Body Dysmorphia

Body dysmorphic disorder (BDD), sometimes called body dysmorphia, is when someone spends lots of time worrying about how they look. They focus on parts of their body that they think look wrong or different - but other people usually can't see these problems at all.

Who Gets BDD?

BDD can affect anyone at any age, but it's most common in teenagers and young adults. Both men and women can have it. Having BDD doesn't mean you're vain or obsessed with yourself - it's a real mental health condition that can be very upsetting.

What Are the Signs?

You might have BDD if you:

• Worry a lot about one part of your body, especially your face
• Spend ages comparing how you look to other people
• Look in mirrors all the time, or avoid them completely
• Spend hours trying to hide the parts you don't like - like doing your hair, putting on makeup, or choosing clothes
• Pick at your skin to try to make it "better"

BDD can make daily life really hard. It can affect your work, friendships, and relationships. It can also lead to feeling very low, hurting yourself, or even thoughts about ending your life.

Getting Help

If you think you might have BDD, speak to your GP. They'll ask about your symptoms and how they affect your life. They might also check if you've had thoughts about harming yourself.

Your GP might treat you themselves or send you to a mental health specialist. If you're under 18, you might be referred to children's mental health services.

It can feel scary to ask for help, but there's nothing to be ashamed about. Getting treatment is important because BDD rarely gets better on its own and often gets worse without help.

You can also refer yourself directly to NHS talking therapy services without seeing your GP first.

Treatment Options

BDD can get better with the right treatment:

For mild symptoms: You'll usually get talking therapy called cognitive behavioural therapy (CBT). This helps you change how you think and behave.

For moderate symptoms: You might get CBT or medicine called antidepressants (specifically SSRIs like fluoxetine).

For severe symptoms: You'll usually get both CBT and medicine together.

CBT Therapy

CBT helps you understand what triggers your symptoms and teaches you new ways to cope. You'll work with a therapist to set goals and learn techniques called "exposure and response prevention" - this gradually helps you face situations that make you anxious about your appearance.

Medicine

SSRIs are a type of antidepressant that can help with BDD. It can take up to 12 weeks to work, and you might need to take it for several months. Your doctor will watch you carefully, especially at the start.

What Causes BDD?

We don't know exactly what causes BDD, but it might be linked to:

• Family history of BDD, OCD, or depression
• Past trauma like bullying or abuse

Getting Support

Support groups can be helpful. The BDD Foundation has local and online groups. Organizations like Mind, Anxiety UK, and OCD Action also provide information and support.

Taking regular exercise, getting enough sleep, and trying relaxation techniques can also help your mental wellbeing.

Based on NHS.uk guidance. Written by Dr Krishnan Pasupathi, NHS GP.