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What It Is Like To Live With Body Dysmorphic Disorder

May 26, 2015 3 min read

People don't generally understand that body dysmorphic disorder is so much more than low self esteem. It often isn't diagnosed until someone is in their 20's but many report feeling the effects much earlier in life. This needs to be a part of our conversation so people are able to receive the treatments they deserve. Some classic signs may include:

A preoccupation with appearance

Preoccupation means being anxious about appearance in moments that might not necessarily be the obvious sorts of moments. It is normal to feel a little anxious when meeting an attractive person or when you have to get undressed in front of someone. But for someone with BDD, it goes beyond those moments. It happens at any given moment. It messes with concentration. Like you're at work but can only focus on it for a few minutes at a time before you start thinking again about how unattractive you are.

Obsessive compulsive behaviour

In order to ease the anxiety caused by the preoccupation with appearance, people with BDD may engage in ritualistic behaviours to make them feel as though they are more acceptable in their appearance. These can include wearing makeup constantly (even to go to bed), constantly wearing a scarf (or other clothing) in order to hide parts of the body, sitting in certain ways so people can only see you from certain angles or even dermatillomania (compulsive skin picking). Although these behaviours may temporarily relieve the anxiety, the relief doesn't last. As time goes on, these rituals must be performed more frequently and with increased vigilance to work. If they cannot be performed to the appropriate standard, the individual may then adopt avoidance behaviours.


BDD in and of itself is delusional. This means that it is incredibly difficult to distinguish between reality and the falsehoods the brain is feeding you. The reflection someone with BDD sees in the mirror is very different from what is actually reflected there. This person may believe that people are staring and laughing at them in public when this anything but the case.

An incessant desire for cosmetic surgery

People with BDD want to have it all corrected. From ear pinning to forehead lifts to laser skin procedures to hair extensions, the list goes on. And the problem with this is that the issues of BDD are not actually physical. Going through with any or all of these procedures won't stop the delusions or heal the individual's anxiety. The problem lies much deeper than skin level. Think of those people we've see on TV that are addicted to plastic surgery, who have hundreds of different procedures and have plans for more. There is a real possibility that they are suffering below the surface.


As I'm sure you can understand by now, all this can lead to crippling depression. An inability to ever feel comfortable in your skin can lead one down an impossibly dark hole. Cognitive behaviour therapy is a wonderful solution but it requires time and patience. This treatment is more likely to work if we show compassion and understanding. If you or someone you know presents with some of these symptoms, the sooner help is sought, the sooner the healing can begin. Body dysmorphic disorder is not an overly understood mental illness compared to others. It is important to understand it as a serious condition and not just a case of vanity. As we grow in our awareness and acceptance of mental illness in general, let's add body dysmorphic disorder to the discourse. For a better understanding of what it is like to live with BDD, watch this powerful video put together by the BDD foundation: https://www.youtube.com/watch?v=kNrxksPbgUg&feature=iv&src_vid=Jwh11-TvHbw&annotation_id=annotation_2954054929

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