Feeling Ugly – Body Dysmorphic Disorder

Also called “ugliness imagined”, Body Dysmorphic Disorder (BDD) is a chronic mental illness. In general, afflicted individuals are unable to stop obsessing about their appearance.

It could be that they are actually disfigured. It could be that they just have some minor physical flaw. And it could be that they are just imagining all of it.

Sufferers of BDD feel ashamed of themselves. They feel that their appearance is so distressing to others that they are better off just being unseen. Sometimes, hours are spent every day intensely thinking about the real or imagined appearance flaws.

BDD is also called dysmorphophobia. That translates literally into the fear of deformity. Those that have it often try various procedures to defeat it. Many times, they undergo cosmetic surgeries to no avail. Most often, no matter what they try they are still left with feelings of physical inferiority.

Symptoms of Body Dysmorphic Disorder:

  • Either looking in the mirror all the time – or completely avoiding mirrors
  • Undergoing regular cosmetic procedures that yield no positive results
  • A strong preoccupation with a real or imagined flaws in physicality
  • Being convinced that an appearance abnormality exists
  • Shying away from photographs
  • Obsessive grooming, including plucking hair out
  • Picking your skin
  • Consistently comparing your physical appearance to those of others
  • Wearing too much makeup
  • Attempting to cover the flaw with various types of clothing

Common bodily features targeted by BDD:

  • Skin and hair
  • Nose and eyes
  • Head, facial and body hair
  • Freckles and moles
  • Baldness
  • Size of muscles
  • Size of breasts
  • Size and appearance of genitalia

A given individual suffering from dysmorphophobia may experience changes concerning which bodily parts they obsess over as time progresses. Any attempts by others to try to convince them that they are erroneous in their self-judgment are fruitless. With a mindset similar to those afflicted with anorexia nervosa, those with BDD often seem insane to others.

Some individuals may be so affected by this imagined ugliness that they are even too ashamed to seek treatment. And if left untreated, the symptoms of Body Dysmorphic Disorder may trigger thoughts and actions of suicide.

What causes Body Dysmorphic Disorder?

In short, nobody knows for sure. However, medical professionals understand that BDD, like many types of mental illness, can be brought on by a variety of factors including:

  • Genetic causes
  • Biochemical causes
  • Environmental causes

Factors that may increase an individual’s risk of developing BDD:

  • Having relatives with the condition
  • Being teased too much as a child
  • Being abused either sexually or physically
  • Having low self esteem
  • Pressure from society to be beautiful

Body Dysmorphic Disorder occurs equally amongst women and men. Approximately 1% of the planet’s population is thought to suffer from BDD. It normally begins developing during adolescence. Without treatment, BDD may also lead to other conditions including:

  • Suicide
  • Mood disorders including depression
  • OCD (obsessive compulsive disorder)
  • Improper eating habits
  • Fear of socialization
  • Drug abuse
  • Isolation
  • Problems with work or school attendance
  • Unwarranted cosmetic surgery procedures
  • Anxiety


Treating BDD is a difficult undertaking. Many times, the disorder is lodged deeply within the mind. Basically, there are two treatment methods to consider: medicine and counseling.


Regular counseling sessions can help individuals afflicted with Body Dysmorphic Disorder to make better sense of their moods, behaviors, feelings and thoughts. Developing the ability to disallow the triggers of BDD, psychotherapy retrains the minds of patients to see the world in a more positively realistic manner.

Additionally, psychotherapy can teach you how to healthily deal with urges to pick your skin, constantly check the mirror and more. Cognitive behavioral therapy is the intervention of choice.


No medications exist specifically for the treatment of Body Dysmorphic Disorder. However there are medications mainly used for treating depression, that affect serotonin levels in the brain, which used for treatment of BDD symptoms. SSRIs (Selective Serotonin Reuptake Inhibitors) and tricyclic antidepressants are utilized.

In many cases, up to 12 weeks or more are necessary for effective symptom alleviation. Also be aware that the first medication that your doctor tries may not be the one that’s right for you. And of course, as with all medications, you need to be on the lookout for possible side effects. In extreme cases, individuals may require in-house treatment at a psychiatric hospital.


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