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Body Dysmorphic Disorder: Causes, Diagnosis & Treatment

  • Published: 2012-06-11 (Revised/Updated 2015-07-28) : Author: Thomas C. Weiss : Contact: Disabled World
  • Synopsis: Body dysmorphic disorder is when a person worries about their appearance and is concerned with something that is not present.
Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) is defined as a form of mental illness. People who experience BDD constantly worry about their appearance and may be concerned with something that is not present, or that other people do not notice, thinking it is a serious defect.

Main Document

"The symptoms associated with body dysmorphic disorder (BDD) may vary depending upon which part or parts of a person's body are targeted, although in general there are a number of symptoms."

Body dysmorphic disorder (BDD) is a form of mental illness. People who experience this form of illness constantly worry about their appearance and may be concerned with something that is not present, or that other people do not notice, thinking it is a serious defect. The severity of BDD a person experiences varies. While some people are aware their feelings are irrational or unjustified, others are nearly delusional in their convictions.

Body dysmorphic disorder (BDD) causes a person serious emotional distress. The illness is not simply a matter of vanity and is not something a person can simply, 'get over,' or forget about. The person's preoccupation with their appearance may become so extreme they have difficulties with functioning while they are at school, work, or while they are in social situations. Any part of the person's body may be the focus of the person's concerns.

Approximately 1 - 2% of the population is believed to experience BDD. Men and women experience the illness equally, and BDD commonly begins while a person is in their adolescence when concerns over physical appearances are common. Unfortunately, the suicide rates associated with BDD are high. If you believe you have BDD, it is important for you to see your doctor or a mental health professional. Areas of the body people with BDD are usually concerned with include the following:

The person may be concerned with the overall shape and size of their body, the symmetry of their body, or specific parts of their body. People with BDD may be concerned about the shape or size of nearly any part of their body. A small example might be my husband Tom. He has surgery scars on the side of his chest from the chest tubes used to remove an infection when he was younger. He won't take his shirt off in public because of the scars, even when it is very hot outside. He even dislikes taking his shirt off for his doctor.

Symptoms of Body Dysmorphic Disorder

The symptoms associated with body dysmorphic disorder (BDD) may vary depending upon which part or parts of a person's body are targeted, although in general there are a number of symptoms. A person may think about their perceived defect for hours each day, or worry about a failure to match the, 'perfection,' on a physical level of celebrities or models. They may be distressed about their preoccupation, and constantly ask loved ones for reassurance about the way they look, while disbelieving their loved one's answers.

People with BDD may constantly look at their reflection in a mirror, or make efforts to avoid their reflection by throwing away or covering mirrors. They might diet constantly, or overexercise. People with BDD may groom themselves excessively; for example, by shaving the same area of skin repeatedly. A person with BDD may avoid situations they believe will focus attention on their perceived defect; in extremes this could mean the person might never leave their home.

Making great efforts to camouflage or hide their perceived, 'defect,' or picking or squeezing blemishes for hours are other things people with BDD may do. A desire for cosmetic or dermatological surgery, even when a professional thinks treatment is not needed, may be something a person with BDD wants. Repeated cosmetic surgery, particularly if the same part of their body is seen as being somehow, 'improved,' with every procedure, is something else a person with BDD may pursue. A person with BDD may also experience anxiety, depression, and even suicidal thoughts.

The Cause of Body Dysmorphic Disorder

The exact cause of BDD remains unknown at this time, although there are some theories. A person with BDD may have a genetic tendency to develop this form of mental illness. The, 'trigger,' might be stress during the person's adolescence. Certain illegal drugs like ecstasy might trigger the onset of BDD in people who are susceptible.

Body dysmorphic disorder (BDD) might be caused by a chemical imbalance in the person's brain. The person may have low self-esteem and have impossible standards of perfection, judging some parts of their body as being, 'ugly.' Over a period of time, their behavior then becomes increasingly compulsive. Western society also presents rather narrow standards of what, 'beauty,' comprises and might trigger BDD in people who are vulnerable.

Conditions that are Similar to Body Dysmorphic Disorder

Body dysmorphic disorder is similar to a number of other conditions. These conditions include one's such as agoraphobia, hypochondriasis, anorexia nervosa, obsessive-compulsive disorder and others. Conditions that are similar to body dysmorphic disorder include the following.

Hypochondriasis: Hypochondriasis involves a preoccupation with the development of disease. A person with BDD; however, is preoccupied with their appearance, not their health.

Anorexia Nervosa: Anorexia nervosa is a diagnosis many people who actually have BDD receive due to a preoccupation with their appearance. Anorexia nervosa; however, is characterized by a drive to control a person's weight. It is possible for a person to have both forms of illness at the same time.

Trichotillomania: Trichotillomania involves an irresistible urge to pull out or pluck a person's hair. If the behavior is triggered by a concern about a person's appearance, the underlying issue might be BDD. Squeezing or picking at skin blemishes for hours is a condition that is similar to trichotillomania.

Social Phobia: Social phobia is a form of anxiety disorder that is characterized by a fear of interacting with people. A person with social phobia might worry they will be criticized, judged, humiliated, or ridiculed. If the avoidance is caused by concerns the person has about their appearance, the real issue might be BDD.

Obsessive-Compulsive Disorder (OCD): OCD is characterized by recurrent and undesired images and thoughts or obsessions, as well as repetitious rituals or compulsions. People with BDD are obsessively preoccupied with a certain aspect of their appearance; it has been suggested that BDD might be a form of OCD. Some people who have received a diagnosis of BDD either have or have had OCD.

Agoraphobia: Agoraphobia is a form of anxiety disorder that is characterized by a fear of places or situations the person believes are difficult to escape from. In more extreme instances, a person who experiences agoraphobia is unable to leave their own home. It is important to note that a person who remains at home out of a fear of publicly exposing a perceived, 'defect,' might have BDD instead of agoraphobia.

Diagnosis and Treatment of Body Dysmorphic Disorder (BDD)

Achieving a diagnosis of body dysmorphic disorder (BDD) is difficult for several reasons. A person with BDD is often more likely to reach for help from a cosmetic surgeon or a dermatologist instead of a psychiatrist or psychologist. People with BDD are often ashamed and do not want to reach for help from a mental health professional. Body dysmorphic disorder is a form of mental illness that does not get a lot of publicity; even some health care professionals might not be aware of it's existence. BDD is also a form of mental illness that is similar to other forms of conditions and a misdiagnosis is very possible.

Very little research has been performed into the effectiveness of treatments related to body dysmorphic disorder. Some of the treatments that seem to help include a combination of the following forms of treatments.

Coping and Management Skills: Coping and management skills involves training to cope with symptoms of anxiety. A person might learn relaxation techniques, for example.

Cognitive Behavioral Therapy (CBT): CBT involves training in how to change underlying attitudes with the goal of thinking and feeling in different ways. The training includes learning to tolerate exposing the person's perceived, 'defect,' to others.

Medication: Medication may be administered, such as antidepressant medication. The medication may include selective serotonin reuptake inhibitors (SSRI's). The medication can help to reduce the symptoms of BDD, to include depression, anxiety, and compulsive thoughts. In general, the medication is used in combination with psychotherapy.

People with body dysmorphic disorder (BDD) may reach for cosmetic surgery with the goal of, 'correcting,' a perceived or actual physical flaw. Medical experts remain ethically divided where these surgeries are concerned; any surgical or medical procedure presents health risks. Unnecessary surgery in order to change a person's appearance can lead not only to dissatisfaction; it may actually worsen the BDD the person experiences.

Study of Patients With Body Image Issues Treated With 2 Different Behavioral Interventions

"Body Dysmorphic Disorder (BDD) is a disabling condition that until recently has been largely ignored. Sufferers of BDD worry excessively and unreasonably about some flaw in their appearance that may be minimal or even nonexistent."

Body dysmorphic disorder: recognizing and treating imagined ugliness

"Body dysmorphic disorder (BDD), also known as Dysmorphophobia, is a severe psychiatric disorder that occurs around the world. However, the diagnosis is usually missed in clinical settings."

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