Am I Body Dysmorphic? Understanding The Signs And Symptoms Of Body Dysmorphia

In an age where unrealistic beauty standards and social media filters make it easy to cover up our “flaws,” feelings of insecurity can be common. Many of us may have times when we compare ourselves to these “ideals” and then think about perceived defects in our appearance we wish we could change. 

But body dysmorphic disorder (BDD) goes beyond the occasional feeling of doubt or insecurity. Instead, those living with BDD may experience intense preoccupation with perceived flaws or defects in one’s appearance, which can cause significant distress and negatively impact their daily lives. If this is something you’re experiencing, you are not alone: estimates suggest that BDD affects around 2.4% of adults in the U.S. overall.

Whether you are here seeking solace, knowledge, or a way to assist someone you love, we'll provide you with the resources to understand what BDD is, its common signs and symptoms, and where to turn for help.

Understanding the basics of body dysmorphia

Though many people may feel self-conscious about their appearance from time to time, there is a significant difference between these occasional feelings and body dysmorphic disorder. Those living with BDD may feel anxious about their body or appearance, causing them to fixate in a way that can be detrimental to their mental and physical health.

What is body dysmorphic disorder?

To meet the diagnostic criteria for BDD, an individual must also at some point engage in repetitive behaviors or mental acts in response to their appearance concerns; these might include things like skin picking, checking their appearance in the mirror, or comparing their appearance to the appearance of others.

The DSM first recognized Body Dysmorphic Disorder as a mental health condition in 1980, but the history of the condition goes back much further. In the late 1800s, an Italian psychiatrist named Enrico Morselli used the term "dysmorphophobia” to describe a condition in which people perceived themselves as flawed without having obvious physical deformities. Today, BDD is classified in the DSM-5 under obsessive-compulsive and related disorders.

While BDD can cause significant distress on its own, research has found that BDD is also significantly associated with depression, anxiety, and stress, and that untreated BDD may be linked to an increased likelihood of self-harm, eating disorders, and suicidal tendencies.

Living with body dysmorphic disorder can be a deeply isolating experience and can often involve intense feelings of shame. Those living with BDD may find themselves in strained personal relationships or feeling disconnected from friends and family members due to feelings of shame or embarrassment. While many people living with BDD may be able to maintain a career, the preoccupation with perceived physical flaws can negatively impact performance and productivity. 

Common misconceptions and myths about BDD

Despite the prevalence and seriousness of body dysmorphic disorder, there are still many misconceptions and myths surrounding the condition.

Common myths about BDD include:

• BDD is the same as eating disorders like anorexia or bulimia.

• People with BDD are just vain or attention-seeking.

• People with BDD can get rid of distress by getting cosmetic surgery to “fix” perceived physical flaws.

• Recovery from BDD is impossible.

These misconceptions can lead to stigmas and a lack of understanding of BDD, which can be detrimental to people living with the disorder and may discourage people from seeking help. 

Signs and symptoms of body dysmorphic disorder

Now, let's take a look at some of the signs and symptoms of body dysmorphic disorder. This list is not exhaustive, but it captures some of the common signs of this mental illness. 

For more information, consider speaking with a mental health professional about your body image concerns or to take a body dysmorphia test. 

Preoccupation with physical appearance

Those living with BDD may exhibit an obsessive focus on their physical appearance. Perceived flaws may be magnified, with the person fixating on what they consider to be defects in their physical features. This focus can lead them to unhealthy comparisons with others and feelings of intense shame or self-loathing.

In addition to these feelings, people living with BDD may also engage in repetitive behaviors such as excessive mirror checking, excessive grooming, hair styling, makeup application, or skin picking. These behavior patterns can be difficult to break due to the person's distorted perception of their physical appearance.

Avoidance and social isolation

Heightened self-consciousness and shame can lead to an avoidance of social situations. A person with BDD may fear that others will notice the “flaws” they perceive in themselves, and they may avoid social situations due to feeling judged or embarrassed by their appearance.

While some people with BDD may engage in frequent mirror checking (as mentioned above), others may try to avoid activities involving mirrors or photographs. Escaping these triggers can be a common reaction for those with the disorder, as it helps them temporarily avoid confronting their distress.

Some individuals may also wear baggy clothes to hide their physical appearance. 

Seeking cosmetic procedures with little satisfaction

In an attempt to conceal or fix perceived physical flaws, people living with body dysmorphic disorder may seek out frequent cosmetic procedures such as plastic surgery or weight loss solutions. Additionally, they may engage in extreme dieting or exercise habits to achieve a desired appearance.

These behaviors are often unhelpful and can lead to further distress due to feeling unsatisfied with the outcome of treatments. People living with BDD often feel that no amount of change is enough and become trapped in an endless cycle of seeking out cosmetic procedures without ever reaching relief.

If you or someone you know is exhibiting the signs and symptoms of body dysmorphic disorder, help is available. A mental health professional can provide support and resources to assist you in managing your distress and improving your daily functioning. 

Risk factors for body dysmorphic disorder and similar mental health conditions

The exact causes of body dysmorphic disorder are not known, but there are several factors that may increase the risk of developing the disorder, including: 

• Genetic factors: Genetics may play a role in the development of BDD. A person with a first-degree relative who has BDD may be more likely to develop the disorder as well. 

• Brain differences: Differences in brain structure, brain chemistry, and brain function may also impact the development of BDD.  

• Negative childhood experiences: Adverse experiences in childhood, such as neglect, abuse, or bullying about appearance, may also increase the risk of developing BDD. These negative experiences can lead to self-consciousness and shame that may persist into adulthood.

• Cultural and societal pressures: A range of social and cultural factors may also be at play, such as pressures from social media, pop culture, and media depictions. For instance, social media can have an immense impact on society's perception of beauty standards and physical perfection. This pressure can make people feel inadequate or unattractive.

Treating body dysmorphic disorder with a mental health professional

If you are living with body dysmorphic disorder, know that help is available. Common treatments for BDD include therapy, medication, or a combination of the two. 

One type of therapy that is often used to treat BDD is cognitive behavioral therapy (CBT), which can help individuals recognize and challenge their unhelpful thoughts and behaviors related to body image. CBT can be conducted in person or online.

Some of the common symptoms of BDD such as avoiding social situations may make traveling to an office or seeing a therapist in person feel difficult or overwhelming. With online therapy, you can meet with a licensed therapist wherever you have an internet connection, so you can have sessions from the comfort of your own home, which may feel easier for some people with BDD symptoms. 

Research has found that CBT delivered online can be effective for individuals with body dysmorphic disorder. For instance, a 2019 research study examined the long-term outcomes of a therapist-guided internet-based CBT program for BDD, and it concluded that the online therapy program was “an effective treatment for BDD” and that the patients’ gains were maintained in the long term. 

Beyond therapy, if you are interested in exploring medication, talk with your doctor to learn more. In addition to these professional treatment options, self-care activities such as mindfulness and meditation may be helpful, as they may help reduce stress and promote relaxation and awareness. Some people may also find support groups to be a helpful way to connect with others and stay on track with recovery.