body Dysmorphic Disorder Treated?

Body dysmorphic disorder can be treated with:

• Cognitive behavioral therapy (CBT). CBT helps people learn to focus less on flaws, change painful thoughts about their body, and stop doing checking behaviors.
• Medicine. Medicines that help serotonin work well are used to treat BDD. These are sometimes called SSRI medicines.

Most of the time, CBT therapy and medicine are used together to treat someone with BDD.

What's It Like for Someone With BDD?

The thoughts and worries that are part of BDD take up a person's time and drain their energy. They never feel OK about how they look. Because of BDD, people often miss out on being with friends, going to school or work, or doing normal activities. This can make them feel alone, sad, or depressed.

Some look for treatments or surgery they don't need, hoping to "fix" a flaw. But this doesn't relieve or improve BDD. It can be hard for them to see that the problem with BDD is not the way they look. It's the skewed way BDD makes them see themselves.

How Can I Help My Child?

If you think your child may have BDD:

• Find a trained CBT therapist. Make an appointment to take your child for an evaluation.
• Help your child go to all therapy visits. Follow the directions for any medicines prescribed.
• Ask the therapist how you can help your child. Ask about the best ways to respond when your child asks you about how he or she looks.
• Talk with your child. Offer support. Share what you know about BDD and talk it over. Listen, and show you understand and care.
• Be patient. It takes time for CBT therapy and medicines to relieve BDD.

You also can visit online BDD sites for more information and support, such as:

• IOCDF
• BDD Foundation
• Online Body Dysmorphic Disorder Support Group