What is body dysmorphic disorder?

It's common for people to want to look their best. Many of us spend some time on our clothes and hair, and we take pride in our appearance. But people who have body dysmorphic (say "dis-MOR-fick") disorder (BDD) believe that they look ugly or deformed. So they spend many hours every day worrying about their appearance and trying to hide or fix it.

Life can be very painful if you have BDD. You may feel ashamed of how you look. You may worry that others will reject you. Or you may be afraid that you aren't lovable.

If you have BDD, you may not see that the problem you have with your appearance isn't real. Other people may tell you that you look fine. They may say that they don't even notice your "flaw." But BDD prevents you from believing them. Most people with BDD can't see themselves as they really are.

People with BDD are often so anxious about how they look that they pull away from work and school. They may avoid friends, family, and social activities. They find it very hard to date or have romantic relationships. Some may consider suicide.

The cause of the disorder is not known. But it may be due to a mix of genetics, family behaviours, social factors, and personality traits.

It's important to know that BDD is not your fault. It's a mental health condition that can be treated with medicines and counselling. Treatment can help you see yourself in a more positive way.

What are the symptoms?

People with body dysmorphic disorder may:

• Spend many hours a day checking their appearance in mirrors and windows, or avoiding them.
• Try to hide the "flawed" part from others by often changing their clothes or posture.
• Pick at their skin.
• Seek treatment for wrinkles, bumps, marks, or scars that aren't there or are minor. They may also seek plastic surgery that they don't need. And if they get the treatment or surgery, they tend to be unhappy with the results.
• Think about suicide.

Men and women with BDD may act in different ways.

• Men might spend many hours a day lifting weights. They might also diet and take steroids or other drugs to make them look more muscular.
• Women might re-do their makeup or hair often. They may eat too little or take drugs to control their appetite. Or they might exercise for hours.

How is BDD treated?

There are two main treatments for body dysmorphic disorder:

• Cognitive behavioural therapy. This is a type of counselling that focuses on changing certain thoughts and behaviours. It can help you change how you think and feel about your appearance. Try to find a counsellor who understands the pain this condition causes. Your doctor can help you find one.
• Medicines, such as serotonin reuptake inhibitors (SSRIs). These are usually used together with counselling.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

• You feel you cannot stop from hurting yourself or someone else.

Where to get help 24 hours a day, 7 days a week

If you or someone you know talks about suicide, self-harm, a mental health crisis, a substance use crisis, or any other kind of emotional distress, get help right away.

• Call Talk Suicide Canada: 1-833-456-4566 or text 45645 (4 p.m. to midnight ET).
• Kids or teens can call Kids Help Phone: 1-800-668-6868 or text CONNECT to 686868.
• Go to the Talk Suicide Canada website at https://talksuicide.ca or the Kids Help Phone website at https://kidshelpphone.ca for more information.

Consider saving these numbers in your phone.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if:

• You have new anxiety, or your anxiety gets worse.
• You have been feeling sad, depressed, or hopeless or have lost interest in things that you usually enjoy.
• You are not getting better as expected.