Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder (BDD), as outlined in the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), is a mental disorder characterised by an obsessive focus on a perceived flaw in appearance, which may be minor or not observable to others.

1. Preoccupation: Individuals with BDD are preoccupied with one or more perceived defects or flaws in their physical appearance, which are not observable or appear slight to others.
2. Repetitive Behaviours: This preoccupation leads to repetitive behaviours (e.g., mirror checking, excessive grooming, skin picking) or mental acts (e.g., comparing one’s appearance with that of others) in response to the appearance concerns.
3. Clinical Significance: The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
4. Differentiation from Eating Disorders: The preoccupation with body image must not be better accounted for by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.

BDD is often associated with significant emotional distress and can severely impact daily functioning. Individuals may avoid social situations due to feelings of self-consciousness about their appearance, and in severe cases, might resort to multiple cosmetic procedures with little satisfaction.

It’s important to note that BDD is distinct from normal preoccupations with appearance. The level of preoccupation in BDD is excessive and can often lead to significant distress and difficulties in daily functioning. The disorder may co-occur with other mental disorders, such as major depression and anxiety disorders, and is often linked to a high risk of suicidal thoughts and behaviours.

Treatment often involves a combination of cognitive-behavioural therapy (CBT), which helps individuals challenge and change their distorted perceptions and behaviours, and medication, typically selective serotonin reuptake inhibitors (SSRIs), which can help reduce the obsessive-compulsive aspects of the disorder.