Body Dysmorphic Disorder
Body Dysmorphic Disorder (BDD) is characterized by a preoccupation with perceived defects in one’s appearance or an excessive concern with small physical imperfections. Although most people have some concerns about their physical appearance, for BDD the level of concern is excessive, time consuming, and causes significant distress or impairment in daily functioning. Those with BDD spend a lot of time and energy trying to reduce their feelings of distress by performing compulsions, such as excessive grooming, camouflaging the perceived defect, checking reflective surfaces, repeatedly touching or measuring parts of the body, and/or asking for reassurance from others about their perceived deficits.
Onset of BDD may occur in childhood but often begins in adolescence. BDD may not be apparent until several years after the initial onset because of the embarrassment associated with one’s physical appearance and the reluctance to reveal BDD symptoms to others. Onset may be sudden or gradual, and BDD symptoms often last a long period of time with variations in severity and course.
Approximately 1-2% of the general population has BDD. BDD affects men and women equally, although concerns may vary. For example, concerns about hairline and muscle tone are more frequent in men. BDD often leads to social isolation, in an effort to avoid perceived judgment, and many people with BDD also experience depression.
BDD can be treated using the same techniques used to treat OCD and other obsessive-compulsive spectrum disorders. A form of Cognitive-Behavioral Therapy (CBT) known as Cognitive Restructuring can be used to challenge the person’s faulty beliefs about their appearance. In addition, Exposure and Response Prevention (E/RP) is an important part of the treatment. Treatment may also include prescribed antidepressants known as selective serotonin reuptake inhibitors (SSRIs).