Body dysmorphic disorder is a mental health disorder in which you can't stop thinking about one or more perceived defects or flaws in your appearance — a flaw that appears minor or can't be seen by others. But you may feel so embarrassed, ashamed and anxious that you may avoid many social situations.
When you have body dysmorphic disorder, you intensely focus on your appearance and body image, repeatedly checking the mirror, grooming or seeking reassurance, sometimes for many hours each day. Your perceived flaw and the repetitive behaviors cause you significant distress, and impact your ability to function in your daily life.
You may seek out numerous cosmetic procedures to try to "fix" your perceived flaw. Afterward, you may feel temporary satisfaction or a reduction in your distress, but often the anxiety returns and you may resume searching for other ways to fix your perceived flaw.
Treatment of body dysmorphic disorder may include cognitive behavioral therapy and medication.
Signs and symptoms of body dysmorphic disorder include:
Preoccupation with your appearance and excessive thoughts and repetitive behaviors can be unwanted, difficult to control and so time-consuming that they can cause major distress or problems in your social life, work, school or other areas of functioning.
You may excessively focus over one or more parts of your body. The feature that you focus on may change over time. The most common features people tend to fixate about include:
A preoccupation with your body build being too small or not muscular enough (muscle dysmorphia) occurs almost exclusively in males.
Insight about body dysmorphic disorder varies. You may recognize that your beliefs about your perceived flaws may be excessive or not be true, or think that they probably are true, or be absolutely convinced that they're true. The more convinced you are of your beliefs, the more distress and disruption you may experience in your life.
Shame and embarrassment about your appearance may keep you from seeking treatment for body dysmorphic disorder. But if you have any signs or symptoms, see your primary care provider or a mental health professional.
Body dysmorphic disorder usually doesn't get better on its own. If left untreated, it may get worse over time, leading to anxiety, extensive medical bills, severe depression, and even suicidal thoughts and behavior.
Suicidal thoughts and behavior are common with body dysmorphic disorder. If you think you may hurt yourself or attempt suicide, get help right away:
It's not known specifically what causes body dysmorphic disorder. Like many other mental health conditions, body dysmorphic disorder may result from a combination of issues, such as a family history of the disorder, abnormalities in the brain, and negative evaluations or experiences about your body or self-image.
Body dysmorphic disorder typically starts in the early teenage years and it affects both males and females.
Certain factors seem to increase the risk of developing or triggering body dysmorphic disorder, including:
Complications that may be caused by or associated with body dysmorphic disorder include, for example:
There's no known way to prevent body dysmorphic disorder. However, because body dysmorphic disorder often starts in the early teenage years, identifying the disorder early and starting treatment may be of some benefit.
Long-term maintenance treatment also may help prevent a relapse of body dysmorphic disorder symptoms.
After a medical evaluation to help rule out other medical conditions, your primary care provider may make a referral to a mental health professional for further evaluation.
Diagnosis of body dysmorphic disorder is typically based on:
Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.
Cognitive behavioral therapy for body dysmorphic disorder focuses on:
You and your therapist can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills. Involving family members in treatment may be particularly important, especially for teenagers.
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 health conditions ― such as depression and obsessive-compulsive disorder ― can be effective.
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.
Body dysmorphic disorder warrants treatment from a mental health professional. But you can do some things to build on your treatment plan, such as:
Talk with your doctor or therapist about improving your coping skills, and ways to focus on identifying, monitoring and changing the negative thoughts and behaviors about your appearance.
Consider these tips to help cope with body dysmorphic disorder:
Although you may start out talking with your primary care provider about your concerns, you'll likely be referred to a mental health professional, such as a psychiatrist or psychologist, for further evaluation and specialized treatment.
Before your appointment, make a list of:
Some basic questions to ask your doctor or mental health professional include:
Don't hesitate to ask additional questions during your appointment.
Your doctor or mental health professional may ask you questions, such as:
Your doctor or mental health professional will ask additional questions based on your responses, symptoms and needs. Preparing and anticipating questions will help you make the most of your time with the doctor.