Body Dysmorphic Disorder (BDD)
Is a mental disorder where an individual is excessively concerned and preoccupied with an imagined or minor defect in their appearance. They may complain of several specific features or a single feature of their appearance, or a vague feature or general appearance. The preoccupation causes them significant psychological distress that impairs important functioning (e.g. occuppational or self-care), or social aspects of their lives. Culture and clinician bias may play a significant part in the subjectivity behind determining what physical appearance is considered 'normal' and who they diagnose with this disorder.
BDD usually develops in adolescence, a time when people are generally most sensitive about their appearance. However, many patients suffer for years before seeking help. When they do seek help through mental health professionals, patients often complain of other symptoms such as depression, social anxiety or obsessive compulsive disorder, but do not reveal their real concern over body image. Most patients cannot be convinced that they have a distorted view of their body image, due to the very limited knowledge of the disorder as compared to OCD or others.
An absolute cause of body dysmorphic disorder is unknown. However research shows that a number of factors may be involved and that they can occur in combination, including:
A chemical imbalance in the brain.
An insufficient level of serotonin, one of the brain's neurotransmitters involved in mood and pain, may contribute to body dysmorphic disorder. Although such an imbalance in the brain is unexplained, it may be hereditary.
BDD often occurs with OCD, where the patient uncontrollably practices ritual behaviors that may literally take over their life. A history of, or genetic predisposition to, OCD may make people more susceptible to BDD.
Generalized anxiety disorder.
Body dysmorphic disorder may co-exist with generalized anxiety disorder. This condition involves excessive worrying that disrupts the patient's daily life, often causing exaggerated or unrealistic anxiety about life circumstances, such as a perceived flaw or defect in appearance, as in BDD.
- Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces.
- Alternatively, an inability to look at one's own reflection or photographs of oneself; often the removal of mirrors from the home.
- Compulsive skin-touching, especially to measure or feel the perceived defect.
- Reassurance-seeking from loved ones.
- Social withdrawal and co-morbid depression.
- Obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble.
- Excessive grooming behaviors: picking, combing hair, plucking eyebrows, shaving, etc.
- Obsession with plastic surgery or multiple plastic surgeries, with little satisfactory results for the patient.
- In extreme cases, patients have attempted to perform plastic surgery on themselves, including liposuction and various implants with disastrous results. Patients have even tried to remove undesired features with a knife or other such tool when the center of the concern is on a point, such as a mole or other such feature in the skin.