I am ‘Ugly’?: Body Dysmorphic Disorder’s Causes and Treatments

By Wasim Kakroo

YOU may not be comfortable about your physical appearance. Your broad thighs, the breadth of your nose, the size of your lips, or the amount of space between your eyes may be something you do not like. Some people, however, take their concerns to a new level. They are overly concerned with their appearance to the point where it is interfering with their lives. Despite evidence to the contrary, they have predominantly unfavourable opinions about their appearances and bodies. This body consciousness may interfere with their ability to function at school or at job. Such people may be suffering from BDD, or body dysmorphic disorder.

What is body dysmorphic disorder (BDD)?

Body dysmorphic disorder is a mental health issue. A person suffering from body dysmorphic disorder becomes extremely concerned about a physical flaw. Frequently, they’re imagining the flaw, or it’s so insignificant that no one else notices it. As a result, people with this illness typically regard themselves as “ugly,” avoiding social situations or sometimes even resorting to plastic surgery to alter their appearance. The emotions associated with the concern about their appearance overwhelm a person’s mind, impairing their day to day social and professional activities.

What are the effects of body dysmorphic disorder (BDD) on people?

People who suffer from body dysmorphic disorder may:

Believe they are “ugly.”

Spend hours thinking about their perceived defects on a daily basis.

Skip work or school because they don’t want to be seen.

Avoid spending time with relatives and friends.

Have plastic surgery (perhaps numerous surgeries) to improve their appearance.

Experience a lot of emotional pain and do a lot of things that aren’t good for them.

Who is at risk of developing body dysmorphic disorder (BDD)?

People of any gender might be affected by body dysmorphic disorder. It usually starts in adolescence or early adulthood. At this age, children begin to compare themselves to others. Body dysmorphic disorder is a chronic mental health issue.

Body dysmorphic disorder if left untreated can worsen as people age. Physical changes associated with ageing, such as wrinkles and grey hair, make them even more sad.

What parts of the body are patients with Body dysmorphic disorder (BDD) concerned about?

The following are the most common areas of worry for people with this condition:

Wrinkles, scars, acne, and pimples are examples of skin flaws they feel concerned about.

Hair, whether on the head or on the body, or baldness.

The nose is one of the most common facial feature they are concerned about. Some feel their nose is too short, some feel it is too long, while as others feel it is too broad or it is not straight.

Then shape of their stomach or chest

Other areas they feel concerned about are:

Size of the penis.


Size of breasts.

Shape of thighs.

Size of buttocks.

Odours from the body

What factors contribute to Body Dysmorphic Disorder (BDD)?

We don’t know the exact cause of Body Dysmorphic Disorder (BDD). According to one view, certain neurotransmitters (brain chemicals) are malfunctioning (chemicals that help nerve cells in the brain send messages to each other). This notion is supported by the fact that patients with Body Dysmorphic Disorder (BDD) are more likely to have additional mental health issues, such as significant depression and anxiety.

Other factors that could impact or induce the onset of Body Dysmorphic Disorder (BDD) include:

Having been exposed to traumatic events or emotional conflict as a child.

Poor self-esteem.

Parents and others who would criticize the patient’s appearance.

Peer pressure and a society that associates beauty and worth with physical appearance.

What are the various symptoms of Body Dysmorphic Disorder?

People who suffer from Body Dysmorphic Disorder have distorted perceptions of themselves. This can lead to them avoiding others, engaging in dangerous habits, or undergoing many repetitive surgical procedures to cure problems they believe they have.

The following are some of the warning signs that a person may have Body Dysmorphic Disorder:

Preoccupation with one or more physical flaws or defects that are not visible to others or look minor to others.

Looking in the mirror, picking at the skin, and attempting to hide or cover up the flaw are all examples of repeated and time-consuming actions.

Continually seeking assurance that the flaw isn’t visible or obvious.

Because the person can’t stop thinking about the flaw, they’re having troubles at job, school, and in relationships.

Feeling self-conscious and unable to go out in public, or experiencing anxiety when in the presence of others.

Visiting medical specialists, such as plastic surgeons or dermatologists, on a regular basis to discuss strategies to improve his or her appearance.

Why is it so difficult to diagnose Body Dysmorphic Disorder (BDD)?

Because people are typically ashamed of their feelings and symptoms, diagnosing this illness can be difficult. They may be embarrassed and prefer not to disclose their symptoms to their healthcare practitioners. For years, the disorder may go unnoticed. Many people who suffer from Body Dysmorphic Disorder (BDD) go undiagnosed.

Who are the professionals that diagnose body dysmorphic disorder (BDD)?

BDD can be diagnosed and treated by a psychiatrist and/or a trained psychologist.

The person’s attitude, conduct, and symptoms are assessed by these mental health professionals. Body dysmorphic disorder is frequently diagnosed when a person:

Is fixated on a flaw or deficiencies in their physical appearance.

Perform repetitive actions (grooming, checking their appearance in the mirror) because they are concerned about their appearance.

Is unable to function at work or at home because they are preoccupied with their appearance.

What are the various treatment options for body dysmorphic disorder?

Treatment for Body Dysmorphic Disorder frequently comprises a combination of the following:

Psychotherapy: Individual counselling focuses on altering a person’s thinking (cognition) and behaviour. Through counseling, a trained psychologist restructure their thoughts about the fault and reduce their obsessive behaviours about their appearance.

Exposure and Response Prevention (ERP): ERP employs thoughts and real-life experiences to demonstrate to the person that their perception of oneself is inaccurate.

Medication: Body dysmorphic disorder can be treated with antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

Family Support: Family support is essential for successful treatment. Family members need to learn to recognize and understand the signs and symptoms of body dysmorphic disorder and encourage the person to handle it. Family support can be phenomenal in terms of recovery from this mental health issue.

  • The author is a licensed clinical psychologist (alumni of Govt. Medical College Srinagar). He works at Kashmir Life Line, a free mental health counseling service. Author can be reached at [email protected]

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