BDD. Body dysmorphic disorder

Body dysmorphic disorder affects 1.7–2.4% of the general population – about one in 50 people

Characteristics of BDD

BDD is a body-image disorder characterised by persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance.

People with BDD can dislike any part of their body, although they often find fault with their hair, skin, nose, chest or stomach. In reality, a perceived defect may be only a slight imperfection or non-existent. But for someone with BDD, the flaw is significant and prominent, often causing severe emotional distress and difficulties in daily functioning.

BDD most often develops in adolescents and teens, and research shows that it affects men and women almost equally. BDD occurs in about 2.5% of males, and in 2.2% of females. BDD often begins to occur in adolescents of 12–13 years old.

The causes of BDD are unclear, but certain biological and environmental factors may contribute to its development, including genetic predisposition, neurobiological factors, such as malfunctioning of serotonin in the brain, personality traits, and life experiences (e.g. child maltreatment, sexual trauma, peer-abuse).

 

Signs and symptoms of BDD

People with BDD suffer from obsessions about their appearance that can last for hours or up to an entire day. This can lead to low self-esteem, avoidance of social situations, and problems at work or school.

BDD sufferers may perform some type of compulsive or repetitive behaviour to try to hide or improve their flaws, although these behaviours usually give only temporary relief.

Examples of these repetitive behaviours include:

• Camouflaging (with body position, clothing, make-up, hair, hats, etc.)

• Comparing body parts to others’ appearance

• Seeking surgery

• Checking in a mirror

• Avoiding mirrors

• Skin picking

• Excessive grooming

• Excessive exercise

• Changing clothes excessively.

BDD and other mental health disorders

People with BDD commonly also suffer from anxiety disorders, such as social anxiety disorder, as well as other disorders including depression, eating disorders, or obsessive-compulsive disorder (OCD).

BDD can also be misdiagnosed as one of these disorders because they share similar symptoms. The intrusive thoughts and repetitive behaviours exhibited in BDD are similar to the obsessions and compulsions of OCD. BDD is distinguished from OCD when the preoccupations or repetitive behaviours focus specifically on appearance.

Treatment

To get an accurate diagnosis and appropriate treatment, people must mention specifically their concerns with their appearance when they talk to a doctor or mental health professional. A trained clinician should diagnose BDD1.

However, you can take a self-test that can help suggest if BDD is present, but it will not offer a definitive diagnosis. If your child is preoccupied with appearance so that it interferes with concentration in school or if behaviours listed above appear, talk to a mental health professional.

Effective treatments are available to help BDD sufferers live full, productive lives:

Cognitive behavioural therapy (CBT) teaches patients to recognise irrational thoughts and change negative thinking patterns. Patients learn to identify unhealthy ways of thinking and behaving and replace them with positive ones

Anti-depressant medications, including selective serotonin reuptake inhibitors (SSRIs), can help relieve the obsessive and compulsive symptoms of BDD.

Treatment is tailored to each patient, so it is important to talk with a doctor to determine the best individual approach. Many doctors recommend using a combination of treatments for best results.

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