Are you a young person with BDD?
You are not alone. Did you know around 2% of young people have BDD? That means in a school with 1,000 students, on average there will be 20 young people with BDD.
Please Note: we have another page dedicated to the Parents of Young People with BDD
What is BDD?
BDD, or Body Dysmorphic Disorder, is NOT about being vain. In fact, BDD is the opposite of vanity. People with BDD are concerned about perceived flaw/s in their appearance and typically worry that they look ugly or abnormal. Read more about what is BDD >
The core feature of BDD is worrying about perceived flaw/s in appearance. The flaw/s are things that other people cannot see or do not generally notice. These worries may make people feel anxious, depressed, disgusted, and/or ashamed of the way they look.
Young people with BDD also carry out various behaviours in an attempt to cope with their worries, such as checking or camouflaging (covering up) their perceived flaw/s. These worries and behaviours can be extremely time-consuming and interfere in people’s lives.
Do I have BDD?
How to get help
Talking about appearance concerns and anxiety can be difficult and embarrassing.
We talked to other young people who had been through an assessment and treatment with a specialist BDD clinic to see what they would have wanted to at the time. Here’s what they wanted to pass on to other young people who think they may have BDD:
“I would say that BDD is not a disease to be ashamed of. I would say that BDD is a recognised disease and that there is effective treatment for it.”
“You shouldn’t worry because everyone is really friendly and understanding. They will talk everything through with you and listen to any concerns you may have.”
“Everyone is friendly and considerate and will always listen to any questions or concerns that you have.”
“Feel positive because speaking out will help things improve eventually.”
How to access treatment for BDD
If you think you might have BDD, it is really important to get help. Speaking to your general practitioner (GP) might be the first step and you can use the GP card to help you. He or she will probably refer you on for an assessment with a mental health professional, who will help you to figure out whether or not you are suffering from BDD.
Whilst this process can sound daunting, seeking help is the first step towards recovery as there are effective treatments available.
Barriers to accessing treatment
People have shared that accessing that treatment is not always a straightforward process, despite BDD treatment being available. There are a few different reasons for this:
- People feel embarrassed and ashamed to seek help
- They might feel that it’s a physical problem, so no-one can really help or people go to places where it can be ‘fixed’ instead of mental health services.
- BDD can be misdiagnosed as Depression, Social Anxiety or an eating disorder or just say worrying about appearance is a normal part of being a teenager.
If any of these things happen, it can leave people feeling person feeling isolated and alone and can put people off seeking help.
The problem is, BDD is unlikely to just get better by itself, so if you do think that this sounds like something you are going through, it is really important that you try to reach out to someone. Try to speak to someone you trust and maybe share information on this website to help explain how you are feeling. It can be helpful to have someone with you to support you to seek help.
Treatment for BDD
We talked to some of the young people who completed treatment to see what they wished they had known at the start of the process. Here’s what they had to say to other young people who may be thinking about or due to start treatment for BDD:
“I wish I had known that everything would be done at a pace I was comfortable with, and that I wouldn’t be pushed into doing things I wasn’t ready for.”
“Trust the people in the clinic who are helping you during your treatment. You will not be immediately thrown into a situation that makes you highly anxious or uncomfortable, but instead you’ll start by working on much lower anxiety provoking situations. Believe in your capabilities, stay open minded and take every step as it comes!”
“Take each step at a time. Make sure you follow through with ‘exposure’ tasks – these are the most helpful in my opinion.”
“Make sure you have someone to support you doing tasks.”
“Even though it can feel like an uphill battle, you should never give up and should always be open to offers of help.”
“Don’t let yourself believe you are stuck with BDD. Treatment will help you get better. After treatment I realised how many doors I’d shut in the past.”
If you feel that you are suffering from BDD, or have been diagnosed with BDD, the good news is that treatments are available. The best evidence so far supports two possible treatment options, which can be delivered independently of each other or can be given together. One treatment is psychological, Cognitive Behaviour Therapy (CBT) and the other option is medication.
Anybody seeking psychological help for BDD should be offered Cognitive Behaviour Therapy (CBT) as this is the only psychological treatment which has been proven to work for BDD.
In the UK, CBT is the treatment recommended by the National Institute for Health and Care Excellence (NICE), which provides treatment guidelines based on the best available evidence. Based on the research so far, we know that there are a few components that should be included in a good course of CBT for BDD for it to be as effective as possible.
Key components of CBT for BDD
- Should meet with your therapist once a week for sessions of about 60 minutes each.
- You may need up to 20 sessions – this can vary.
- Therapist should check with you how much you want/need your family involved in sessions.
- You should be given homework tasks in-between each session to complete, including tasks to reduce BDD-related behaviours (see below)
- You should complete the following topics in CBT:
- Learning about BDD, anxiety, and key psychological processes associated with this condition
- Understanding your own BDD, in particular the behaviours which you engage in and how these fuel worries about appearance and difficult emotions
- Practicing reducing your BDD-related behaviours, with the help of your therapist and maybe also your family and friends. This will involve physically carrying out tasks and challenges in sessions. It is important to note that this process is done gradually, in steps that feel manageable for you
- Some additional/specialist CBT for BDD components may include:
- Practicing how to shift your focus of attention from your appearance to the world around you
- Learning how to use mirrors in a helpful and non-judgmental way
- Working directly with specific unhelpful thoughts
- Working through relevant, difficult experiences from your past such as appearance-related bullying
- Help with improving your self-esteem
- How to manage social media with BDD
- How can your school support you
- Hear from others who have lived experience of BDD
- Guide on BDD for young people
Appearance Anxiety: A Guide to Understanding Body Dysmorphic Disorder for Young People, Families and Professionals
Maudsley Hospital National and Specialist OCD, BDD and Related Disorders Service
The first book for teens that explains the causes and impact of body dysmorphic disorder (BDD). The book is interspersed with accounts and artwork from young people with BDD, along with perspectives of their families. BDD is a debilitating mental health disorder, and this book gives advice on treatment including CBT and medication, and shows where to get help.
It increases awareness, provides solidarity for people with BDD, and alerts others to key signs and symptoms so they can prevent further suffering. It also includes a short section for families and professionals on what they can do to help, making this the go-to book for professionals and families to recommend to teens, as well an invaluable resource for young people themselves.