Symptoms
Being extremely preoccupied with a perceived flaw in appearance that to others is unnoticeable or appears minor.
Believing that you have a terrible appearance or that you are ugly.
Engaging in behaviors aimed at fixing or hiding the perceived flaw (e.g., excessive grooming, seeking reassurance, camouflaging).
Frequently examining yourself in mirrors, comparing your appearance with that of others, or avoiding mirrors altogether.
Constantly seeking reassurance about your appearance from others.
Having significant distress about your appearance, impacting your ability to function in daily life.
Feeling anxious, depressed, or having suicidal thoughts due to your appearance.
Avoiding social situations or feeling embarrassed or ashamed.
Undergoing multiple cosmetic procedures with little satisfaction.
Causes
The exact cause of BDD is not fully understood, but it is believed to be a combination of factors:
Genetics: There may be a genetic predisposition to developing BDD.
Brain Differences: Studies suggest differences in brain structure and function, particularly in areas related to visual processing and emotional regulation.
Environmental Factors: Trauma, negative experiences related to body image, bullying, and societal pressure to conform to beauty standards may contribute to the development of BDD.
Personality Traits: Certain personality traits, such as perfectionism, anxiety, and low self-esteem, may increase the risk.
Medicine Used
The primary medications used to treat BDD are:
Selective Serotonin Reuptake Inhibitors (SSRIs): These antidepressants help regulate serotonin levels in the brain and are often the first-line treatment. Examples include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and citalopram (Celexa).
Clomipramine (Anafranil): A tricyclic antidepressant (TCA) that affects serotonin levels. It's also used in some cases. Note: Medication is almost always used in conjunction with therapy.
Is Communicable
No, Body Dysmorphic Disorder is not a communicable disease. It is a mental health condition and cannot be transmitted from person to person.
Precautions
There are no specific precautions in the way you would think of for a contagious illness. However, some preventive measures that could be taken for someone at risk of developing BDD are:
Promote Positive Body Image: Encourage a healthy and realistic view of body image from a young age.
Address Teasing/Bullying: Intervene when teasing or bullying related to appearance occurs.
Mental Health Awareness: Raise awareness about mental health conditions and reduce stigma.
Early Intervention: If someone exhibits early signs of body image concerns, seek professional help promptly. For someone with BDD:
Therapy Adherence: Stay consistent with therapy and medication regimens.
Avoid triggers: Identify and avoid situations or activities that worsen your symptoms.
Support groups: Join a BDD support group.
How long does an outbreak last?
BDD is not an outbreak-based disease. It's a chronic condition that can persist for many years or a lifetime if left untreated. Symptoms can fluctuate in severity over time. With treatment, symptoms can be managed and reduced, but complete remission isn't always achievable.
How is it diagnosed?
BDD is diagnosed by a mental health professional (psychiatrist, psychologist, or licensed therapist) using the criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Diagnosis typically involves:
Clinical Interview: The mental health professional will ask detailed questions about the person's thoughts, feelings, and behaviors related to their appearance.
Assessment of Symptoms: The professional will evaluate the severity and impact of the person's preoccupation with perceived flaws.
Rule Out Other Conditions: The professional will rule out other mental health conditions that may be contributing to the symptoms, such as social anxiety disorder or eating disorders.
DSM-5 Criteria: The diagnosis is based on meeting specific criteria in the DSM-5, including:
Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.
Repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking, reassurance seeking) or mental acts (e.g., comparing appearance with others) in response to the appearance concerns.
Significant distress or impairment in social, occupational, or other important areas of functioning due to the appearance concerns.
The appearance concerns are not better explained by concerns with body weight or shape in an individual whose symptoms meet diagnostic criteria for an eating disorder.
Timeline of Symptoms
The onset of BDD typically occurs during adolescence or early adulthood. The timeline can vary, but a general progression might look like this:
Early Stage: Vague feelings of dissatisfaction with appearance begin to emerge.
Development: The preoccupation with perceived flaws intensifies. Repetitive behaviors like mirror checking or camouflaging start.
Progression: Social withdrawal, anxiety, and depression become more pronounced. Attempts to "fix" the perceived flaws may increase, such as seeking cosmetic procedures.
Chronic Stage: If untreated, the condition can persist for years or decades, leading to significant impairment in all areas of life. Suicidal thoughts or attempts may occur in severe cases. Note: The exact timeline can vary significantly from person to person. Early intervention is critical to disrupt this progression.
Important Considerations
Suicide Risk: BDD is associated with a high risk of suicidal thoughts and attempts. It is crucial to take these concerns seriously and seek immediate help if someone is experiencing suicidal ideation.
Comorbidity: BDD often occurs with other mental health conditions, such as depression, anxiety disorders, obsessive-compulsive disorder (OCD), and eating disorders. Addressing these co-occurring conditions is essential for effective treatment.
Treatment Adherence: Treatment for BDD can be challenging, and adherence to therapy and medication is crucial for improvement.
Stigma: Stigma surrounding mental health conditions can prevent people from seeking help. Raising awareness about BDD and reducing stigma is essential.
Family Involvement: Involving family members in the treatment process can provide support and improve outcomes.
Professional Help: BDD requires specialized treatment from a mental health professional experienced in treating anxiety disorders and obsessive-compulsive related disorders.