Body Dysmorphic Disorder
Body dysmorphic disorder (BDD) is a problem characterized by a person’s obsessive concern with a part of the body that he or she thinks is severely flawed or deformed. The anxiety that this obsession causes is extremely troubling. People with BDD often think of themselves as ugly and abnormal. When these beliefs become strong enough, many people with BDD begin avoiding social events and other places, like work, where other people might notice their “defects.” In extreme cases, people with BDD may even become housebound or leave their homes only at night, when their “defects” are harder to see.
People with BDD often spend a great amount of time checking their appearance in mirrors, store windows, spoons, and other reflective surfaces. In a study published in Behaviour Research and Therapy in 2001, people with BDD reported that they constantly checked their appearance because they hoped that when they did, they would either look better than they remembered or finally feel comfortable with the way they looked. Some of the people reported spending as long as two hours and forty-five minutes in front of a mirror checking their appearance. Unfortunately, most of these people reported that they didn’t feel better after spending any amount of time checking their appearance.
In comparison, other people with BDD behave in a very different way. They often avoid mirrors completely or keep them covered so that they don’t have to look at themselves at all.
Many people with BDD find fault with their skin, eyes, ears, nose, hair, thighs, hips, mouth, arms, feet, stomach, breasts, or genitals. They may even be extremely concerned with more than one part of their body at the same time. The supposed imperfection can be very large or very small. Other people might say that they don’t notice it or that the person with BDD is imagining the problem to be bigger than it really is. But to the person with BDD, the imperfection is glaring and embarrassing.
The obsessional concern may feel as though it’s out of the person’s control, and it might occupy most of his or her thoughts throughout the day. The person probably spends a great deal of time and goes to great lengths to change the imperfection or hide it from others. People with BDD often pick the skin of the imperfection, constantly cover imperfections with makeup or styling, or seek reassurances from other people that they can’t see the imperfection. Most likely, a person with BDD also has had plastic surgery or is currently considering it.