Body Dysmorphic Disorder – Diagnosis and Treatment

Diagnosis

Healthcare providers first rule out other medical causes when they suspect body dysmorphic disorder (BDD). Then, a mental health expert assesses the person’s thoughts, emotions, and behaviors linked to a negative self-image.

They review the person’s medical and family history and ask about the frequency and intensity of concerns about physical appearance.

Common signs include obsessive thoughts about perceived flaws, muscle dysmorphia, excessive grooming or mirror-checking, skin picking, and significant distress or avoidance of social situations.

The evaluation may also screen for related mental health conditions such as depression, anxiety disorders, eating disorders, or obsessive-compulsive disorder (OCD). Standardized questionnaires or diagnostic tools, like the Body Dysmorphic Disorder Questionnaire (BDDQ), may be used to support the diagnosis.

Diagnosis is typically based on clinical interviews following DSM-5 criteria, which include preoccupation with perceived defects that are not observable or appear slight to others, repetitive behaviors or mental acts related to appearance, and significant distress or impairment in daily functioning.

Treatment

Talking Therapy Approaches

Therapists often use cognitive-behavioral therapy (CBT) to manage body image disorders. They help people notice and change unhelpful thoughts about their appearance.

The main goals are to challenge negative beliefs about body image and encourage more positive thinking patterns.

Therapists teach skills to avoid checking mirrors, asking for constant reassurance, or using cosmetic services too much. They also help build healthy habits and increase participation in social and supportive activities.

CBT can be tailored to each person’s needs. Family involvement, especially when treating teenagers, can improve results.

Medication Options

Doctors may prescribe selective serotonin reuptake inhibitors (SSRIs) to help with BDD. These medications target the brain’s serotonin system and can reduce obsessive thinking and repeated behaviors linked to body image.

If symptoms do not improve with SSRIs alone, a doctor might suggest adding another medication.

Inpatient Care for Severe Cases

If symptoms become very serious, such as when a person cannot handle daily life or is at risk of harming themselves, a short stay in a mental health hospital may be necessary.

Inpatient care offers a safe place for support, monitoring, and treatment until it is safer for the person to return home.

Psychiatric hospitalization helps stabilize severe symptoms and allows doctors to start or adjust care as needed.

Everyday Tips and Self-Help

People with body dysmorphic disorder can take practical steps at home to support recovery. Learning about the condition can help individuals understand their symptoms and feel more in control.

Following the treatment plan, including attending therapy and taking prescribed medication, is important, even on days when motivation is low. It helps to know personal warning signs and triggers.

Keeping a list of these and sharing it with healthcare providers can make it easier to manage flare-ups. Practicing coping skills learned in therapy, such as stress management and positive self-talk, builds confidence over time.

Staying active with enjoyable activities like walking, swimming, or gardening can relieve stress and improve mood. Gentle exercise is helpful, but avoid over-exercising to change appearance, as this can make symptoms worse.

People should avoid alcohol and recreational drugs because these may worsen symptoms or medication side effects. If someone is thinking about cosmetic surgery for scars or other perceived flaws, they should talk with a mental health provider first.

Cosmetic procedures usually do not help with body dysmorphic disorder and can lead to more distress.

Ways to Manage and Find Support

People with body dysmorphic disorder often find it challenging to maintain good mental health and daily functioning. Building positive coping skills and seeking support can improve well-being.

Helpful Strategies Include:

Tip Benefit
Write in a journal Manage thoughts and emotions
Stay connected Reduce isolation
Prioritize self-care Boost overall well-being
Join a support group Get emotional support
Learn stress skills Handle daily challenges
Wait before big decisions Avoid choices made in despair
  • Keeping a journal to track negative thoughts and feelings. This helps someone notice patterns and start changing unwanted behaviors.

  • Staying connected with friends and family. Social activities can reduce feelings of isolation and offer support during difficult times.

  • Looking after physical health by eating balanced meals, exercising regularly, and getting enough rest.

  • Joining support groups to connect with others facing similar struggles. Shared experiences can offer comfort and new coping ideas.

  • Practicing stress management with techniques like deep breathing or meditation. These can lower anxiety and improve mood.

  • Delaying big decisions during periods of distress, especially if experiencing suicidal thoughts. Waiting and talking to a mental health provider can help.

If someone struggles with constant dissatisfaction, low self-esteem, or finds it hard to manage daily tasks, speaking to a mental health professional can help.

Professionals can guide people toward safer coping strategies and provide more support if there are signs of suicidal thoughts.

Getting Ready for Your Visit

Steps You Can Take Beforehand

Adolescents, adults, and their families can prepare for a mental health appointment by making a detailed list before the visit.

Some things to write down include:

  • Noticed Symptoms: List any changes in behavior, thoughts, or feelings that have lasted for a while. Ask family or friends if they have noticed anything.

  • Personal Information: Record life events that may be stressful or traumatic. Include anything that has affected your emotions or mental health.

  • Family Medical Background: Find out if anyone in your family has had body dysmorphic disorder, obsessive-compulsive disorder, or other mental health conditions.

  • Diagnosed Conditions: List any physical or mental health conditions you have been told you have before.

  • Medications and Supplements: Write down all medications, vitamins, herbs, or supplements you use, with names and doses.

  • Questions for the Provider: Prepare questions ahead of time. For example:

Sample Questions
What might be causing my symptoms?
Could behavioral therapy work for me?
Are there medications I should consider?
How long might treatment last?
What can I do at home to help myself get better?
Do you have brochures or materials I can read?

Bringing this information helps everyone make the most out of the visit. Be ready to write down new questions during your appointment.

Questions You Might Get from the Provider

During your visit, the healthcare provider or mental health professional will likely ask questions to better understand your situation.

Here are some examples:

  • Are you worried about specific parts of your appearance?

  • When did these worries start?

  • How do these feelings or behaviors affect your everyday life?

  • How much time each day do you think about your appearance?

  • Have you tried any treatments in the past?

  • Have you ever had any cosmetic procedures?

  • What things have you done to try to cope or feel better?

  • Is there anything that makes your symptoms worse?

  • Have family or friends noticed any changes in you?

  • Does anyone in your family have a mental health diagnosis?

  • What are you hoping to achieve with treatment?

  • What medications or supplements are you currently using?

The provider may ask more questions based on your answers.

If you think about these topics in advance, you can feel more comfortable during the visit. This preparation can also help the process go more smoothly.


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