Body dysmorphic disorder, also called BDD, is an obsession with an imagined or minor flaw in one's looks. The affected person looks normal to others, but not to him or herself. BDD distresses the person and may impair social or work functioning.
The symptoms usually appear when the person is 15 to 20 years old. A person with BDD may become totally preoccupied and obsessed with his or her body appearance. This obsession can take over the person's whole life.
Symptoms of BDD include a preoccupation with a perceived physical flaw. This flaw may be minor, or even imagined. Behaviors that can indicate BDD include: often looking in the mirror and other reflecting surfacesoften comparing appearance with that of otherscovering up some aspect of appearance with clothing, makeup, hat, hair, or handoften touching the supposed defectexcessive groomingavoiding having photos taken
There is no single clear cause for body dysmorphic disorder. Biological, psychological, and even social or cultural factors are thought to contribute.
The disorder is more common among women than men. Someone with this disorder is more likely to be single. He or she may have a history of depression, anxiety, or psychosis.
There is no known prevention for BDD.
Diagnosis of body dysmorphic disorder can be difficult because the person often keeps his or her symptoms secret due to shame. The diagnosis is based on the symptoms. In addition to a medical history, a psychological and social history is also taken.
Some people with BDD function fairly well. Others may be incapacitated by their symptoms. The ability to work, do schoolwork, manage a household, attend school, and function socially can be affected.
Many people with BDD become depressed, and some may consider suicide. A person with this disorder is more likely to seek plastic surgery to "correct" the perceived flaw. In more severe cases, he or she may seek many surgeries to alter his or her looks.
Body dysmorphic disorder is not contagious and poses no risk to others. However, relationships with others may be affected.
Antidepressant medicines can control the symptoms of BDD. Counseling is often used to help the person deal with depression and anxiety. Cognitive-behavioral therapy may be used. The therapist helps the person change problematic beliefs and create more realistic beliefs and attitudes.
At times, surgery is used to correct the perceived flaw. This is often unsuccessful, because the root of BDD is more psychological than physical.
Side effects of the medicines used to treat BDD vary but may include drowsiness and allergic reactions. Surgery can be complicated by bleeding, infection, and allergic reaction to anesthesia.
It may take up to 3 months for medicine to take effect. If surgery is done, the person often needs ongoing psychological treatment, since surgery alone will not resolve his or her negative self-image.
Ongoing counseling may be needed to help the person with BDD deal with anxiety or depression and to improve function at work and home.
Principles and Practice of Psychiatric Nursing, 4th edition, Stuart and Sundeen, 1991
Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994
Body Dysmorphic Disorder: When Appearance Becomes an Obsession, [hyperLink url="http://www.worldcollegehealth.org/031199.htm" linkTitle="www.worldcollegehealth.org/031199.htm"]www.worldcollegehealth.org/031199.htm[/hyperLink]
