What it is
Body Dysmorphic Disorder is a mental health condition marked by preoccupation with perceived flaws in appearance (skin, hair, nose, body shape, muscles, etc.) that others see as minor or not noticeable. The concern causes significant distress or time-consuming behaviors (mirror checking, camouflaging, comparison, reassurance-seeking, skin picking). BDD is treatable.
BDD is different from typical appearance concerns: the worry is intense, persistent, and disruptive.
Common signs and symptoms
- Preoccupation: hours spent thinking about a “flaw” daily
- Behaviors: mirror checking or avoidance, excessive grooming/makeup, skin picking, changing clothes repeatedly, taking or avoiding photos, seeking constant reassurance, comparing with others
- Avoidance: skipping social events, work/school, dating; avoiding bright light or close distances
- Muscle dysmorphia: believing one’s body is too small/insufficiently muscular despite normal or muscular build
- Impact: depression, anxiety, isolation; frequent dermatology/cosmetic consultations with limited satisfaction
Cosmetic procedures rarely resolve BDD distress and can worsen it.
Why it happens
- Brain and cognitive factors: heightened error detection, detail-focused visual processing, perfectionism
- Psychological and social factors: teasing/bullying, social comparison, cultural pressures, trauma
- Co-occurring conditions: depression, social anxiety, OCD-spectrum traits
What helps
- First-line therapy: CBT tailored for BDD
- Exposure and Response Prevention (ERP): gradually reduce camouflage/rituals and face feared situations (e.g., bright light, photos) without safety behaviors
- Cognitive work: challenge appearance assumptions and “zoom out” from detail to whole-person view
- Reduce reassurance and checking cycles
- Medications:
- SSRIs at therapeutic doses for BDD can reduce obsessions/compulsions and distress
- Lifestyle supports:
- Sleep consistency, stress reduction, gentle movement
- Media hygiene: limit body-comparison triggers; diversify your feed with body-neutral/positive content
- Caution:
- Cosmetic procedures are not recommended as treatment for BDD; they seldom help the underlying concern
When to seek help now
- Hours lost daily to appearance worries or rituals
- Avoiding important parts of life due to appearance concerns
- Skin picking causing injury/infection
- Thoughts of self-harm or not wanting to live (seek urgent help)
How to talk to a clinician
- “I spend several hours daily worrying about [feature] and do repeated checking/camouflaging. It’s affecting work and social life. I’d like CBT for BDD (with ERP) and to discuss SSRI options.”
Outlook
With CBT-BDD and, when needed, medication, most people see meaningful reductions in distress, rituals, and avoidance—and greater confidence in daily life.
Resources for readers in the USA
- Immediate help: Call/text 988; Crisis Text Line text HOME to 741741; Veterans: 988 then 1; The Trevor Project: 1-866-488-7386 or text START to 678678
- Find care: Psychology Today (filter for BDD/ERP/CBT); FindTreatment.gov; NAMI HelpLine (nami.org/help)
- BDD-specific: International OCD Foundation (IOCDF) BDD resources: iocdf.org
- Low-cost/community: Open Path Collective; Community Health Centers (findahealthcenter.hrsa.gov); 211
- Insurance tips: Ask about in-network mental health benefits, telehealth, deductible, copay/coinsurance, prior authorization, out-of-network reimbursement, out-of-pocket max; note rep name/date/reference number
- Work/school supports: ADA accommodations if substantially limiting; EAP; campus counseling
- Urgent options besides ER: Mobile Crisis via 988 (where available), behavioral urgent care
Disclaimer: Educational information, not a diagnosis. If in crisis, use the resources above.