Body dysmorphic disorder (BDD) is a potentially devastating and often disabling mental condition that is under recognized and quite often misunderstood by the general public and therapists alike.  Inflicting more than possibly 2% of the population, it is not extremely common, yet also not insignificant enough to be ignored. Sufferers display a wide variety of symptoms, recorded since the late 19th century, revolving around obsessive thoughts and compulsive behaviors relating to physical appearance. The term body dysmorphic disorder is somewhat misleading, considering not only the body, but also aspects of the face and extremities, can be the object of dissatisfaction as well.  Although BDD has been classified since 1987 in the DSM-IV as a somatoform disorder, researchers believe it may be related to the anxiety disorders, such as obsessive compulsive disorder (OCD); some deem it nothing more than a specific type of OCD obsession. Unfortunately, BDD is considered more difficult to cure than many of its possible relatives, but is nevertheless considered treatable.

Understanding BDD
I didn't go to college yesterday. I got up early and started to get ready to go today but I couldn't. I put my makeup on but nothing would go right. I look at my reflection and I feel physically sick. I have huge bags under my eyes and my eyelids are red. My face is all swollen and the skin is terrible. I just collapsed in tears. My mum was angry with me because I didn't go, and I just felt worthless. She said there was nothing wrong with me and I was ruining my life. I don't want to be like this. Yesterday I cut myself all over my arms and my hands, and today it's starting to hurt a bit as the wounds start to heal. I've been crying a lot. I thought maybe things were getting better but I was just kidding myself. Nothing can get better yet. I'm just trapped.
(Anonymous, 2002)


The painful and chilling personal account from an anonymous sufferer illustrates just how severe this little understood disorder can be. BDD, which covers a large spectrum of functionality, with some victims being preoccupied with obsessive thoughts and others being completely housebound, has the potential to be seriously devastating and even life threatening; it is much more serious than a general dissatisfaction with appearance or regular self esteem issues. One of the most unfortunate aspects of the disorder is that it mimics ordinary appearance concerns, or even vanity, making non-sufferers assume it is trite and insignificant, when in reality, most do not truly comprehend the severity of the disorder.