Dr Joanna Silver discusses body dysmorphic disorder (BDD) on Psych Central.com
Body dysmorphic disorder (BDD) is an anxiety disorder linked to body image. Sufferers of BDD will spend an obsessional amount of time worrying about one or more perceived flaws in their physical appearance. Often, these ‘flaws’ can be minor and not usually recognised by others.
When someone has BDD, they will intensely focus on appearance and body image. This can lead to constantly checking themselves in the mirror, seeking reassurance from others or grooming themselves. These obsessional behaviours can often occupy many hours each day in the lives of sufferers. As a result, BDD can cause severe emotional distress and impact someone’s ability to carry out day-to-day responsibilities.
“People with BDD have a belief that they have a perceived ‘flaw’ that makes them very ugly,” explains Dr Joanna Silver.
“They will spend a lot of time thinking about this flaw, and it will impact their life significantly.”
Body dysmorphic disorder is different from an eating disorder, Dr Silver points out.
“People with eating disorders are largely concerned with their weight and shape, whereas people with BDD are fixated on their belief they are ‘ugly’ and ‘defective,’” Silver says. “There is some overlap, however, and some people present with both BDD and an eating disorder.”
Signs someone has body dysmorphic disorder (BDD)
- They start wearing more makeup. “Those with BDD often try to hide their defect in various ways, including camouflaging their appearance — for example, by wearing lots of makeup or clothing,” says Dr Silver.
- They either start actively seeking out or avoiding mirrors and reflective surfaces. “People with BDD often have a difficult relationship with mirrors,” says Dr Silver. You might notice them spending a lot more time in front of one or avoiding reflective surfaces so they don’t have to see themselves.
- They suddenly begin talking about having plastic surgery. People experiencing BDD feel driven to “fix” their concerns. In some instances, this can extend to researching and undergoing plastic surgery procedures.
- They repeatedly ask you how they look. Silver explains, “People with BDD may compare their appearance to others and constantly ask for reassurance about how they are looking.”
- They become withdrawn. Many people with BDD feel too self-conscious or fearful of being judged to go out in public. As a result, they may actively avoid social situations and may become depressed.
How do I help someone who has body dysmorphic disorder (BDD)?
- Comfort but don’t reassure. Dr Silver explains that reassuring someone with BDD may inadvertently perpetuate their obsession. Instead, she advises on validating the way they are feeling and trying to soothe their distress, “without getting into conversations about whether their appearance is flawed or trying to reassure or reason with them,” suggests Silver.
- Listen without judgement. “Often people with BDD are very ashamed of the way they feel, so listening to them in a non-judgmental way can be very helpful,” Silver says. “Even if they do not want to always talk, just knowing you’re available to listen to them can be very comforting.”
- Encourage them to seek professional support. “People with BDD can really benefit from professional treatment, such as cognitive-behavioural therapy, which challenges their thoughts and behaviours,” Silver says.
- Be patient with them. Although someone can recover from BDD, it’s likely to be a process that will not happen overnight. “If your loved one is trying to challenge their beliefs and behaviours, it can be helpful to encourage small successes and not expect them to challenge too much too soon,” says Silver.