An introduction to Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) has for a long time been an under recognised and an under researched area in mental health. This has led to a lot of people suffering in silence and not being able to access the help they need. Over the last couple of years, BDD has been receiving a greater input of resources and media attention and now has a fantastic charity dedicated to supporting BDD sufferers, The BDD Foundation. Whilst there is still a lot more to do, this is a positive for all those that are passionate about the field, and more importantly the people whose everyday lives are overruled by BDD.

So, what is BDD? BDD is a mental health condition that has a number of similarities with Obsessive-Compulsive Disorder (OCD) in that it can involve a great deal of obsessional thoughts and compulsive behaviours. However, in BDD these obsessions and compulsions revolve a perceived defect regarding ones appearance. Whilst to an outside person this feature may be unnoticeable or very minor, to the person with BDD it can cause extreme distress and can consume their lives. There are many compulsions and behaviours that a person with BDD may exhibit to try to compensate for the often constant bombarding thoughts about their perceived deficit. This may include spending extended periods of time, in extreme cases many hours at a time, in front of mirrors checking the feature in detail, taking pictures of the feature to review, avoiding daily tasks so as to avoid contact with people who may judge them for their perceived defect, and camouflaging or covering body parts.  Unsurprisingly, low mood, a deep sense of shame and clinical depression often go hand in hand with BDD.

People always say I’m really vain. Do I have BDD? If you are spending time looking at yourself in the mirror, admiring your appearance, then you are extremely unlikely to have BDD. Those with BDD are looking in mirrors, monitoring and editing their appearance due to an internal feeling of disgust at their appearance. They are not admiring themselves but are constantly monitoring their perceived defect. People with BDD are in fact often quite secretive about their disorder as they do not want to be judged negatively by others and therefore they are unlikely to exhibit behaviours publicly that would cause their friends to see them as vain. In fact, they are likely to withdraw from social situations in order to avoid these judgements.

I think I may have BDD, what do I do? If you feel that you have BDD then it is important to know that treatment is available and effective - and there are a number of charities and skilled clinicians that are there to support you, so you are not alone.  After having spoken with your GP, it is important to be assessed by someone who has experience with assessing and treating BDD, whether in the NHS or private services.  The primary form of therapy that will be offered is Cognitive-Behavioural Therapy (CBT) for BDD which is specifically designed to target and treat BDD (not the same as generic CBT).

It is hoped that this brief article has helped to highlight the problem of BDD to an audience that may have not heard of BDD before. We hope to increase awareness of BDD and help reduce the shame and stigma that often comes with this disorder.  This article has simply scratched the surface of what BDD is and instead gives a basic idea of the disorder. If you are interested in learning more about this disorder then we encourage you to go to The BDD Foundation website.

Author Jack Ball, Assistant Psychologist, themindworks, a private psychology practice

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