Home > Articles > Conditions-disorders > Somatoform >

Body Dysmorphic
Disorder


Body Dysmorphia Disorder (BDD) is a type of somatoform disorder, a mental illness in which a person has symptoms of a medical illness, but the symptoms cannot be fully explained by an actual physical disorder. The Diagnostic and Statistical Manual of Mental Disorders defines body dysmorphic disorder as a somatoform disorder marked by a preoccupation with an imagined defect in appearance that causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.


BDD may involve an actual defect that is slight, but the sufferer constantly obsesses over it. As a result, people with this disorder see themselves as "ugly" and often avoid social exposure to others because their appearance seems so shameful and distressing. Some may turn to plastic surgery to try to improve or "fix" their appearance, but are never satisfied. Body dysmorphic disorder is also known as dismorphophobia, or the fear or having a deformity. BDD is a chronic (long-term) disorder that affects men and women equally usually beginning during the teen years or early adulthood.


Causes


The exact cause of BDD is not known. Researchers believe that, like many other mental illnesses, body dysmorphic disorder may result from a combination of factors.
BDD may involve an actual defect that is slight, but the sufferer constantly obsesses over it. As a result, people with this disorder see themselves as "ugly" and often avoid social exposure to others because their appearance seems so shameful and distressing. Some may turn to plastic surgery to try to improve or "fix" their appearance, but are never satisfied. Body dysmorphic disorder is also known as dismorphophobia, or the fear or having a deformity. BDD is a chronic (long-term) disorder that affects men and women equally usually beginning during the teen years or early adulthood.

  • Biochemical - Some evidence suggests that naturally occurring brain chemicals called neurotransmitters, which are linked to mood, may play a role in causing body dysmorphic disorder. In particular, the neurotransmitter serotonin may have a causal role
  • Genetic - Some studies show that body dysmorphic disorder is more common in people whose biological family members also have the condition. This may indicate a genetic pathway behind body dysmorphic disorder
  • Environment - Your environment, life experiences and culture may contribute to body dysmorphic disorder, especially if they involve negative experiences about your body or self-image

Diagnosis


The disorder is generally diagnosed in those who are extremely critical of their mirror image, physique or self-image, even though there may be no noticeable disfigurement or defect. The three most common areas that those suffering from BDD will feel critical of have to do with the face: the hair, the skin, and the nose. Outside opinion will typically disagree and may protest that there is not even a defect. The defect exists in the eyes of the beholder, and one with BDD really does feel as if they see something there that is defective.


The secrecy and shame that often accompany BDD make its diagnosis difficult. Most experts agree that many cases of BDD go unrecognized. People with the disorder often are embarrassed and reluctant to tell their doctors about their concerns. As a result, the disorder can go unnoticed for years or never be diagnosed. One red flag to doctors is when patients repeatedly seek plastic surgery for the same or multiple perceived physical defects.


In diagnosing BDD, the doctor will begin his or her evaluation with a complete history and physical exam. If the doctor suspects BDD, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist makes a diagnosis based on his or her assessment of the person's attitude, behavior, and symptoms.


Common Areas of Concern for People with BDD Include:

  • Skin Imperfections - These include wrinkles, scars, acne, and blemishes
  • Hair - This might include head or body hair or absence of hair
  • Facial Features - Very often this involves the nose, but it also might involve the shape and size of any feature
  • Body Weight - Sufferers may obsess about their weight or muscle tone

Other areas of concern include the size of the penis, muscles, breasts, thighs, buttocks, and the presence of certain body odors.


Symptoms of Body Dysmorphic Disorder


There are many common symptoms and behaviors associated with BDD. Often, these symptoms and behaviors are determined by the nature of the BDD sufferer's perceived defect; for example, use of cosmetics is most common in those with a perceived skin defect. Due to this perception dependency, many BDD sufferers will only display a few common symptoms and behaviors.


BDD shares some features with eating disorders and obsessive-compulsive disorder. BDD is similar to eating disorders in that both involve a concern with body image. However, a person with an eating disorder worries about weight and the shape of the entire body, while a person with BDD is concerned about a specific body part. Similarities with OCD include a person's preoccupation with the defect which often leads to ritualistic behaviors, such as constantly looking in a mirror or picking at the skin. The person with BDD eventually becomes so obsessed with the defect that his or her social, work, and home functioning suffers.


Common Symptoms of BDD include:

  • Obsessive thoughts about (a) perceived appearance defect(s)
  • Obsessive and compulsive behaviors related to (a) perceived appearance defect(s)
  • Major depressive disorder symptoms
  • Delusional thoughts and beliefs related to (a) perceived appearance defect(s)
  • Social and family withdrawal, social phobia, loneliness and self-imposed social isolation
  • Suicidal ideation
  • Anxiety; possible panic attacks
  • Chronic low self-esteem
  • Feeling self-conscious in social environments; thinking that others notice and mock their perceived defect(s)
  • Strong feelings of shame
  • Avoidant personality: avoiding leaving the home, or only leaving the home at certain times, for example, at night
  • Dependent personality: dependence on others, such as a partner, friend or family
  • Inability to work or an inability to focus at work due to preoccupation with appearance
  • Decreased academic performance
  • Problems initiating and maintaining relationships
  • Alcohol and/or drug abuse
  • Repetitive behavior applying make-up; regularly checking appearance in mirrors
  • Seeing slightly varying image of self upon each instance of observing a mirror or reflective surface
  • Perfectionism

Any kind of body modification may change one's appearance. There are many types of body modification that do not include surgery/cosmetic surgery. Body modification (or related behavior) may seem compulsive, repetitive, or focused on one or more areas or features that the individual perceives to be defective.


Compulsive Behaviors Associated with BDD Include:

  • Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces
  • Alternatively, an inability to look at one's own reflection or photographs of oneself; also, the removal of mirrors from the home
  • Attempting to camouflage the imagined defect: for example, using cosmetic camouflage, wearing baggy clothing, maintaining specific body posture or wearing hats
  • Use of distraction techniques: an attempt to divert attention away from the person's perceived defect, e.g. wearing extravagant clothing or excessive jewelry
  • Excessive grooming behaviors: skin-picking, combing hair, plucking eyebrows, shaving, etc
  • Compulsive skin-touching, especially to measure or feel the perceived defect
  • Becoming hostile toward people for no known reason, especially those of the opposite sex, or same sex if same-sex attracted.
  • Seeking reassurance from loved ones
  • Excessive dieting or exercising, working on outside appearance
  • Self-harm
  • Comparing appearance/body parts with that/those of others, or obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble
  • Compulsive information-seeking: reading books, newspaper articles and websites that relate to the person's perceived defect, e.g. hair loss or being overweight
  • Obsession with plastic surgery or dermatological procedures, often with little satisfactory results
  • In extreme cases, patients have attempted to perform plastic surgery on themselves, including liposuction and various implants with disastrous results
  • Excessive enema use

Treatment


Common Treatments for BDD Include:

  • Psychotherapy - This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with body dysmorphic disorder. The goal is to correct the false belief about the defect and to minimize the compulsive behavior
  • Medication - Certain antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are showing promise in treating body dysmorphic disorder
  • Therapy - Family support is very important to treatment success. It is important that family members understand body dysmorphic disorder and learn to recognize its signs and symptoms

Prevention


There is no way to prevent BDD. However, it might be helpful to begin treatment in people as soon as they begin to have symptoms. Teaching and encouraging healthy and realistic attitudes about body image also might help prevent the development and worsening of BDD. Finally, providing the person with an understanding and supporting environment might help decrease the severity of the symptoms and help him or her better cope with the disorder.




 

 
Find Treatment Near You
 


 
Add Your Business!
 
Advertisement




Advertisement

 
Do You Have An Addiction?
Not sure if you need treatment? Take our free self assessment tests and find out if you need help.

 Search the Directory


©2016 Treatment4Addiction.com