Sometimes I am so intensely busy washing my hair, styling it and starting over if it is not right, that I forget the time. For example, I'm late for school several times a week.

Imane

Did you know this?

With Body Dysmorphic Disorder (BDD), disturbed body perception is at the forefront. You don't like yourself or a certain part of your body. This "imperfection" is either imagined or greatly exaggerated. BBD occurs in 2% of the population. In young people, this figure rises to 4%. It manifests on average at the age of 16 and is equally common in males and females. Because of shame, adolescents with BDD find it difficult to seek help.

Obsessed with appearance

Everyone likes to look good. Appearance is important to young people. Sometimes dissatisfaction with one's own appearance goes too far and you can become obsessed with apparent "defects" about your appearance, when to others those defects are undetectable or minor.

With Body Dysmorphic Disorder, you put an awful lot of time and energy into fretting about how you look. Your thoughts about your appearance are difficult, if not impossible, to stop. They determine much of your daily functioning. Concerns can be very specific (e.g., "My nose is too big," "I'm not muscular enough") or vague (e.g., "I feel ugly"). Males especially worry about their muscle size.

To feel better, you develop rituals. For example, you often stand in front of the mirror for hours, wear a cap, exercise for hours every day, spend a lot of money on cosmetics and clothing, or even get plastic surgery.

You might have BDD if you:

  • Worry a lot about a particular part of your body for no reason
  • Spend a lot of time comparing your appearance to others
  • Look at yourself a lot in mirrors or avoid mirrors altogether
  • Spend a lot of time on your appearance to hide flaws
  • Are anxious in social situations or avoid them because you fear that others will reject you due to the body features you are conscious of

The impact on your functioning cannot be underestimated. Worrying about your appearance makes you feel upset, anxious, lonely and depressed. You often experience life as a struggle and struggle with guilt. BDD can also lead to depression, self-injury and even suicidal thoughts.

I sometimes spent 4 to 5 hours getting ready to leave. All my energy went into applying foundation and concealer to make my face as 'presentable' as possible.

Meryem

Talk about it

Do you spend (too) much time in front of the mirror? Are you overly concerned with how you look? Are you avoiding social activities because you don't feel good about your appearance? If so, try to start a conversation about this.

Talk to somebody you trust and feel good around, preferably someone you know, like a good friend, your parents or siblings.

If you struggle to talk to someone in your close surroundings, try to approach a person who is familiar with similar experiences, such as a GP or a student advisor at your college or university.

Would you prefer to share your story anonymously? You can always get in touch with Awel (102 or awel.be) or Tele-Onthaal (106 or tele-onthaal.be). For questions about suicide, contact the Suicide Hotline (1813 or zelfmoord1813.be).

Get help

BDD can have a strong impact on your functioning. You can turn to counsellors who specialize in anxiety and compulsion, or behavioural therapy. Your GP can certainly help you have an initial consultation.

Cognitive behavioural therapy and psychoeducation are very helpful for the treatment of BDD. The emphasis of the treatment is on a gradual confrontation with your body image and making your body experiences negotiable. You learn to understand your negative thoughts and work on your avoidance behaviour. In this way you can break the vicious circle of negative thoughts. Psychoeducation gives you more insight into BDD and thus into your own reactions.

Mindfulness, training to stop worrying and relaxation can also help regulate your emotions. In some cases, a doctor may prescribe medication for a certain period.

For some young people, it may be helpful to contact peers for information, advice and practical tips for dealing with BDD.

Get help

Worried about someone?

Have you noticed a friend dealing with symptoms of BDD, and are you worried about them? Talk about it and share your concerns. Try to be understanding and listen to their story without judging.

Tips to start a conversation

Keen to learn, read or hear more about this topic?

Podcasts

Ted Talks

Websites

  • On Bddfoundation.org you can find extensive info, a self-test, testimonials, sources of strength and information on the path to self-help, support and therapy.
  • On Bdd.iofcd.org you can find more info on signs and symptoms and how BDD can be treated.
  • BDD-Info brings testimonials from fellow sufferers (men, women and those around them).
  • In the Guide for students with BDD you can find info on signs, impact, self-teting and how to cope with BDD.