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Body Dysmorphic Disorder

Introduction


Body dysmorphic disorder (BDD), also known as body dysmorphia, is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are usually unnoticeable to others but might seem very obvious to the individual suffering from BDD.


BDD can affect people of all ages, but is more prevalent in teenagers and young adults. It affects around the same amount of males and females, with 2.5% of males and 2.2% of females.

Causes


It is not completely clear what the exact causes of BDD are, but studies have shown that the following most likely have an effect on the probability a person might develop BDD:


  • Genetics - an individual is more likely to develop BDD if a relative has BDD, OCD or depression

  • Chemical imbalance in the brain

  • A traumatic experience in the past - e.g. child maltreatment, sexual trauma, peer-abuse

  • Negative evaluations about your body or self-image

  • Low self-esteem

  • Parents and other people who were critical of one’s appearance


Risk factors


There can be many risk factors which increase the probability of an individual developing BDD. Here are a few:


  • Relatives with BDD, OCD or depression

  • Negative life experiences

  • Certain personality traits like perfectionism

  • Societal pressure or expectations of beauty

  • Having another mental health condition, such as anxiety or depression


Symptoms


  • Worrying about a specific area of their body - the most common features that people tend to fixate on are: face, hair, skin and vein appearance, breast size, muscle size and genitalia

  • Spending a lot of time comparing their looks to others

  • Looking in mirrors a lot to check their appearance or avoiding mirrors altogether

  • Using lots of effort to cover flaws - e.g. using lots of time to brush hair, using lots of makeup

  • Picking at their skin to make it “smooth”

  • Seeking cosmetic procedures with little satisfaction

  • Avoiding social situations

  • Having perfectionist tendencies

  • Seeking reassurance of your appearance from others

  • Excessive exercise

  • Changing clothes excessively

  • May lead to depression, self harm or even suicide


Complications


Many complications, both primary and secondary, could come with BDD. Here are a few:


  • Depression or other mood disorders

  • Suicidal thoughts or behaviour

  • Anxiety disorders

  • OCD

  • Eating disorders

  • Substance misuse

  • Health problems

  • Physical pain due to repeated surgical interventions


Treatment


There are two main treatment options that doctors would suggest for BDD: cognitive behavioural therapy (CBT) and the taking of selective serotonin reuptake inhibitors (SSRIs). In most cases, these two things are adequate to help an individual manage their negative thoughts and learn ways to handle urges, but in special cases where these don’t work, a different type of SSRI may be used.


Cognitive behavioral therapy (CBT) is a type of therapy which changes the way one might think and behave through challenging negative thoughts, learning more flexible ways of thinking, and helping individuals learn what might trigger their symptoms. Those undergoing CBT might also learn alternative ways to handle their urges to reduce obsessively mirror checking, reassurance seeking or other behaviours.


Doctors might use a technique in CBT called exposure and prevention (ERP), which makes those suffering with BDD face situations that make them feel anxious and think obsessively about their appearance, and teach them ways to handle these types of situations.


Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant. In the case of BDD, fluoxetine is the most common type of SSRI prescribed. SSRIs may take up to 12 weeks to be effective, but once it starts to take effect, it is the most helpful in controlling negative thoughts and repetitive behaviours.


However, SSRIs have many common side effects, such as:

  • Feeling agitated, shaky or anxious

  • Feeling or being sick

  • Loss of appetite and weight loss

  • Dizziness

  • Insomnia

  • Headaches

If you think you are suffering from body dysmorphic disorder, please make sure to seek professional help! There are many links in our Instagram bio and website to help you!


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