When does concern with appearance become BDD?
Many of us are concerned with some aspect of our appearance, but it doesn’t always amount to BDD.
In order to be diagnosed as Body Dysmorphic Disorder (BDD), the preoccupation for appearance must last for at least an hour a day, cause significant distress and/or interfere with at least one area of life. A team of researchers has developed a test to help people and professionals understand whether they might have BDD.
Some people with Body Dysmorphic Disorder avoid social and public situations to prevent feelings of discomfort and worry about being rated negatively by those around them. Others, may enter such situations but remain very self-conscious. They may use excessive camouflage to hide their perceived defect – heavy make-up perhaps, or a change of posture, a particular hairstyle or heavy clothes. They may spend several hours a day thinking about their perceived defect and asking themselves questions that cannot be answered (for example, ”Why was I born this way?” “If only my nose was straighter and smaller”).
People with BDD may feel compelled to repeat certain time consuming behaviours such as:
- Checking their appearance in a mirror or reflective surface
- Checking by feeling their skin with their fingers
- Cutting or combing their hair to make it “just so”
- Picking their skin to make it smooth
- Comparing themselves against models in magazines or people in the street
- Discuss their appearance with others
- Camouflaging their appearance
People with BDD may also avoid certain places, people, or activities because of concerns over their appearance (e.g. bright lights, mirrors, dating, social situations, being seen close-up).
These behaviours all make sense if you feel you look ugly as they are designed to make you feel safe (for example camouflage) or to determine whether you look as bad as you think you do (for example checking in a mirror). However, they lead to an increase in preoccupation and distress with your appearance.