Body Dysmorphia: When The Mirror Lies

Body Dysmorphia (sometimes known as BDD or body dysmorphic disorder) is a mental health condition in which the sufferer continuously worries about the flaws they perceive in their appearance. Usually, those flaws go unnoticed by others. People can suffer from body dysmorphia at any age. However, young adults and teenagers are most susceptible.

Some people are under the misconception that BDD means you’re self-obsessed or vain. In fact, this isn’t the case. Body dysmorphic disorder is actually a very distressing condition which impacts on every aspect of the sufferer’s life and has nothing to do with vanity.

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Someone may be diagnosed with BDD if they:

• Experience many obsessive worries about perceived physical flaws which other people cannot see or which are only minor.
• Develop compulsive routines and behaviors such as using mirrors excessively or picking at their skin in an attempt to relieve the anxiety they are experiencing.

For those with body dysmorphic disorder, those behaviors and obsessions are emotionally distressing, impacting on their ability to manage their daily life. It is very closely linked to another mental health disorder, OCD (obsessive-compulsive disorder).

Body dysmorphia varies in severity between different sufferers and even from day to day. In some cases, the sufferer is so concerned about their appearance that they struggle to see others or go out of the house. This anxiety clearly has a significant impact on relationships.

Body dysmorphic disorder causes a host of other issues, including:

• Feelings of loneliness, guilt or shame
• Isolation to avoid discomforting situations
• Anxiety or depression
• Misuse of drugs or alcohol
• Feeling the need to have an unnecessary medical procedure or cosmetic surgery
• Self-harm
• Eating disorders
• Suicidal thoughts

Unfortunately, many sufferers fail to get help as they’re worried they will experience judgment by others or thought to be vain. For this reason, most sufferers remain untreated for extended periods before finally getting the support they need.

What Are The Symptoms Of Body Dysmorphia?

You may be suffering from Body Dysmorphia if you:

• Worry excessively about one body part
• Spend excessive amounts of time comparing your appearance with other people
• Look frequently in mirrors or, alternatively, avoid looking in mirrors completely
• Spend an excessive amount of effort on concealing flaws by choosing clothes or applying makeup
• Pick at your skin in an attempt to smooth it

Some common worries that those with body dysmorphia experience include feeling that either one part of their body or sometimes several are:

• Disproportionate
• Too large or small
• Asymmetrical
• Disfigured

Although BDD affects all parts of the body, some of the most common areas which cause anxiety include the genitals, lips, chin, nose, hair, and skin.

BDD And Its Link With Eating Disorders

There are a number of similar symptoms shared between eating disorders and BDD. In both cases, sufferers have a poor body image and worry excessively about their physical appearance. In both cases, they also develop compulsive behaviors to help them deal with their worries. Yet eating disorders and BDD are not the same things. If someone is suffering from an eating disorder like anorexia or bulimia, their main concern is about their shape and weight. Somebody with BDD usually experiences other concerns about their body, for example, fear about one of their facial features being uneven or distorted. Some people who have BDD also have an eating problem, but not everybody with an eating disorder suffers from BDD.

What Sort Of Compulsive Behaviors Does Someone With Body Dysmorphia Display?

If you’re suffering from BDD, you will eventually develop some compulsive routines and behaviors to help you cope with your anxiety. It’s likely that you’ll spend a considerable amount of time every day repeating these behaviors which may either briefly reduce the worries or may you actually feel worse.

Some common compulsive behaviors displayed by those with body dysmorphia include:

• Obsessive checking of their appearance
• Using a lot of makeup to hide perceived flaws
• Changing their posture or wearing baggy clothes to disguise their shape
• Constantly seeking reassurance about their appearance
• Excessively exercising
• Frequently checking their body with their fingers
• Picking at their skin to try to smooth it
• Excessively using tanning products
• Frequently weighing themselves
• Styling or brushing their hair obsessively
• Comparing themselves constantly with others around them
• Seeking surgery, whether medical or cosmetic, to improve their perceived flaws

What Is The Cause Of BDD?

Nobody really knows the exact cause of body dysmorphia, however recent studies have suggested there could be several risk factors which put you at a higher risk of experiencing BDD. These include:

• Bullying or abuse
• Poor self-esteem
• Fear of isolation or loneliness
• Genetics
• Perfectionism or being competitive with others
• OCD, anxiety or depression

Bullying and abuse can cause someone to have a poor self-image and also may lead to obsessions about appearance. Young adults and teenagers particularly have a higher sensitivity about their changing body and appearance and so are at risk of developing BDD at this challenging time in their lives.

People with poor self-esteem often become obsessed on the elements of their appearance they feel need to be improved, while those who are afraid of not fitting in or of being isolated may develop worries about the way they look if they believe that they must look a particular way to find a relationship or maintain friends.

Anyone who tries to appear perfect physically or who regularly compares the way they look with other people are much more at risk of developing body dysmorphia. Those with a job or hobby which focuses primarily on the body like modeling, gymnastics, or bodybuilding are at an even greater risk.

There is also some evidence which suggests that body dysmorphic disorder is more common in those who have a family member with the same condition. However, it’s hard to be certain whether the symptoms are actually inherited through parental genes or simply learned from their behavior.

People who suffer from other mental health conditions like OCD, anxiety, or depression also have a greater chance of suffering from BDD. It isn’t clear, however, whether these mental health problems cause BDD or if BDD causes those other issues.

How Can I Get Help For Body Dysmorphia

If you’re worried that you may suffer from body dysmorphia, it’s very important not to suffer in silence. You needn’t worry about being judged or about people thinking that you’re vain. It’s imperative to seek support as quickly as possible for your condition. Unfortunately, too many people with BDD wait for many years before finally getting the help they need, and this leads to a lot of misery and distress, not to mention other mental health issues.

Talking to a friend or family member about your worries is often an excellent first step, but you should really go and visit your doctor to discuss your symptoms. Your doctor will probably ask many questions about the symptoms you’re displaying and the way in which they’re impacting on your life. You’ll probably also be asked whether you’ve ever thought about hurting yourself. Your doctor may then be able to offer you treatment themselves or may give you a referral to mental health specialists who can assess you thoroughly and get you the help you need.

While it’s never easy to get help for body dysmorphia, it’s vital to remember there’s nothing at all to be embarrassed or ashamed about. Getting help is essential since it’s unlikely your symptoms will go away if you don’t get any treatment and they will actually probably get worse over time.

What Are The Treatments For Body Dysmorphia?

The good news for anyone suffering from BDD is that it is possible to get better if you receive the right treatment.

Anyone with fairly mild symptoms can benefit from talking therapies like CBT (Cognitive Behavioral Therapy) which may be on a one to one basis or as part of a group. Cognitive behavioral therapy helps BDD sufferers to manage their symptoms by changing the way in which they behave and think. CBT helps sufferers to learn what triggers their symptoms and teaches them different ways to think about their habits and to deal with them. Goals are agreed on for therapy and the patient works with their therapist to reach them.

Usually, CBT for BDD includes a technique called ERP (exposure and response prevention). This involves facing situations gradually which make the sufferer normally think about their appearance obsessively and so become anxious. The therapist helps the patient to find new ways to deal with their feelings in such situations so that, with time, they will start to be able to cope with them with no fear or self-consciousness.

CBT usually involves being given homework to do between sessions and there may also be some group work involved depending on the sufferer’s symptoms. In the case of young people, CBT may involve carers or family members.

Someone with more serious symptoms will benefit from both talking therapies and antidepressant medications called SSRIs (selective serotonin reuptake inhibitors). While there are several SSRIs which may be prescribed for BDD, the most common one for this condition is Fluoxetine. It can take as long as 12 weeks before SSRIs show any effect, so it’s important to take them for at least 6 months to ensure symptoms are improved and won’t return.

Although SSRIs do have some side effects, these usually pass after a few weeks. During this time, patients are closely monitored by their doctor and are encouraged to report back if they’re feeling especially emotional or anxious or if they feel like harming themselves.

Once the sufferers no longer have any symptoms, they may have their dose of SSRIs gradually reduced to help avoid relapsing and any negative withdrawal symptoms like anxiety.

Young people with very severe BDD symptoms may be given SSRIs as well as therapy.

There are other treatment options too. If both SSRIs and CBT fail to help the symptoms of BDD after twelve weeks, there are other, different types of antidepressant which can be tried.

Self Help For Body Dysmorphia

If you are suffering from body dysmorphia, there are also a number of things you can do to help yourself as well as seeking medical advice. Joining a support group is often a good idea, where you can meet other sufferers with similar symptoms and share practical advice about how to cope with BDD.

There are also a number of things you can do to improve your mental wellbeing. Lots of people find that practicing mindfulness exercises are beneficial when they are feeling anxious or low, while others find that breathing and relaxation exercises are helpful in relieving anxiety and stress.

Maintaining as healthy a lifestyle as possible is important to give yourself the best chance of combating your mental health condition. Eating regularly and having a healthy diet is always important, and taking exercise can also help to relieve stress and to improve feelings of well-being.

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Body dysmorphia is a distressing condition which affects both males and females equally, and which impacts on people of all ages, although it is especially prevalent in young people. It can be a difficult condition to live with because it is still relatively misunderstood when compared to other mental health problems like anxiety, OCD and depression. Sufferers often fail to realize that they have BDD, and are too embarrassed or afraid to ask for the help that they need. However, it’s vital for those who are struggling with body dysmorphic disorder to recognize that they have absolutely nothing to be ashamed of, and to seek out medical support as quickly as possible.

BDD is a distressing problem but it isn’t one that is insurmountable. With the right help and treatment, it’s possible to overcome your worries about the way you look and to cope with your anxieties in a much healthier way. With the correct therapy and possibly with the right medication, you can find a way forward in your life without having to be held back by your concerns about your perceived flaws.