Body dysmorphic disorder is a mental disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that, to others, is either minor or not observable. But you may feel so ashamed and anxious that you may avoid many social situations.

When you have body dysmorphic disorder, you intensely obsess over 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 a temporary satisfaction, but often the anxiety returns and you may resume searching for a way to fix your perceived flaw.

I have Body Dysmorphic Disorder. I believe it started when I was around 16 years old. I felt pretty good about myself until my alcoholic step father came into the picture. Dinner time was always chaotic and I can remember him telling me almost every day that I was fat, ugly and would never amount to anything. Those words haunt me to this day. I was young and impressionable and certainly didn’t deserve that treatment. Later on I developed anorexia and bulimia to no surprise. I still struggle with my appearance and weight but I try positive self talk and that seems to help me feel more accepting of myself. I am in my late fifties and it has taken this long for me to feel good about myself most of the time.

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
  • Always seeking reassurance about your appearance from others
  • Having perfectionist tendencies
  • Seeking frequent cosmetic procedures with little satisfaction
  • Avoiding social situations
  • Being so preoccupied with appearance that it causes major distress or problems in your social life, work, school or other areas of functioning

You may obsess over one or more parts of your body. The feature that you focus on may change over time. The most common features people obsess 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

Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may not be true, or think that they probably are true, or be absolutely convinced that they’re true.

Body dysmorphic disorder typically starts in the early teenage years and it affects both males and females. An obsession that body build is too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.

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

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

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