The majority of people with Body Dysmorphic Disorder (BDD) worry about lots of aspects of their appearance, and it can be extremely distressing.

Symptoms

• Avoidance – Due to heightened self-consciousness and anxiety about their appearance, individuals with BDD may start avoiding social situations altogether. This avoidance is often driven by the fear of being negatively judged or perceived as flawed by others. It can lead to social isolation, withdrawal, and a decline in quality of life. Individuals may also avoid mirrors and anything that could be considered a reflective surface.
• Preoccupation – Individuals with BDD will have an overwhelming and persistent focus on a perceived flaw/s in their physical appearance. These perceived flaws are typically very minor or of normal variation, but they become the central point of attention, causing intrusive thoughts and significant distress.
• Repetitive Behaviours – Much like OCD, people with BDD may engage in repetitive behaviours as a way to cope with their distress. See below for more details. These behaviours become time consuming and interfere with daily functioning.
• Reassurance Seeking – Individuals with BDD often seek reassurance from friends, family or even strangers to alleviate their anxiety about their appearance. They may repeatedly ask questions about their looks, but no amount of reassurance seems to be enough to dispel their concerns. In fact, evidence shows that providing reassurance about appearance can perpetuate the problem.
• Significant Distress & Functional Impairment – The preoccupation with perceived flaws and the associated behaviours can lead to significant emotional distress, anxiety and impairment in various areas of life, such as work, education, relationships and daily activities.

Common Worries

• The most common worries are usually around facial features e.g. skin, hair, nose, eyes, chin, and teeth. However, any part of the body can become a focus of concern, including genitals.
• Some people with BDD do not worry about specific features but instead say that they feel generally ugly. Others say that they do not mind their individual features but feel that they do not “fit together” properly or do not look symmetrical.
• Sometimes young people worry that they look too feminine or masculine, or that they do not look right compared to their family or others.

Common Behaviours

• People with BDD typically carry out a range of repetitive behaviours to try to cope with their appearance concerns e.g. try to camouflage their perceived flaw by covering it with clothing, excessive amounts of make-up or using other parts of their body.
• They can also spend huge amounts of time examining their appearance in mirrors and other reflective surfaces or may avoid looking in mirrors as they find this too distressing.
• It is very common for people with BDD to also spend a lot of time carrying out grooming routines, such as applying make-up and cosmetic products. This is not about vanity; it’s about trying to correct their perceived defects in an attempt to look “normal”.
• Lots of people compare their appearance to others; this is often done online. Seeking reassurance is common too. 
• Some people with BDD engage in behaviours that can be harmful when they are trying to improve their appearance e.g. picking spots or skin, which actually then causes scars and further anxiety.

Impact of BDD on Mood

If you have BDD, you will probably have noticed a number of changes to your mood. This can include lots of negative emotions, including:

• anxiety,
• sadness or low mood,
• poor self-esteem (thinking that they are useless or worthless),
• or feeling disgusted about yourself.

It may be hard to enjoy things that they liked doing before, have less energy, have difficulty concentrating or have problems with eating or sleeping (either too much or too little). 

The difficulty of getting the right diagnosis

You may have tried to seek help but felt misunderstood.

Lots of people may have received the wrong diagnosis such as Depression, Social Anxiety or an Eating Disorder or have been told that worrying about appearance is normal, particularly if you are a teenager. If this has happened to you, it can be a difficult experience and it may have meant you were also offered a less helpful type of treatment.  You may have turned to using drugs or alcohol in an attempt to manage your feelings. 

At its most severe, it is not uncommon for people with BDD to feel as though they do not want to be alive as a result of their appearance worries and feelings. If you have been through this, it can make you feel misunderstood and hopeless, but you are in the right place. If you feel BDD explains how you are feeling, it is important you seek the right help.

Find out more about getting support >

Impact of BDD on Social Life

If you are struggling with BDD, you may be finding it more difficult to be around others, maybe because you want to hide your physical appearance from them. 

Sometimes people find it hard to make eye contact, speak or interact with others; it may be a way to keep attention away from you and your appearance.  You may find it hard to be in social situations because you feel self-conscious and your attention is on your appearance so you do not get to enjoy time with others.

Other ways people’s social lives are affected by BDD is that some people end up giving up activities they enjoy, giving them more time for their BDD behaviours such as going to the gym, spending time doing hair and make-up. Also, it can be tough being with friends or other people if you find yourself comparing your appearance with them.  Some people avoid sex or relationships with boyfriends/girlfriends because of appearance. 

At its worst, BDD may stop people from leaving their home or bedroom entirely. 

Impact of BDD on Family Life and Relationships

Family members often get pulled into ways to try to help reduce the anxiety that people with BDD experience; this can include helping you with grooming routines or giving you lots of reassurance about your appearance. This can sometimes give you relief at first, but this often does not last, and the worries and anxiety often come up again. Alternatively, it may be that whatever others try to do to help does not work.

There are sometimes disagreements in families because you have different ideas about what is going on; they won’t be able to see what you see in terms of the perceived flaw. This can be frustrating for BDD sufferers and families as each cannot see what the other can. Some families have shared that disagreements can sometimes lead to physical aggression. 

Watch this video on ‘Managing Intimate Relationships and BDD’ with Dr Natalie Stechler >

When BDD leads to dangerous behaviours, such as self-harm, not eating or not being able to leave the house, family members can become really worried and feel helpless to make things better for their loved one.  It is easy to see how family tension and conflict can develop as a result of BDD and cause additional stress in the home. Are you a parent of a person with BDD? Find out more >

Find out how best to help if you are a friend of someone with BDD >

Impact of BDD on Work and Education

BDD at its worst can make regular employment, education or family life impossible.

Those in regular employment or who have family responsibilities would almost certainly find life more productive and satisfying if they did not have the symptoms of BDD. At the same time, partners, friends, and family members find it very distressing when they are unable to help the person they love to stop feeling ugly and regain control of their lives.

You can read more about how BDD can impact work life and what employers can do to help via this article that we partnered on with Mind.

Find out how to best support a student with BDD >

Take the test

Do I have BDD? Our test, developed by specialists and healthcare professionals, can help you understand whether someone might have Body Dysmorphic Disorder.

Do I have BDD? Take the test