Body Dysmorphic Disorder

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KEY POINTS

• Body dysmorphic disorder causes you to dislike something about the way you look and think about it all the time.
• Treatment may include cognitive-behavioral therapy or medicine. With professional help, you may feel less anxious, depressed, and preoccupied with how you look.

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What is body dysmorphic disorder?

Body dysmorphic disorder (BDD) causes you to dislike something about the way you look and think about it all the time. You may get to the point where it is very hard to go outside or even talk to others without thinking about how you look. For example, you may worry all the time that your skin is too pale, your chest is too small, or your nose is too long. Often the flaw that you worry about is not real, or is something that others do not notice.

BDD is different from eating disorders. People with BDD may not be concerned about weight or body size. Instead, they feel that they have extremely ugly flaws of the face, hair, skin, or some other body part.

What is the cause?

The exact cause of the disorder is not known. Possible causes include:

• The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
• Someone whose family has a history of obsessive-compulsive, depression, or anxiety disorders is more likely to develop BDD. Families with very high expectations may be at higher risk for BDD.
• Neglect and abuse in childhood increase the risk for BDD.

BDD most often starts in the teen years and may continue through adulthood. It may start slowly or suddenly.

What are the symptoms?

Symptoms may include:

• Always comparing yourself to how other people look
• Constantly trying to cover or hide the area that you think is flawed
• Feeling nervous and self-conscious or avoiding other people
• Often touching, measuring, or looking at the area that you think is flawed, or completely avoiding mirrors or touching the area
• Checking with other people to see if they think the flaw is as ugly as you think it is
• Constantly thinking about your flaw
• Wanting surgery or treatment that isn't needed

You may also be anxious, depressed, or even suicidal because of always focusing on the area that you think is flawed

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.

How is it treated?

Cognitive behavior therapy (CBT) is a way to help you identify and change views you have of yourself, the world, and the future. CBT can make you aware of unhealthy ways of thinking. It can also help you learn new thought and behavior patterns. The therapist also helps you resist compulsive behaviors, such as mirror checking. Other types of therapy do not appear to be very effective in treating BDD.

Medicines may be prescribed to help you feel less anxious, depressed, and preoccupied with how you look.

What can I do to help myself?

• Get support. Talk with family and friends. Join a support group in your area.
• Learn to manage stress. Ask for help at home and work when the load is too great to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
• Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions.
• Don’t let what you see online, on TV, or in magazines affect your self-esteem. Question advertisements or articles that make you feel bad about your body shape or size. Are they are trying to sell you something? Is what they say and show true? Or, have the pictures been air-brushed or computer generated to make the person look so perfect?
• Understand that plastic surgery usually does not help. You may get addicted to plastic surgery because you can never be satisfied with the way you look.
• Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all of the medicines, natural remedies, vitamins, and other supplements that you take. Take your medicines as directed by your provider or therapist. Take mineral and vitamin supplements as recommended by your healthcare provider.
• Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse. See your healthcare provider regularly to have your weight, blood pressure, heart rate, and temperature checked.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.