Body dysmorphic disorder (BDD)
Body Dysmorphic Disorder, or BDD, is experienced as a persistent and distressing preoccupation with a perceived flaw in appearance. To the person, the perceived flaw feels obvious, important and impossible to look past.
This is not vanity, and it is not about caring too much about looks. It is a real and often exhausting source of distress. It makes complete sense that it feels so consuming, because often a person's sense of worth has become exclusively tied to it over time.
This can slowly shrink a person's world. They might stop going out, avoid situations where they feel seen, spend more and more time at home, pull back from friendships, or find it harder to stay close to the people who matter to them.
BDD can be misunderstood and goes unrecognised for a long time, sometimes years. People who experience it, despite being highly intelligent, can have little insight that BDD is at work in their lives. It doesn't tend to feel like a psychological problem. Rather, it feels like a physical problem, a flaw that is getting in the way of living.
It is almost always accompanied by deep shame, a sense that this can't be spoken about, that it's somehow too much, that it needs to stay hidden.
That grip tends to loosen the moment it's actually spoken about. Simply naming what's going on is often where things start to feel more manageable.
Signs you might notice
It doesn't need to tick every box. What matters is how this feels and how it impacts your life. BDD affects men and women at similar rates. The concern can centre on any part of the body, and in men it may also take the form of muscle dysmorphia.
- Preoccupation
- Most people think about how they look sometimes. BDD tends to be different in degree: thinking about it for an hour or more most days, sometimes much longer, and finding it hard to redirect your attention away once it starts.
- Checking
- Long stretches in front of mirrors or reflective surfaces, often more than once a day.
- Camouflaging
- Makeup, styling, or specific clothing, most days, to hide the area of concern.
- Comparing
- Comparing yourself to others many times a day, in person, in photos, or online, and finding it hard to stop once it starts.
- Reassurance-seeking
- Repeatedly asking if you look okay, even right after being told you do, and the relief not lasting long.
- Avoiding
- Skipping photos, events, or certain lighting because of how you might look.
- Shrinking life
- Slowly doing less and seeing fewer people, without it being obvious that's what's happening.
This list is not a diagnostic tool, and it doesn't need to tick every box. If some of this feels familiar, that is worth looking at. Many people carry this kind of pain for years before recognising it or reaching out for support.
Further support
Organisations with information, helplines and self-help resources.
Talk to Sarsha
BDD is a particular area of interest and published research for Sarsha. If you'd like to talk it through, you're welcome to get in touch, in person in Fremantle or by telehealth anywhere in Australia.
Because the belief is held so strongly and the distress runs so deep, BDD carries a higher risk of suicide than many other conditions. It is serious, and it is treatable. If things feel urgent right now, Lifeline (13 11 14) is available 24 hours a day.
Get in touch