Body Dysmorphic Disorder (BDD) Symptoms

Posted by in Body Dysmorphic Disorder (BDD) Symptoms of Body Dysmorphic Disorder (BDD) Body dysmorphic disorder (BDD) is a somatoform disorder that closely resembles obsessive-compulsive disorder (OCD). Symptoms of body dysmorphic disorder include excessive concern about perceived physical flaws, defects, or imperfections. Individuals with body dysmorphic disorder become obsessed with these unwanted aspects of their appearance and perform a variety of rituals and avoidance behaviors in order to disguise or conceal these “flaws.” BDD symptoms typically result in extreme distress and a variety of social and occupational difficulties. Body dysmorphic disorder symptom areas vary between individuals and commonly focus on the skin, hair, weight, and specific facial features, such as the nose (Philips, 2005). In The Broken Mirror (2005), Dr. Philips breaks down the frequency of different types of BDD concerns: Skin 73% Genitals 8% Hair 56% Cheeks/cheekbones 8% Weight 55% Calves 8% Nose 37% Height 7% Toes 36% Head size/shape 6% Abdomen 22% Forehead 6% Breasts/chest/nipples 21% Feet 6% Eyes 20% Hands 6% Thighs 20% Jaw 6% Teeth 20% Mouth 6% Face size/shape 20% Back 6% Legs overall 18% Fingers 5% Lips 12% Neck 5% Buttocks 12% Shoulders 3% Chin 11% Knees 3% Eyebrows 11% Ankles 2% Hips 11% Body build/bone structure 1.50% Ears 9% Facial features  general 1.40% Arms/wrists 9% Facial muscles 1% Waist 9% In my South Florida (Palm Beach County) psychological practice, I often treat individuals with body dysmorphic disorder whose BDD symptoms focus on specific facial features or skin quality.  They often worry about facials scars, pores, dimples, moles, birthmarks, skin tags, hair, wrinkles or lines, under-eye circles, or general facial symmetry.  Some men have symptoms that include a preoccupation with muscle growth and development. This is sometimes referred to as muscle dysmorphia, or “manorexia”, and often involves a preoccupation with muscle symmetry and fears about being “too skinny” or “too small”. Regardless of the body area of concern, BDD involves appearance-related perfectionism. For people with body dysmorphic disorder, concerns about body symmetry are quite common.  Individuals may worry about the symmetry of specific body parts (breasts, buttocks), facial features (eyes, eyebrows, ears), or the distribution of body hair.  Other individuals experience excessive concern about scarring from elective cosmetic procedures or enhancements (e.g., over-concern about the appearance of one’s breasts following breast augmentation). Symptoms of body dysmorphic disorder are maintained by rituals and avoidance behaviors. These behaviors are often targeted in treatment of BDD in the context of exposure and response prevention (ERP). Although...
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Body Dysmorphic Disorder (BDD)

Posted by in Body Dysmorphic Disorder (BDD) What is Body Dysmorphic Disorder (BDD)? Body dysmorphic disorder (BDD) is not formally classified as an anxiety disorder; however, it shares many overlapping features with anxiety disorders like obsessive-compulsive disorder (OCD). In contrast to OCD which typically focuses on specific external feared outcomes, body dysmorphic disorder involves hyper-attention to one or more perceived bodily defects, imperfections, or flaws.  BDD “flaws” are experienced as distressing and intolerable. In some cases, the imperfections that bother individuals with body dysmorphic disorder can be perceived by other people, but BDD magnifies and distorts these imperfections in the eyes of the sufferer.  In other cases, individuals with BDD notice and attend to “flaws” that cannot be readily perceived by others.  Regardless of the form of one’s symptoms, body dysmorphic disorder is associated with extreme distress and shame.  Moreover, because BDD-related “flaws” are often perceived as being permanent, inescapable, or un-fixable, many individuals with body dysmorphic disorder experience hopelessness, depression, self-loathing, and suicidal thoughts. Due to shame about their appearance, many people with BDD go to great lengths to keep their symptoms a secret. Individuals with body dysmorphic disorder often use mirrors to check or scrutinize their appearance.  They also engage in a variety of avoidance behaviors in order to mask or hide their perceived defect(s) from others.  They often avoid going out in public (e.g., skipping class or work), limit involvement in situations in which they might be the center of attention (e.g., dating), or spend excessive time trying to camouflage, disguise, or alter their appearance.  Preparation for leaving the house may involve elaborate grooming behaviors that span hours every day. Although many people have sensitivities about certain aspects of their appearance, typical sensitivities do not reflect BDD.  By comparison, symptoms of body dysmorphic disorder are extremely distressing and potentially disabling. The checking and grooming rituals that characterize body dysmorphic disorder resemble the compulsive behaviors found in obsessive-compulsive disorder.  However, there are some notable distinguishing features between individuals with OCD and BDD.  One of the major differences between OCD and BDD is the degree to which one recognizes his/her rituals as excessive or unreasonable.  Although individuals with OCD experience extreme anxiety about their particular feared outcome (e.g., fear of getting sick, fear of hitting someone with their car), they often recognize that their rituals are excessive.  This is particularly true when the individual is not actively exposed to a symptom trigger. In contrast, body dysmorphic disorder tends to...
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