Body dysmorphic disorder (BDD) is a body image disorder in which individuals are preoccupied with a perceived flaw in physical appearance, which can result in severe functional impairment and suffering. Individuals with BDD usually focus on one or more aspects of their appearance, such as skin, nose, hair, eyes (or any other part of their appearance), which they believe to be defective or ugly. Individuals with BDD often feel depressed, anxious and ashamed. Their degree of anguish and distress is such that it interferes with their day-to-day activities such as work, school, or social situations.

BDD is believed to affect 1-2% of the general population. It also affects as many as 6-14% of those in mental health settings presenting with an anxiety or depressive disorder, 10-15% of those in dermatology settings, and 6-15% in cosmetic surgery settings.

People with BDD frequently compare their appearance to others and check their appearance in mirrors or other reflective surfaces. They often camouflage their perceived flaw with make-up, hair, or clothing. They may change their body position to only allow people to see them from certain angles or in certain lighting conditions. Other behaviors include mirror avoidance, skin picking and seeking out dermatologists or plastic surgeons with the hope they can overcome the distress by changing the perceived defect.

Here are questions that might help you decide if you are experiencing symptoms of body dysmorphic disorder:

• Are you preoccupied with a specific aspect of your appearance that you believe is ugly or defective?
• Does this preoccupation cause you a lot of distress, or significantly affect your social life, your ability to work, your job performance, or other important areas of your life?
• Do you feel anxious, ashamed, depressed, or disgusted by specific aspects of your appearance?
• Do you spend more than an hour per day thinking about these specific aspects of your appearance?
• Are there behaviors do in regards to your appearance concerns, such as checking or avoiding mirrors, trying to hide parts of your appearance, or spending a long time getting ready to leave your residence?
• Have you seen doctors about changing your appearance significantly, by getting a cosmetic surgery or dermatology procedure?

If you answered yes to several of these questions, you might have body dysmorphic disorder and should seek a full diagnostic evaluation.

Fortunately, treatment is available and can often result in significant improvements in BDD symptoms.

Studies have shown that treatment with medications and/or cognitive-behavioral therapy can result in significant improvement in symptoms and functioning.

The following information is provided as a guideline and should not be used in substitution for a consultation with a mental health specialist. People with BDD may have a variety of additional problems and may experience varying responses to treatments, so a comprehensive assessment by a psychiatrist and an individualized treatment plan (ideally in conjunction with a psychotherapist) are highly recommended.

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The Neurobiology of Body Dysmorphic Disorder