Body Dysmorphic Disorder
What Causes Body Dysmorphic Disorder?
The exact cause of BDD is not known. One theory suggests the disorder involves a problem with the size or functioning of certain brain areas that process information about body appearance. The fact that BDD often occurs in people with other mental health disorders, such as major depression and anxiety, further supports a biological basis for the disorder.
Other factors that might influence the development of or trigger BDD include:
- Experience of traumatic events or emotional conflict during childhood
- Low self-esteem
- Parents and others who were critical of the person's appearance
Pressure from peers and a society that equates physical appearance with beauty and value also can have an impact on the development of BDD.
How Is Body Dysmorphic Disorder Diagnosed?
The secrecy and shame that often accompany BDD make its diagnosis difficult. Most experts agree that many cases of BDD go unrecognized. People with the disorder often are embarrassed and reluctant to tell their doctors about their concerns. As a result, the disorder can go unnoticed for years or never be diagnosed. One red flag to doctors is when patients repeatedly seek plastic surgery for the same or multiple perceived physical defects.
In diagnosing BDD, the doctor will likely begin his or her evaluation with a complete history and focused physical exam. If the doctor suspects BDD, he or she might refer the person to a psychiatrist or psychologist, health care professionals who are specially trained to diagnose and treat mental illnesses. The psychiatrist or psychologist makes a diagnosis based on his or her assessment of the person's attitude, behavior, and symptoms.
How Is Body Dysmorphic Disorder Treated?
Treatment for BDD likely will include a combination of the following therapies:
- Psychotherapy: This is a type of individual counseling that focuses on changing the thinking (cognitive therapy) and behavior (behavioral therapy) of a person with body dysmorphic disorder. The goal is to correct the false belief about the defect and to minimize the compulsive behavior.
- Medication:Certain antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) are showing promise in treating body dysmorphic disorder, as are antipsychotic medicines such as olanzapine, aripiprazole, or pimozide (either alone or in combination with an SSRI). No drug is formally FDA-approved for the treatment of BDD.
- Group and/or family therapy: Family support is very important to treatment success. It is important that family members understand body dysmorphic disorder and learn to recognize its signs and symptoms.
What Complications Are Associated With Body Dysmorphic Disorder?
In cases of BDD, social isolation can occur if the person becomes too self-conscious to go out in public. This also can have a negative impact on school or work. People with BDD also are at high risk for developing major depression, and the distress associated with the disorder puts people with BDD at high risk for suicide. Further, people with this disorder might undergo many surgical procedures in an attempt to correct their perceived defect.