A person who suffers from BDD perceives that they are flawed in physical appearance. They may believe that they look ugly, unattractive, hideous, abnormal, or deformed. These perceptions are not supported by others. Others tend to view them as “normal-looking.”
The person suffering BDD can experience distress ranging from mild to severe. The focus of concern with appearance can be anywhere on the body, but is often focused on the skin including acne, wrinkles, lines, scars or paleness.
The focus can also be on the hair or nose with concerns of thinning hair or excessive facial hair or concerns with the shape and/or size of their nose. Other concerns include the perception of asymmetry of body areas, concerns about their eyes, teeth, weight, stomach, chest, breast, legs, face size or shape, lips, chin, eyebrows, or genitals.
Common negative beliefs around the areas of concern are:
- Defective appearance: “My body part is ‘deformed’ or ‘flawed,’” “My skin is terribly scarred,” or “I’m going bald.”
- Coloring: “My legs are too pale,” “My face is too red” (or too splotchy, uneven, etc.)
- Shape/size: “My biceps are too scrawny” (may involve body build, muscle tone, muscularity, and/or the size or shape of any body area)
- Asymmetry/disproportion: “My eyebrows are uneven”
The person experiencing BDD finds their preoccupations intrusive, unwanted and can consume from 3-8 hours of their time per day. The sufferer finds the symptoms difficult to control or manage successfully. There are many ways in which the individual tries to manage the anxiety produced by their BDD. Rituals are a primary focus and can include both excessive and repetitive behaviors and mental acts. These acts in and of themselves can create anxiety and sadness.
The rituals of BDD can include:
- Comparing one’s appearance with the appearance of others.
- Repeatedly checking perceived defects in mirrors or reflective surfaces or examining them directly.
- Examining perceived defect directly.
- Excessively grooming, shaving, combing, plucking, styling, pulling out of place or unwanted hair, repeated cutting of hair to achieve symmetry.
- Camouflaging with makeup, or using hats, scarfs, or other clothing for the purpose of hiding the perceived defect.
- Reassurance seeking about how the perceived flaw looks.
- Touching areas to check.
- Excessive exercise or bodybuilding.
- Tanning to “fix” perception of pale skin.
- Seeking repeated cosmetic procedures.
- Possible compulsive shopping for cosmetics.
- Skin picking in order to smooth out perceived flaws.
Muscle Dysmorphia is a form of BDD that is generally seen in males. A person who suffers from Muscle Dysmorphia suffers a preoccupation with the idea that one’s body is too small or not lean or muscular enough. A person who suffers from Muscle Dysmorphia may engage in excessive weight lifting, excessive dieting, or potentially dangerous anabolic-androgenic steroids and other substance use to make their body bigger and more muscular.
Conclusion on BDD
We all may find ourselves on this list to one degree or another. However, BDD affects a person in such a way as to cause noticeable and painful impairment in social, occupational, or other important life attachments.
BDD affects about 1 in 50 people (2.5% of women and 2.2% of men). It is as common or more prevalent than obsessive-compulsive disorder (OCD), anorexia nervosa, and social anxiety. The onset is most common during adolescence between ages 12-17. Research suggests that people with BDD have differences in visual processing and may actually see themselves differently than other people do.
Consult an expert if you or someone you know or care about fits the above symptom profile. Low insight is not uncommon and suicide rates are high in adults/children and adolescents. You can reach the suicide hotline at 1-800-273-8255 or simply click HERE.
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