More threads by David Baxter PhD

David Baxter PhD

Late Founder
The XYZs of Body Dysmorphic Disorder (BDD)
by Bill White
Feb 3rd 2011

Tens of millions worldwide endure it. 80% have considered suicide. And the suicide completion rate is double that of major depressive disorder. What emotional/mental health disorder am I talking about? Body Dysmorphic Disorder (BDD)

Imagine being consumed - beaten down - by the fact that you have some sort of horrible defect in your physical appearance. And you're sure it'll have others view you as repulsive.
Of course, the defect(s) is perceived - others don't notice.

What Is BDD?
Very simply, BDD is a condition characterized by over-the-top preoccupation with an imaginary physical defect. And the preoccupation is of such magnitude that one's routine life-functioning is turned upside down. BDD typically presents in adolescence and early adulthood. It strikes women and men equally.

Here's a list of the top five areas of focus for those enduring BDD, beginning with the most upsetting...

  • Skin
  • Hair
  • Nose
  • Toes
  • Weight
  • Abdomen
In addition to being misdiagnosed, BDD is all too often misunderstood as an issue of vanity. Actually, the exact opposite is true, as those enduring BDD believe themselves to be incredibly difficult to behold.

In spite of their great pain, those enduring BDD often don't seek treatment - men more than women. And two of the major reasons are a fear of being perceived as vain, and the sheer embarrassment of coming forth and being seen. Indeed, being terrified of harsh judgment and ridicule are foundational in BDD.

BDD is a curious phenomenon. If you're into categorizing, it's a fit with the anxiety and somatoform disorders. And it could easily be a manifestation of an eating disorder. With regard to the anxiety disorders in particular, its social judgment piece makes it a great match with social phobia (social anxiety disorder).

BDD Symptoms & Behaviors

Here are some common BDD symptoms and behaviors...
  • Obsessive thoughts about an appearance defect(s)
  • Obsessive and compulsive behaviors related to the defect(s) - e.g.: the use of makeup to remedy a skin flaw
  • Delusional thoughts and beliefs related to the defect(s)
  • Social and family withdrawal
  • Suicidal ideation and behavior
  • Severe anxiety and panic
  • Poor self-esteem
  • Strong feelings of shame
  • Over-dependence on a significant other, family member, or friend
  • Inability to work or go to school
  • Problems with initiating and maintaining relationships
  • Substance abuse
  • Repetitive behaviors - e.g.: applying makeup, looking in the mirror
  • Body modifications
  • Mirror/reflection checking
  • Inability to look at one's image - removing/blocking mirrors
  • Distractions such as outrageous clothing or behavior
  • Excessive skin picking, hair combing, shaving, etc.
  • Irritability and aggression
  • Seeking of reassurance
  • Excessive self-work - e.g.: exercise, dieting
  • Comparing body parts and appearance with others'
  • Obsession with research relating to repairs for the defect(s)
  • Obsession with curative procedures
  • Excessive enema use
Any notion of the existence of BDD calls for immediate intervention. Research has shown that the combination of cognitive behavioral therapy (CBT) and the selective serotonin and serotonin/norepinephrine reuptake inhibitors (SSRIs, SSNRIs) can deliver relief.

David Baxter PhD

Late Founder
See also:

  • Body Image Betrayal & Related Issues
    The Body Image Betrayal & Related Issues (BIBRI) homepage is the starting point for information regarding eating disorders and related issues, including obsessive compulsive disorder, abuse, and violence/rape. It offers various links, as well as personal experiences, poetry and a large list of alternative suggestions. It also openly discusses therapy abuse.

  • BDDCentral
    BDD Central is a good introduction to the often misunderstood and rarely discussed illness, Body Dysmorphic Disorder. While the information on the site is basic, when coupled with personal accounts and links to other BDD-related websites make it an important resource for people wishing to learn about Body Dysmorphic Disorder. The background colours and the fonts used in the website make the material a bit difficult to read, but still a good site.
Body Dysmorphic Disorder- A Serious Disease

Body Image, Eating Disorders, and Obesity
Body Image, Eating Disorders, and Obesity in Youth
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