By Madeleine Latimer
Have you ever heard of Body Dysmorphia Disorder? Body Dysmorphia Disorder, also called BDD, is an extremely common disorder, even more so than Obsessive Compulsive Disorder (OCD), anorexia, and schizophrenia, developing often in adolescence. BDD is most easily described as a body-image disorder. Sure, everyone has parts of themselves that they don’t like; but people with BDD spend the majority of their time obsessing over their imperfections. BDD is not curable. It can last for someone’s entire lifetime. It can also lead to suicide.
For people with BDD, they spend almost all of their time obsessing over their body. Most of the time, these thoughts that people have about their body and the things they are obsessing over are delusions or complete exaggerations of their imperfections or flaws. Most people would barely recognize these things a person with BDD might obsess over and think are highly noticeable. Common behaviors of BDD may be obsessively checking oneself in the mirror, excessive self-grooming (such as compulsive hair styling, hair cutting, shaving, plucking eyebrows, plucking body hair), extreme makeup application, constantly asking other people if they look okay, skin picking, frequent changing of clothes, tanning to cover freckles or pale skin, and shopping for beauty products and clothing items constantly. Most people with BDD attempt to hide the things they hate about themselves by doing things like wearing a hat all the time, wearing sunglasses, wearing bulky clothes that cover their body, wearing very heavy makeup, or by holding their body in certain positions, like turning the perceived “bad side” of their face away from other people. These thoughts they have can cause extreme emotional stress and interfere with their day-to-day functions. BDD is not simply hating your smile or the way your thighs look. It is a disorder that is much more pervasive and self-destructive, needing to be diagnosed by a doctor and addressed with treatment. BDD in its extreme can even result in suicide.
About 1 in 50 people is affected by Body Dysmorphia Disorder. It affects about 2.4% of the population and is almost equally distributed amongst women and men. According to Katherine A. Phillips’ article “Suicidality in Body Dysmorphic Disorder,” 80% of people who suffer with BDD have had suicidal thoughts and 28% of them have attempted suicide. The suicide rate for those diagnosed with BDD is very high. The suicide attempt rates are estimated to be 6–23 times higher than what is reported for the US population. It is within the range reported for depressed outpatients, and it is higher than that reported for generalized anxiety disorder, panic disorder or agoraphobia. People with BDD tend to isolate themselves in social situations because they feel they are unacceptable in the eyes of others because of perceived flaws or inadequacies. BDD can be a lead in to additional disorders such as bulimia, anorexia and binge-eating. It can also bring other disorders, such as Major Depressive Disorder, Social Anxiety Disorder, and Obsessive-Compulsive Disorder. A significantly higher amount of people with BDD, compared to people with OCD, have reported suicidal thoughts. One study found that lifetime suicide attempts, with the leading cause being their disorder of either BDD or OCD, had a higher rate among people with BDD than those subjects with OCD. People with BDD are at 22% compared to people with OCD at 8%. Another study found a higher lifetime rate of suicide attempts, being at 40% among people with combined diagnosis of both BDD and OCD, compared to those with only a single diagnosis of either BDD or OCD. BDD is not curable and there are no medications that can treat it, since the disorder is purely psychological. Therapy is the primary treatment which can help change the way that a person processes information and copes with their BDD, but just like depression and anxiety, it can never fully be cured so the goal is management.
BDD is not widely known. More awareness for the disorder needs to be spread through community education at all age levels, throughout the medical specialties and within the educational institutional ranks. Often times, it goes unrecognized due to people not knowing or fully understanding what this disorder is and the signs which give rise to a possible affliction with BDD. Often people may be too ashamed to tell their doctor during check-ups they are having these feelings, even further, the questions are not being asked by physicians. There are depression and anxiety surveys that most doctors ask teens to complete during these annual check-ups, but not for Body Dysmorphia Disorder. Those practicing in this area of specialty agree that mental health check-ups should be at least a bi-annual expectation for all patients.
When it comes to types of treatments, those most commonly used are serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy (CBT) both of which appear to be effective for a majority of patients. Cosmetic treatments, such as surgery and dermatologic treatment, are typically ineffective for BDD as this fails to address the underlying psychological issue resulting in the disorder.
Social media and media in general, has a strong effect on today’s youth. It is causing an increase in the prevalence of Body Dysmorphia Disorder. Television, social media, and peer competition have their own influences on how one looks at themselves and their body. Many believe that a simple fix to this problem is to simply put down your phone. This is not in itself an effective solution. The media is everywhere and almost impossible to avoid. Tom Quinn, an eating disorder specialist says that “teaching emotional intelligence and embedding coping mechanisms into the school curriculum can ensure that young people grow up not only aware of their emotional needs but also able them to support themselves.” The school curriculum could benefit from an overhaul to health education and the issues facing teens and young adults today. Outside of social media, even advertisements are at fault for encouraging people to feel bad about their bodies. A 2014 Victoria Secret ad campaign had ten women, all of which were tall and slender, and only featuring three women of color. It was called “The Perfect Body” and received much backlash due to its lack of variety in body types, shapes and sizes.
Body Dysmorphia Disorder is not exclusive to young adults. BDD is something that will affect a person their entire life. Michael Jackson and Andy Warhol both suffered from BDD. Michael Jackson’s tell was his extreme plastic surgery, which even though he denied, was quite obvious to everyone else. Andy Warhol obsessed over the redness of his nose. He was very obsessed with his image and the way he looked. A few other famous people known to struggle with BDD include Franz Kafka, Sylvia Plath and Shirley Manson. There are most likely more famous people with BDD, but since the topic is not widely talked about, people are less likely to bring it up. It is not similar to the discussion surrounding depression. Depression is talked about on a global scale. Many famous people and influencers will bring it up to influence others to go get help with their depression or call the suicide hotline. BDD does not have that.
Body Dysmorphia Disorder is not well known, and although it only effects 2.8% of the population, it is a rapidly growing disorder due to the effects of social media. It is also going on without treatment because it is less known than the other psychological disorders. There should be more knowledge of BDD. The BDD suicide rates are so much greater than they should be. Education and recognition of this disorder is critical to improving the outcome of this segment of the population. The proper diagnosis and treatment for those suffering from BDD is the only way to slow the growth of this public health problem and improve the mental health and body images of our next generation. If people become educated about BDD and a global conversation, it could lower the rates of suicide caused by BDD and open up resources for people get the help they need to become more comfortable dealing with their BDD on a day to day basis.
Header photo from psycom.net
Adkins, Alyce. “How Social Media Contributes to Body Dysmorphic Behavior.” The Lexington Line, The Lexington Line, 9 May 2018, www.thelexingtonline.com/blog/2018/5/7/how-social-media-contributes-to-body-dysmorphic-behaviors.
“Famous People with BDD.” BDD, Body Dysmorphic Disorder Foundation, bddfoundation.org/resources/famous-people-with-bdd/.
Phillips, Katharine A. “Suicidality in Body Dysmorphic Disorder.” Primary Psychiatry, U.S. National Library of Medicine, Dec. 2007, www.ncbi.nlm.nih.gov/pmc/articles/PMC2361388/.
“Body Dysmorphic Disorder (BDD).” Anxiety and Depression Association of America, ADAA, Anxiety and Depression Association of America, adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd.