SYMPTOMS AND TREATMENT OF BODY DYSMORPHIC DISORDER (BDD)

Body Dysmorphic Disorder (BDD) typically develops during adolescence. BDD is when one cannot help but think about this believed flaw in their physical appearance, this can be any part of the body but is commonly a facial feature, skin, or hair (Singh, & Veale, 2019), or an overall feeling of being unattractive (Philips, 2004). BDD occurs around the world and similarly affects people however, the beauty standard the person is trying to reflect differs between cultures. 

 The flaw they are constantly thinking about can be small or not real (Singh, & Veale, 2019), but that is not to take away from their experience as for them it is prominent (Smith, Waterman, & Veale, 2019). BDD can be categorized into two subcategories, one where the person can understand they may be wrong about how they perceive their appearance and another why they believe it to be true. BDD is followed by the behaviour of checking the flaw either by touch or looking in the mirror, hiding the flaw by makeup or clothing(Singh, & Veale, 2019), and thoughts repeating where the individual needs reassurance from others or are comparing themselves to others The cause of BDD is unsure but can be due to critical parents (Smith, Waterman, & Veale, 2019), being made fun of as a kid, lack of relations, genetics, critical parents, and being keen on aesthetics(Veale, 2004).

 Now, what differs from an individual with BDD and being self-critical at times, is that it affects the individual's life. Individuals with BDD have fewer social interactions, as they fear they will be judged for their flaws, in turn, they are less likely to be married and have few friends (Philips, 2004) . They avoid situations as they are not pleased with how they look, creating avoidance behaviour (Veale, 2004). It affects their abilities at work and school because they cannot focus, as they are too busy thinking about this flaw and how to possibly hide it. It is hard to stop thinking about the thought and can create a real sense of despair. Consequently, BDD increases the chance of suicide (Singh, & Veale, 2019). It goes past appearance and affects one overall self-esteem, those with BDD typically have low self-esteem (Kuck, Cafitz, Bürkner, et al., 2021).

 BDD coexists with other mental health issues such as substance abuse, depression, anxiety, OCD (Singh, & Veale, 2019), and an eating disorder (Perkins, 2019), we have many therapists at Vaughan Counselling and Psychotherapy Inc that can support clients with BDD, low self-esteem, and the coexisting mental health issues mentioned. 

 Now, these comorbid issues may be recognized before BDD. BDD is often missed because it's not often explained by people, as they are not aware of BDD, they are embarrassed (Singh, & Veale, 2019), and they believe it to be a physical problem and not to do with mental health (Smith, Waterman, & Veale, 2019). For All these reasons they may seek assistance to how they feel through cosmetic surgery rather than therapy. This typically does not fix the situation, not everyone who gets cosmetic surgery has BDD but those who do typically are dissatisfied afterwards, and the critical thinking is transferred to another body part (Veale, 2004). Instead, effective treatment involves educating people on body dysmorphic disorder (Philips, 2004) and asking questions to see if they exhibit symptoms of it because many will not describe those symptoms themselves (Singh, & Veale, 2019). It’s not about the flaw, but rather its impact on the individual which would be dealt with in therapy (Smith, Waterman, & Veale, 2019). Treatment involves Cognitive Behaviour Therapy (CBT) to help change negative thoughts about oneself and Exposure and Response Prevention – to change the non-helpful coping behaviour developed mentioned earlier, such as avoidance, or covering (Philips, 2004). All therapists at Vaughan Counselling and Psychotherapy Inc practice CBT and can assist you. 

Jovita would a good match for anyone looking to discuss Body Dysmorphia. For more information, and to book an appointment with a therapist please give us a call at 647-267-9853 or email us info@vaughanpsychotherapist.com

 References

Kuck, N., Cafitz, L., Bürkner, P.C. et al. (2021).Body dysmorphic disorder and self-esteem: a meta-analysis. BMC Psychiatry, 21(310). https://doi.org/10.1186/s12888-021-03185-3

Perkins, A. (2019). Body dysmorphic disorder, Nursing Made Incredibly Easy, 17 (1),  32-38. doi: 10.1097/01.NME.0000549614.97772.88

 Phillips, K.A. (2004). Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry, 3(1), 12-17. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1414653/

Singh, A.R., Veale D. (2019). Understanding and treating body dysmorphic disorder. Indian J Psychiatry, 61(1):131-135. doi:10.4103/psychiatry.IndianJPsychiatry_528_18

Smith, A., Waterman, L., & Veale, D. (2019). Recognising and managing body dysmorphic disorder. The Pharmaceutical Journal. DOI:10.1211/PJ.2019.20206935

Veale, D. (2004). Body dysmorphic disorder. Postgraduate Medical Journal, 80(940), 67-71. http://dx.doi.org/10.1136/pmj.2003.015289