What is BDD?
You may or may not have heard of something called “Body Dysmorphic Disorder” before, but what exactly is it? This disorder, also known as BDD, can basically be summed up as “a mental disorder involving obsessive focus on one’s real or perceived flaws in their appearance”, but it’s much more in depth than that.
If you refer to the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders: 5th Edition), which is used by professionals in the mental health field to diagnose mental disorders, the criteria for BDD are as follows:
Appearance preoccupations: The individual must be preoccupied with one or more nonexistent or slight defects or flaws in their physical appearance. “Preoccupation” is usually operationalized as thinking about the perceived defects for at least an hour a day (adding up all the time that is spent throughout the day). Note that distressing or impairing preoccupation with obvious appearance flaws (for example, those that are easily noticeable/clearly visible at conversational distance, such as obesity) is not diagnosed as BDD; rather, such preoccupation is diagnosed as “Other Specified Obsessive-Compulsive and Related Disorder.”
Repetitive behaviors: To qualify for a diagnosis of BDD, at some point during the course of the disorder, the individual must perform repetitive, compulsive behaviors in response to the appearance concerns. These compulsions can be behavioral and thus observed by others – for example, mirror checking, excessive grooming, skin picking, reassurance seeking, or clothes changing. Other BDD compulsions are mental acts – such as comparing one’s appearance with that of other people. Note that individuals who meet all diagnostic criteria for BDD except for this one are not diagnosed with BDD; rather, they are diagnosed with “Other Specified Obsessive-Compulsive and Related Disorder.”
Clinical significance: The preoccupation must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning. This criterion helps to differentiate the disorder BDD, which requires treatment, from more normal appearance concerns that typically do not need to be treated with medication or therapy.
Differentiation from an eating disorder: If the appearance preoccupations focus on being too fat or weighing too much, the clinician must determine that these concerns are not better explained by an eating disorder. If the patient’s only appearance concern focuses on excessive fat or weight, and the patient’s symptoms meet diagnostic criteria for an eating disorder, then he or she should be diagnosed with an eating disorder, not BDD. However, if diagnostic criteria for an eating disorder are not met, then BDD can be diagnosed, as concerns with fat or weight in a person of normal weight can be a symptom of BDD. It is not uncommon for patients to have both an eating disorder and BDD (the latter focusing on concerns other than weight or body fat).
BBD is considered a disorder of the obsessive compulsive type, for the reason that sufferers are not just unhappy or insecure about their appearance, they obsess over “flaws” which result in chronic anxiety, to the extent it affects daily life. However it’s different from pure OCD because this severe psychiatric disorder manifests itself in significant physical symptoms.
BBD affects around 2% of the population (men and women almost equally, with only a slightly higher diagnosis in women) and usually begins in the pre-teen years when children’s bodies first start to change. Individuals with the disorder may obsess over their body, face, or both. Due to the nagging obsession, the illness can also lead to further obsessions such as hair plucking, skin picking, excessive grooming/makeup, eating disorders, repeated cosmetic surgeries, and even depression. Sufferers spend several hours a day in a ritualistic routine, attempting to conceal or “fix” their perceived flaws, either through clothing, hours of makeup and/or grooming, or other measures. Some individuals may be incapable of leaving their home or being around others, until completing their routine to make themselves “less ugly”. Some may feel like the “ugly center of attention” whenever they enter a new place, which then leads to extreme anxiety and more worry over their perceived flaws, which effects their ability to maintain a normal social life, and may eventually lead to depression.
If left untreated, these behaviors can worsen and affect a persons ability to maintain employment or a social life; some may even become homebound or possibly even attempt suicide. In fact, 1/3 of BDD sufferers attempt suicide, and unfortunately, most of those attempts are successful.
Fortunately, treatment of this disorder is possible. Treatment usually consists of psychotherapy (such as cognitive behavioral therapy) and medications (such as selective serotonin reuptake inhibitors), and has shown to be quite helpful over time. Unfortunately, due to the sufferers shame of their false image of “imagined ugliness”, many never reach out for professional help, which is why it’s so important to help your loved one take appropriate action if you see them showing signs of BDD.
[All aspects of mental health should always be taken seriously. If you or a loved one ever feels you may be in need of help, please call this number: 1-877-726-4727]
This is a helpful link from HealthyPlace
https://www.healthyplace.com/ocd-related-disorders/body-dysmorphic-disorder/what-is-body-dysmorphic-disorder-bdd-dsm-5
This blog was written by my granddaughter, Alexandra who shares a category on my blog, Alex’s Articles. Alex has written a few other very interesting and informative blogs that you may enjoy reading.
http://themarthareview.com/category/alex-articles/
This was a great article. Thank you for sharing such detailed information and bringing light to this very important topic. I’ve struggled, undiagnosed with this for years. And it’s only now at 54 I’m able to see myself as beautiful no matter what size or weight I am.
As Alex mentioned in her blog, I’m sure there are many that go undiagnosed because of the embarrassment. I’m hoping people will read it and be able to now understand their feelings and get the help needed. Thanks for stopping by Andrea and yes you are beautiful!
Thanks for sharing this. I hadn’t heard abut BDD. My flaws are real – for everyone to see. Do I like them – no. Do I obsess – yes, sometimes. But not to the point of having a disorder. I’m your run of the mill, overweight senior citizen who is in constant diet mode. LOL
That’s how I am too Eydie, but there are others that see everything as a flaw, even though they are beautiful. Thanks for visiting Alexandra’s blog.
Very interesting!! Sometimes, it is good to read about what it takes to diagnose something like this, because then I know that what I do is not that. I am aware of and not fond of my flaws, and I am sure I notice them far more than others do. I even focus on my weight at times, which others can see. But it is clear from reading this that it takes more than that to have this diagnosis. It’s great that there are places you can go online for more information if you do think you might have a disorder, though. Great and informative article!
I didn’t even realize anything about this either Jeanine but I can see how it would effect some people. Flaws or not, we are all beautiful people! We made it through another challenge, blog on until July!
Well if in fact she has any type of a flaw mental beauty etc I have never seen it in her very strong young lady
That is true Rich, pure beauty both inside and out not to mention a talented writer. This article is an eye opener to others that haven’t heard about it.
Great post, Alex! Too many folks were not so diagnosed (and, therefore, not helped) in the past.
Thanks for your comment Roy. I had never even heard of this before Alex wrote about it. Hopefully it will help others.
SSRI’s can be dangerous. I worry whenever I read these slick professional articles that mention drugs but not their side effects.
I think a lot of teenagers spend a lot of time watching for themselves to grow up, and need to be told that ten years are going to pass at exactly the same rate whether they’re spent staring at ourselves or doing something useful. Some may even need to be told that even inflamed pimples are rarely noticed at conversational distance, and that obvious self-monitoring is an ugly thing while task-focus is much more pleasant to see.
Sometimes it really may become a disorder, but I’m also wary of people wanting to make everything into a “disorder” or “disability” to get some sort of benefits, often to the long-term cost of the young person if s/he wants to get a job some day.
Who doesn’t remember thinking “I am a repulsive teen-troll”? Models did. Movie stars did. Life has a way of correcting this misbelief. Corrections may involve getting pretty-face jobs, or attracting attractive mates, or just finding other things to do with our time and energy.
For me it took a few years to notice, “Which entry-level jobs am I getting? Which jobs are which of my friends getting? There is a reason for this. I must look better from a distance, in motion, than I do while sitting here staring at my skin imperfections.” But I *am* glad nobody told me to call it a DISORDER and mess around with SSRI’s!
Thanks for your comment Priscilla. That is true about some teenagers and their looks but it also goes farther than that on some. If a parent constantly tells their child they are ugly or have flaws, it is going to affect them in some way. There are some people that look for any reason to get benefits but there are just as many that just want a normal life. I personally know a beautiful young lady that was mentally and verbally abused when she was younger but now trying to turn her life around and leave the “flaws” that she thinks she has behind her.