Body Dysmorphic Disorder (BDD)

(Trigger Warning: This article discusses symptoms of Body Dysmorphic Disorder, which includes a brief reference to suicidal ideation)

Of the 328 million people living in the U.S. today, between 5 and 7.5 million are diagnosed with Body Dysmorphic Disorder (BDD), and even more are impacted by episodes of body dysmorphia –  a phenomenon in which an individual becomes preoccupied with their appearance and perceives their body in warped, negative ways.

BDD Background

According to the Anxiety and Depression Association of America (ADAA), BDD is a mental illness defined by incessant and invasive obsessions with negligible or imagined flaws related to physical appearance. Symptoms generally develop in the adolescent and pre-teen years.

“Individuals with BDD tend to have a negative perception of their own appearance, and they tend to believe that others judge their appearance to be undesirable, which can cause heightened levels of anxiety,” states Mental Health America (MHA).  

Dr. Fred Penzel, a licensed psychologist specializing in Obsessive-Compulsive Disorder and other similar disorders, explains the difference between negative body image and BDD in the following statement:

“BDD should not be confused with the more common type of [body] dissatisfaction that many people experience with themselves. In BDD, it is very difficult, if not impossible, to see things the way the sufferer does. BDD sufferers seem to be totally preoccupied with the imagined defect[s], which can be something very specific or very vague. Often, it may be a defect no one else can see. Frequently, the belief in the defect can be so strong it seems to border upon being a delusion.”

Symptoms

Symptoms of the disorder fall into one of two categories: avoidant episodes and compulsive episodes. 

MHA describes avoidant episodes as depressive states brought on by outside stimuli that triggers despair regarding the physical appearance. When someone with BDD falls into a depressive states, they withdraw from society by avoiding school, work, general social interactions, and sometimes even their own family members. 

According to the ADAA, compulsive episodes can also be triggered by external stimuli and involve taking immediate and sometimes severe action to attempt to hide or alter small or imagined flaws in the physical appearance.

The ADAA provides the following examples of compulsions: “camouflaging with body position, clothing, makeup, hair, hats, etc., comparing body parts to others’ appearance, seeking surgery, checking in a mirror, avoiding mirrors, skin picking, excessive grooming, excessive exercise, [and] changing clothes excessively.”

While many people experience episodes of body dysmorphia, those diagnosed with BDD often cannot go one day without experiencing these symptoms. 

“A person with BDD experiences significant distress and the ability to carry out every-day-functions is affected,” states MHA. “These concerns are unwanted, usually difficult to resist or control, and on average occur 3-8 hours per day.”

When symptoms become too intense, suicidal ideation often occurs.

A clinical study done by Katharine Phillips and her colleagues in psychiatry found that out of two-hundred people diagnosed with BDD “80.6% had a history of suicidal ideation, and 44.4% had attempted suicide.”

Resources to Help

The symptoms of BDD can be lessened through cognitive-behavioral therapy and medication. If you’re struggling, please consider reaching out for help or doing further research.

BDD Treatment Information from the ADAA:

https://adaa.org/understanding-anxiety/body-dysmorphic-disorder/treatment

BDD General Information from the ADAA:

https://adaa.org/understanding-anxiety/body-dysmorphic-disorder/resources