Body dysmorphic disorder and how we can help

What is body dysmorphic disorder?

Body Dysmorphic disorder (BDD) is a mental health condition where an individual spends a large amount of time worrying about a perceived flaw in their appearance which is often unnoticeable or seen as minor by others. The individual usually spends at least an hour a day (collectively) pre-occupied by this flaw which causes distress. The person can experience intrusive thoughts and engage in repetitive checking behaviours to ease the distress they suffer. Behaviours may include: looking at themselves in reflective surfaces, trying to camouflage, alter or minimise their perceived flaw or avoiding situations which may trigger feelings of anxiety (e.g. social situations where they feel they may be seen and judged by others). BDD is also associated with feelings of shame for the individual and understandably can be very distressing to talk about with others for fear of appearing vain or self-obsessed.

Actions that can help

1. Try and identify what can trigger your symptoms. Awareness of early warning signs can help you better manage your symptoms.
2. Be more active. Physical activity and exercise can help to ease some of the common symptoms of BDD such as low mood and feeling anxious.
3. Seek help. It can be difficult to seek help for BDD as some people worry about being judged or that they won’t be taken seriously but instead be viewed as self-obsessed. The sooner you reach out for support the sooner you can start to feel better.
4. Look after yourself. By being mindful of your diet and sleep and engaging in regular exercise, you can help to improve your overall mental wellbeing which can build resilience and resources.
5. Use self-help. There are many resources that you can access to help manage BDD such as online courses and books based on Cognitive Behavioural Therapy (CBT) principles. Some people find attending support groups helpful. Check out the BDD Foundation, OCD-UK and OCD Action websites for information on support groups and self-help materials.

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Symptoms

The most common symptoms of BDD are:

• Worry and preoccupation about a specific area of your body (particularly your face).
• Time spent comparing your appearance with that of other people.
• Increased amounts of time spent looking at yourself in mirrors or other shiny surfaces or avoiding mirrors altogether.
• Attempts to conceal flaws by for example by combing your hair in a particular way, and spending increased amounts of time applying make-up or choosing clothes.
• Picking at your skin to make it “smooth”.

These behaviours are completed in an attempt to make a person feel better (e.g. camouflaging) or to confirm the belief that you do look as bad as you thought (e.g. checking your appearance). However, these behaviours, although reducing anxiety in the short-term, can lead to an increase in preoccupation and distress with your appearance and how you look.

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Treatment

BDD can differ in its severity and intensity, and the treatment offered to you will depend on these factors. The two main types of treatment consist of talking therapy and medication. Depending on your previous experiences and how much your symptoms are affecting your daily life, you may be prescribed one or both of these forms of treatments.

For those experiencing mild forms of BDD, you will likely benefit from either individual or group talking therapy called Cognitive Behavioural Therapy (CBT). This will usually involve looking at your worries in detail and behavioural work to check out these worries. Moderate symptoms of BDD, or those that haven’t responded well to CBT in the past may be helped by the addition of antidepressant medication which when taken consistently should help to manage symptoms. In more severe cases, CBT and medication may also be offered together, or your therapist may suggest a more intensive course of CBT.

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How to get help

To access treatment for BDD, you could start by talking to your GP as they will be able to refer you to a specialist for further assessment. Some people find it hard to talk about their BDD and therefore difficult to access help. It is important to try not to let feelings such as embarrassment or shame get in the way of getting the help you need. BDD is treatable and people should not suffer in silen

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Body Dysmorphic Disorder - Five facts

1. BDD affects seven in every 1,000 people in the UK.
2. BDD affects both men and women equally, but the bodily areas of focus tend to be different.
3. Rates of depression and social anxiety can be increased in those with BDD.
4. The causes of BDD are multifactorial, including environmental, psychosocial, genetic and biological influences.
5. With the right support, BBD symptoms can be managed and treated.

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