Body Dysmorphic Disorder: Symptoms, Causes, Treatment

The body dysmorphic disorder , formerly known as body dysmorphic disorder, is characterized by the belief that a person that has a physical defect that really is imaginary, because its appearance is normal.

This non-reality-based belief causes the person to become unrelated to others for fear of being criticized or laughed at in their ugliness.

Body dysmorphic disorder

This psychopathological disorder can develop so much that the person who suffers it can end up losing their social skills .

Being characteristic, this disorder has also been called “imaginary ugliness”.

It is a psychopathology that begins in adolescence and affects both male and female.

One of the symptoms of this disorder are the ideas of reference; The person thinks that everything that happens around him has to do with him / her. This can lead to social isolation.

These are the most common imaginary defects in these people:

  • Hair
  • Nose
  • Skin
  • Eyes
  • Head or face
  • Body constitution
  • Lips
  • Chin stomach or waist
  • Teeth
  • Legs / knees
  • Breasts / body muscles
  • Ears
  • Cheeks
  • Rear
  • Penis
  • arms
  • Neck
  • Front
  • Muscles
  • Shoulders
  • Hips

It is common for people with this disorder to constantly check their physical mirrors to see if there is any change.

However, there is the other extreme; those who avoid mirrors.

Ideas about suicide or attempted suicide can occur in this disorder.

Symptoms of Body Dysmorphic Disorder

Here are the main features of people with body dysmorphic disorder (BCD):

  • They think they have unreal imperfections.
  • Constant preoccupations about imperfections.
  • They want to improve the appearance they consider problematic and may consider dermatological treatments, cosmetics or cosmetic surgeries.
  • These treatments do not usually solve the problem.
  • Treatments can be performed by themselves or by other people and can lead to the worsening of the problem.
  • They can show repetitive or compulsive actions like camouflaging (with clothes, make-up or hats).
  • They look constantly in the mirror or avoid it.
  • High levels of depression and social phobia can occur.
  • Suicidal thoughts.
  • The need to ask for opinion about one’s own physical body to other people.
  • Avoid appearing in photos.

Causes and risk factors

It is not specifically known what causes TDC. Like other psychopathological disorders, it can result from a combination of factors:

  • Genetics: Some studies have shown that BDD is more common in people whose relatives also have the condition, indicating that there might be a gene associated with this disorder.
  • Environmental: the environment, experiences and culture can contribute, especially if there are negative experiences related to the body or self-image.
  • Brain: Abnormalities in brain structure may play a role.

Body Dysmorphic Disorder

The risk factors that make the onset of the problem more likely are:

  • Negative life experiences, such as bullying .
  • Social pressure or expectations of beauty.
  • Having another psychiatric disorder such as anxiety or depression.
  • Having relatives with the same disorder.
  • Personality traits such as low self-esteem .

Diagnostic criteria for the disorder (DSM IV)

  1. A) Concern for an imaginary defect in appearance. If there is a small anomaly, the person’s concern is exaggerated.
  2. B) Worry causes anxiety or significant harm in the social, work and other important areas of life.
  3. C) The concern is not explained by another mental disorder (for example dissatisfaction in form or body size in anorexia nervosa).


The main recommended treatments are:

Cognitive behavioral therapy (CBT)

A meta-analysis found that cognitive behavioral therapy is more effective than medication 16 weeks after starting treatment.

Also Read : Delusional Disorder: Treatment, Symptoms and Causes

It is believed that it can improve the connections between the orbitofrontal cortex and the amygdala .

The goal is to teach patients to recognize irrational thoughts and to change negative thought patterns by positive thoughts.


They include selective inhibitors of serotonin reuptake (SSRI), which can help control obsessional symptoms.

SSRIs are a type of antidepressants that increase levels in the brain of a neurotransmitter called serotonin.

Family therapy

Social support is important for treatment success, and it is important for the family to know what CDD is and how to treat it.


There may be several complications caused by TDC:

  • Social isolation.
  • Social Phobia .
  • Shortage of personal relationships.
  • Difficulty going to work or training.
  • Low self-esteem .
  • Repeated hospitalizations.
  • Suicidal thoughts and behaviors.
  • Obsessive compulsive disorder .
  • Eating Disorders.
  • Substance abuse.

Do cosmetic procedures work?

Although it seems that a surgical procedure could correct the imaginary defect, they do not correct the disorder or relieve its symptoms.

In fact, people do not feel benefited from the surgeries, they can repeat them several times or even sue the surgeons for negligence.


It is recommended that the person with TDC go to a mental health professional – psychologist or pisquiatra – to evaluate their case and establish a diagnosis and treatment.

Cognitive-behavioral therapy is the most effective treatment and plastic surgery should be avoided, at least until psychopathology has not been treated and corrected.


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