People with BDD experience highly distressing thoughts about their physical appearance, or about a particular aspect of their appearance, such as their nose, eyes, or skin. They can focus excessively on their physical “flaws”, believing themselves to be ugly, deformed, unattractive or unlovable in some way. BDD usually starts during late childhood or early adolescence. BDD can be distinguished from normal appearance concerns by the amount of time that is spent worrying about their appearance, the emotional distress they feel (anxiety, sadness, self-consciousness), and the interference in their daily life that is caused by their worries.
In addition, at some point, people with BDD also spend excessive amounts of time completing various “compulsive” behaviours in response to their appearance concerns. These might include comparing their appearance with others, excessively checking mirrors, or spending a lot of time over various other grooming behaviours, for example, wearing excessive make-up, or clothing to hide or mask their appearance.
What are some of the common signs and symptoms of BDD?
- Frequent thoughts about appearance (at least an hour a day)
- Spending a lot of time staring in a mirror, or other reflective surfaces, while focusing on the perceived flaw
- In some cases, complete avoidance of mirrors, or other reflective surfaces
- Covering up the disliked body area, for example, using hats, scarves, make-up, body position, or posture
- Repeatedly asking others if they look okay; this is a form of reassurance seeking
- Sometimes seeking appointments with medical professionals or cosmetic surgeons to get the disliked body area “fixed”
- Avoiding social situations (public places, school, shops) or leaving the house less often to prevent others from seeing their “flaw”
It is important to note that people living with BDD look “normal.” The appearance flaws that they perceive are, in reality, minimal or non-existent. Accessing effective psychological therapy for BDD is very important.