Body Dysmorphic Disorder

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Defining Body Dysmorphic Disorder

Body dysmorphic disorder (BDD) is a documented mental health problem and people suffering from this disorder often keep thinking about a minor (or imaginative) abnormality in their physical appearance. The recurrent thoughts usually make them depressed and distressed, leading to further complications in their cognitive functions.

Individuals with body dysmorphic disorder usually spend a lot of their time focusing their energy and thoughts on an apparent physical defect that may not really exist or may be too minor for others to notice. In most cases, the thought and obsession with the apparent defect maybe a deterrent for patients to participate in social gatherings.

In many ways, BDD is similar to obsessive compulsive disorder and individuals tend to display repetitive behavior in order to overcome their anxiety and stress. Such disorders are usually a result of chemical imbalances (mostly neurotransmitters like serotonin) in the brain. BDD is a somatoform disorder, some other forms of this category are Conversion Disorder, Pain Disorder Hypochondriasis etc.

Signs and Symptoms of Body Dysmorphic Disorder

  • Obsessing about a particular physical feature
  • Obsessing about physical defects that may be too minor to notice
  • Self-imposed exile from social interactions
  • Fear of mixing up with new people
  • Suicidal ideation
  • Anxiety
  • Panic attacks
  • Low self-esteem
  • Feeling ashamed of one-self
  • Self-destructive behavior
  • Repetitive behavior
  • Substance abuse
  • The need to be a “perfectionist” when it comes to ones looks and physical appearance
  • Compulsive mirror checking, especially for a few areas
  • Inability to look at the mirror in extreme negative cases of BDD
  • An obsession with ways to camouflage the defect- wearing glasses, growing a beard or wearing a hat, for instance
  • Seeking plastic surgery
  • An obsession with loved ones- always seeking approvals and attention from the few people the patient is comfortable with

Causes and Risk Factors

The exact causes of BDD are unclear and most patients mistake it as OCD. Broadly speaking, environmental and psychological causes can lead up to BDD. Adolescents are particularly susceptible to acquiring this disorder because of rapid changes in their physical appearance. Unforeseen conditions like acne, skin disorders, baling hair at a young age, wrinkled skin and other pigmentation disorders may take a person by surprise. Surprise mixed with horrifying experiences about their condition can lead the person to be excessively concerned about their condition.

Teasing at criticism of physical defects such as braces, motley skin tone, abnormal hairstyle or acne can cause a huge psychological dent on the minds of patients, especially youngsters and teenagers. Bullying by other “better” looking classmates is known to be one of the biggest reasons for such physical-defect related obsessions.

Parenting style and the environment in which a child grows up can also force him/her into BDD. If he parents are excessively concerned about the aesthetics and their own looks, the child tends to see even minor physical defects are huge imperfections. This causes children to obsess about their physical abnormalities more than these abnormalities apparently deserve.

Such patients are exposed to a number of risk factors like

  • Depression
  • Falling prey to OCD
  • Suicidal ideation


BDD can be treated by a combination of psychological and pathological methods. The patients should undergo CBT (Cognitive behavior therapy) in order to understand and reverse their behavior when faced with their obsession about a physical feature.

SSRIs (Selective serotonin reuptake inhibitors) are commonly administered onto patients of BDD in combination with CBT. Anti-depressants like fluoxetine are also commonly used to calm down patients of BDD if they are faced with an overpowering, often distressing urge to “do something” about the physical defect they are upset about.

BDD can also be treated by administering targeted psychotherapy on patients, on a case to case basis. This can help the patients realize that their obsession about their physical condition is overblown and out of proportion.


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