Certain factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:
Having blood relatives with body dysmorphic disorder or obsessive-compulsive disorder
Negative life experiences, such as childhood teasing and trauma
Certain personality traits, such as perfectionism
Societal pressure or expectations of beauty
Having another psychiatric disorder, such as anxiety or depression
You should visit your doctor if you think you may have BDD. Initially, they will probably ask a number of questions about your symptoms and how they affect you, such as:
Do you worry a lot about the way you look and wish you could think about it less?
What specific concerns do you have about your appearance?
On a typical day, how many hours is your appearance on your mind?
What effect does it have on your life?
Does it make it hard to do your work or be with friends?
If your GP suspects BDD, they can refer you to a mental health specialist for further assessment and any appropriate treatment.
Diagnosis of body dysmorphic disorder is typically based on:
A psychological evaluation that assesses risk factors and thoughts, feelings, and behaviors related to negative self-image
Personal, social, family and medical history
Symptoms listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
With treatment, many people with BDD will experience an improvement in their symptoms. Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.
Cognitive behavioral therapy
Cognitive behavioral therapy for body dysmorphic disorder focuses on:
Helping you learn how negative thoughts, emotional reactions and behaviors maintain problems over time
Challenging automatic negative thoughts about your body image and learning a more flexible and realistic way of thinking
Learning alternate ways to handle urges or rituals to help reduce mirror checking or reassurance seeking
Teaching you other behaviors to improve your mental health
You and your therapist can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills.
Although there are no medications specifically approved by the Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental disorders, such as depression, can be effective.
Selective serotonin reuptake inhibitors (SSRIs). Because body dysmorphic disorder is thought to be caused in part by problems related to the brain chemical serotonin, SSRIs may be prescribed. SSRIs appear to be more effective for body dysmorphic disorder than other antidepressants and may help control your obsessions and repetitive behaviors.
Other medications. In some cases, you may benefit from taking other medications in addition to an SSRI, depending on your symptoms.
In some cases, your body dysmorphic disorder symptoms may be so severe that you require psychiatric hospitalization. This is generally recommended only when you aren't able to keep up with day-to-day responsibilities or when you're in immediate danger of harming yourself.