Body Dysmorphic Disorder (BDD)

What is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD), sometimes called imagined ugliness, is a serious and often overwhelming disorder characterized by a preoccupation with perceived appearance flaws. Although others consider individuals with BDD to be normal looking, at worst, and often extremely attractive, the individuals themselves cannot believe that. The constant intrusive thoughts about their perceived flaws lead to extreme distress and compensatory behavior (such as social avoidance and excessive grooming) and interfere with normal day-to-day functioning.

BDD can be extremely serious. The thoughts are overwhelming and bring severe anxiety attacks, depression, despair, and even suicidality. In these serious cases, patients may spend hours in front of the mirror examining themselves or trying to treat or fix their flaws. Their functioning is very impaired; the individuals may be unable to go to school or work or may even become housebound. BDD takes over their lives. For others, BDD is less severe. For the least affected individuals, the distress is manageable and they are able to function quite well, although not up to their potential, at school and in their careers. Typically, these people function less well socially and may avoid romantic relationships and marriage. Though they may look like they are doing well, BDD saps the joy out of their lives.

Every case of BDD is unique. Typical signs and symptoms of BDD:

How do you know if you suffer from BDD?

These questions cover some of the typical signs and symptoms of BDD:

Are you very concerned about the appearance of some parts(s) of your body that you consider especially unattractive? Do others not understand your dissatisfaction?
Do these concerns preoccupy you? That is, do you think about them a lot and wish you could worry less? How much time do you spend thinking about your defect(s) per day on average? Is it an hour or more?
Do you spend time trying to fix or conceal your appearance? Do you check your appearance in reflective surfaces? Do you scrutinize others and compare their features with yours?
What effect has your preoccupation with your appearance had on your life? Has your appearance caused you a lot of distress, torment, or emotional pain? Has it significantly interfered with your social life, your school work, your job, or your ability to function in other important areas of your life?

Treatment for BDD

Effective treatments for BDD are available. Research and clinical experience have shown that cognitive behavioral therapy (CBT) and certain medications (serotonin reuptake inhibitors: SRIs) are effective in treating BDD.

Most mental health professionals rarely see patients with BDD and have little experience diagnosing or treating it. Since BDD was officially recognized as a disorder in 1988, several groups have focused on studying BDD and developing treatments for it. One of the premiere research groups in this effort has been led by Eric Hollander MD in NYC; Dr. Allen was this group's chief psychologist working on BDD. Dr. Allen has worked on studies of and has written extensively on psychopharmacological treatment of BDD, but her main interest and focus has been on developing a CBT treatment for it. Dr. Allen has written articles on and lectured internationally on BDD treatment, and successfully treated many BDD patients using CBT.

For more information about BDD, its treatment or to set up a consultation, feel free to contact Dr. Allen.