Body Dysmorphic Disorder (BDD, or Body Dysmorphia) 

Body Dysmorphic Disorder (BDD) is related to anxiety disorders but it is considered to be a somatoform disorder in the DSM-IV.  People suffering with BDD are excessively preoccupied with imagined defects in appearance.


Almost everyone has had a distorted perception of their body at some point.  However, people with Body Dysmorphia are "tormented" and "devastated" over these perceived distortions.  The preoccupations about body image are very difficult to control, causing the person to become significantly impaired in social, occupational, and other areas of life.  Avoidance of daily living may lead to severe social isolation and depression. 


People with Body Dysmorphia may try to camouflage their perceived "defect" (e.g., wearing sunglasses to cover tired/baggy eyes, only going out at night, wearing a hat to hide imagined hair loss, stuffing a bra to enhance "small" breasts).  People may also use ideas of reference to enhance their negative perception.  For example, someone with BDD might take notice to a person's facial expression or eye movement in relation to the perceived flaw.  This may be used as "evidence" that people are negatively viewing them. In addition, people with BDD will often compare their body parts with other's.
As stated above, BDD exhibits many characteristics of anxiety disorders.


Suffers engage in catastrophic thinking, engage in behaviors that temporarily reduce anxiety, and even perform common anxiety rituals such as seeking reassurance about the "defect" and checking rituals.


During a checking ritual, a person might excessively check the mirror to see if a defect is still there.  Although, on the other side of the coin, people may avoid checking mirrors because they want to escape their perceived "defect" and avoid distress.  Checking rituals generally intensify the anxiety and preoccupation by reinforcing the need to escape (similar to obsessive-compulsive disorder).
Distress from this disorder may cause a person to seek medical, dental, or surgical treatments to correct their imagined defect.  This disorder is also associated with eating disorders such as Bulimia and Anorexia. 

 

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