Body Dysmorphic Disorder (BDD) is defined as a preoccupation with an imagined ‘defect’ in appearance.
The preoccupation is markedly excessive and causes significant impairment, including personal isolation. Most people with BDD experience their thoughts as intrusive and difficult to resist or control.
Ritualistic behaviours are common and include checking the defect over and over in a mirror, frequent requests for reassurance, and avoidance.
People with BDD tend to have low self-esteem. If their appearance deviates from ‘perfection’, they can view themselves as worthless or unlovable. They may even drop out of school, stop working, or avoid social activities. Their attention is almost exclusively focused on their ‘defect’ and so they become extremely vigilant and discerning about any minor changes that deviate from their high standards.
There can be some overlap between BDD and OCD (Obsessive Compulsive Disorder) – sufferers of OCD sometimes have BDD – and vice versa. However, people with BDD are less likely to be married, have more comorbid depression, and make more suicide attempts than a comparison group of OCD sufferers. Social phobia and social anxiety may also be predisposing factors in the development of BDD.