Body dysmorphic disorder (BDD)
Overview
Body dysmorphic disorder (BDD), or body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others.
Symptoms
You might have body dysmorphic disorder (BDD) if you: worry a lot about a specific area of your body (particularly your face)spend a lot of time comparing your looks with other people'slook at yourself in mirrors a lot or avoid mirrors altogethergo to a lot of effort to conceal flaws – for example, by spending a long time combing your hair, applying make-up or choosing clothespick at your skin to make it "smooth" BDD can seriously affect your daily life, including your work, social life and relationships. BDD can also lead todepression,self-harmand even thoughts ofsuicide.
Causes
It's not known exactly what causes body dysmorphic disorder (BDD), but it might be associated with: genetics – you may be more likely to develop BDD if you have a relative with BDD, obsessive compulsive disorder (OCD) or depressiona traumatic experience in the past – you may be more likely to develop BDD if you were teased, bullied or abused when you were a child Some people with BDD also have another mental health condition, such asobsessive compulsive behaviour (OCD),generalised anxiety disorderor aneating disorder.
Treatment
The symptoms of body dysmorphic disorder (BDD) can get better with treatment. If your symptoms are relatively mild, you should be referred for a type of talking therapy calledcognitive behavioural therapy (CBT), which you have either on your own or in a group. If you have moderate symptoms, you should be offered either CBT or a type ofantidepressantmedicine called a selective serotonin reuptake inhibitor (SSRI). If your symptoms are more severe, or other treatments do not work, you should be offered CBT together with an SSRI. CBT can help you manage your BDD symptoms by changing the way you think and behave. It helps you learn what triggers your symptoms, and teaches you different ways of thinking about and dealing with your habits. You and your therapist will agree on goals for the therapy and work together to try to reach them. CBT for treating BDD will usually include a technique known as exposure and response prevention (ERP). This involves gradually facing situations that would normally make you think obsessively about your appearance and feel anxious. Your therapist will help you to find other ways of dealing with your feelings in these situations so that, over time, you become able to deal with them without feeling self-conscious or afraid. You may also be given some self-help information to read at home and your CBT might involve group work, depending on your symptoms. CBT for children and young people will usually also involve their family members or carers. If treatment with both CBT and an SSRI has not improved your BDD symptoms after 12 weeks, you may be prescribed a different type of SSRI or another antidepressant called clomipramine. If you do not see any improvements in your symptoms, you may be referred to a mental health clinic or hospital that specialises in BDD, such as the National OCD/BDD Service in London. These services will probably do a more in-depth assessment of your BDD. They may offer you more CBT or a different kind of therapy, as well as a different kind of antidepressant.