Body dysmorphic disorder

Body dysmorphic disorder

Overview

Body dysmorphic disorder is a mental health condition in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can't be seen by others. But you may feel so embarrassed, ashamed and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress and impact your ability to function in your daily life.

You may seek out numerous cosmetic procedures to try to "fix" your perceived flaw. Afterward, you may feel temporary satisfaction or a reduction in your distress, but often the anxiety returns and you may resume searching for other ways to fix your perceived flaw.

Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.

Symptoms

Signs and symptoms of body dysmorphic disorder include:

Being extremely preoccupied with a perceived flaw in appearance that to others can't be seen or appears minor

Strong belief that you have a defect in your appearance that makes you ugly or deformed

Belief that others take special notice of your appearance in a negative way or mock you

Engaging in behaviors aimed at fixing or hiding the perceived flaw that are difficult to resist or control, such as frequently checking the mirror, grooming or skin picking

Attempting to hide perceived flaws with styling, makeup or clothes

Constantly comparing your appearance with others

Frequently seeking reassurance about your appearance from others

Having perfectionist tendencies

Seeking cosmetic procedures with little satisfaction

Avoiding social situations

Preoccupation with your appearance and excessive thoughts and repetitive behaviors can be unwanted, difficult to control and so time-consuming that they can cause major distress or problems in your social life, work, school or other areas of functioning.

You may excessively focus over one or more parts of your body. The bodily feature that you focus on may change over time. The most common features people tend to fixate about include:

Face, such as nose, complexion, wrinkles, acne and other blemishes

Hair, such as appearance, thinning and baldness

Skin and vein appearance

Breast size

Muscle size and tone

Genitalia

A preoccupation with your body build being too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.

Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may be excessive or not be true, or think that they probably are true, or be absolutely convinced that they're true. The more convinced you are of your beliefs, the more distress and disruption you may experience in your life.

Causes

It's not known specifically what causes body dysmorphic disorder. Like many other mental health conditions, body dysmorphic disorder may result from a combination of issues, such as a family history of the disorder, negative evaluations or experiences about your body or self-image, and abnormal brain function or abnormal levels of the brain chemical called serotonin.

Risk factors

Body dysmorphic disorder typically starts in the early teenage years and it affects both males and females.

Certain factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:

Having blood relatives with body dysmorphic disorder or obsessive-compulsive disorder

Negative life experiences, such as childhood teasing, neglect or abuse

Certain personality traits, such as perfectionism

Societal pressure or expectations of beauty

Having another mental health condition, such as anxiety or depression

Complications

Complications that may be caused by or associated with body dysmorphic disorder include, for example:

Low self-esteem

Social isolation

Major depression or other mood disorders

Suicidal thoughts or behavior

Anxiety disorders, including social anxiety disorder (social phobia)

Obsessive-compulsive disorder

Eating disorders

Substance misuse

Health problems from behaviors such as skin picking

Physical pain or risk of disfigurement due to repeated surgical interventions

Prevention

There's no known way to prevent body dysmorphic disorder. However, because body dysmorphic disorder often starts in the early teenage years, identifying the disorder early and starting treatment may be of some benefit.

Long-term maintenance treatment also may help prevent a relapse of body dysmorphic disorder symptoms.

Diagnosis

After a medical evaluation to help rule out other medical conditions, your health care provider may make a referral to a mental health professional for further evaluation.

Diagnosis of body dysmorphic disorder is typically based on:

A psychological evaluation that assesses risk factors and thoughts, feelings, and behaviors related to negative self-image

Personal, social, family and medical history

Signs and symptoms

Treatment

Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.

Cognitive behavioral therapy

Cognitive behavioral therapy for body dysmorphic disorder focuses on:

Helping you learn how negative thoughts, emotional reactions and behaviors maintain problems over time

Challenging automatic negative thoughts about your body image and learning more-flexible ways of thinking

Learning alternate ways to handle urges or rituals to help reduce mirror checking, reassurance seeking or excess use of medical services

Teaching you other behaviors to improve your mental health, such as addressing social avoidance and increasing engagement with healthy supports and activities

You and your mental health provider can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills. Involving family members in treatment may be particularly important, especially for teenagers.

Medications

Although there are no medications specifically approved by the U.S. Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental health conditions — such as depression and obsessive-compulsive disorder — can be effective.

Selective serotonin reuptake inhibitors (SSRIs). Because body dysmorphic disorder could be caused in part by problems related to the brain chemical serotonin, SSRIs may be prescribed. SSRIs appear to be more effective for body dysmorphic disorder than other antidepressants and may help control your negative thoughts and repetitive behaviors.

Other medications. In some cases, you may benefit from taking other medications in addition to an SSRI, depending on your symptoms.

Hospitalization

In some cases, your body dysmorphic disorder symptoms may be so severe that you require psychiatric hospitalization. This is generally recommended only when you aren't able to keep up with day-to-day responsibilities or when you're in immediate danger of harming yourself.

Type of Doctor Department : A mental health specialist