What Is The Best Type Of Body Dysmorphic Disorder Treatment For Me?
Many might struggle with accepting their bodies from time to time. However, some individuals can develop a mental health condition that can cause them to experience intense feelings of worry about perceived flaws in their bodies—whether or not those flaws are truly there. This is generally known as body dysmorphic disorder. A range of different treatments can support those who are currently living with this condition, possibly helping them to reduce symptomatic expression and elevate their quality of life.
We’ve summarized a list of possible body dysmorphic disorder treatments below for your consideration.
About body dysmorphic disorder and obsessive-compulsive disorder
Body dysmorphic disorder (BDD) is a mental health condition characterized by obsessive preoccupation with perceived flaws or defects in one's physical appearance, often leading to distress and impairment in daily life.
It is closely related to obsessive-compulsive disorder (OCD) as both are characterized by intrusive thoughts and repetitive behaviors. While individuals diagnosed with BDD obsess over perceived flaws in their appearance, those with OCD may engage in rituals to alleviate the distress caused by intrusive thoughts.
It is closely related to obsessive-compulsive disorder (OCD) as both are characterized by intrusive thoughts and repetitive behaviors.
Risk factors for BDD include a family history of the disorder, social anxiety, and reassurance-seeking behaviors. Without proper attention and treatment by healthcare providers to diagnose BDD, the symptoms may worsen. Individuals might experience severe depression, social avoidance, substance use*, and even suicidal* thoughts or actions if BDD is left untreated.
Therapy for body dysmorphic disorder aims to address the diagnosis, reduce symptoms, and address challenges should symptoms return. For example, a mental health professional might aim to help an individual return to social activities without focusing on his or her appearance.
*If you believe you or a loved one is experiencing or at risk for substance use disorder, reach out for help immediately. The Substance Abuse and Mental Health Services Administration or SAMHSA National Helpline can be reached at 1-800-662-4357 and is available 24/7.
*If you or a loved one is experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide and Crisis Lifeline can be reached at 988 and is available 24/7.
The best type of treatment for BDD
At the time of this publication, there is no singular, unanimously defined "cure" for, or any way to prevent body dysmorphic disorder. However, there are treatments that can help you manage BDD symptoms that you’re experiencing, possibly limiting their implication and role in your daily life. Body dysmorphic disorder is treated with two primary methods found to be effective: SSRI medications and cognitive behavioral therapy.
After having your body dysmorphic disorder diagnosed, doctors might suggest that you undergo both medication and psychotherapy treatment as a combined, concentrated effort if you choose to seek treatment. This might be because medication-related intervention can help abate some of the symptoms of body dysmorphic disorder while you are going through cognitive behavioral therapy.
Consulting with a medical provider before deciding to take a new medication is generally the best path to take, as you can maximize your benefit while limiting your potential for negative outcomes.
We do want to note: The best type of treatment for you will generally depend on what’s most effective for your specific needs. You can work alongside a team of mental health and medical professionals to come up with a plan of action. You may have to try different treatments or even a combination of methods until you find which ones are right for you.
How does cognitive behavioral therapy help those living with body dysmorphic disorder (BDD)?
Cognitive behavioral therapy is generally defined as a form of psychotherapy that can support people in recognizing and changing thoughts or behavior consciously and mindfully.
This approach is called CBT due to the structure of the approach. You may be asked to examine thoughts and behaviors objectively during sessions with the help of a therapist. Over time, you can learn new ways to take control of your thoughts and actions when on your own.
One study found that CBT eliminated symptoms of body dysmorphic disorder in 88% of patients. A total of 77% of patients retained that status and did not relapse after therapy was completed. This not only suggests the possible efficacy of this treatment measure, but it also can serve as an encouragement: Unlearning beliefs that have been held for so long can be difficult, but it is possible to do for many.
Exposure and ritual prevention
This is generally done as a part of cognitive behavioral therapy—however, it can also be done in a standalone way. In this supportive strategy, you may be asked to address your behavioral activities or avoidances. You and your therapist can then develop a hierarchy of nervousness you may experience in different situations that can make you feel uncomfortable or that you avoid.
After this, you may be asked to commit to exposing yourself to the items on this list, one at a time—starting with the least troublesome and most available to you at that time.
During this exercise, your therapist might also challenge you to stop certain rituals that you may be using to cope with your body dysmorphia. For example: If you are constantly checking yourself in the mirror, the therapist may challenge you to only look in the mirror a few times per day, decreasing as time goes on. The therapist can then give you different activities that you can do instead of looking in the mirror.
Perceptual retraining
Perceptual retraining can be helpful for those who might feel as if they obsess about one specific part of their appearance. Many people with body dysmorphia might stand or sit very close to the mirror to closely examine the aspect of their appearance that they are worried about—possibly worsening the symptomatic expression. For many, the first step of this process may include your therapist helping you identify your current bodily insecurities and how to work around them.
Once this occurs, they can then work with you to begin to change your perception of yourself. You may do this in stages, such as looking into a mirror at a conversational distance of two to three feet. The therapist may then challenge you to look into the mirror at the bigger picture rather than only at that thing about your appearance that you are concerned about.
They can help you point out good features that you have and recognize that the overall picture is not as offensive as your thoughts may lead you to believe.
Relapse prevention
Once you have met your goals in cognitive behavioral therapy, your therapist might then work with you to ensure that you do not relapse after therapy ends. Relapse prevention strategies can include helpful steps, such as going over the tools and strategies that you learned and discussing ways to apply those strategies in your everyday life. For some people, follow-up appointments every few months to go over and reinforce strategies may be helpful to prevent relapse.
SSRI medications
Some people with body dysmorphic disorder can benefit from treatment with medication. Body dysmorphia has some key characteristics that can be similar to obsessive-compulsive disorder, which can be frequently treated with SSRI antidepressant drugs.
Studies have suggested that SSRI drugs can be very effective in the treatment of BDD. Research and similar subsequent findings have been attributed to several different SSRI medications, many of which are thought to work in the same way.
If you are considering medication for the management of BDD, we do want to encourage you to reach out to a healthcare provider. They can help you to maximize your benefits and minimize medication-related risks, keeping you as safe as possible as you work to address BDD.
How can online therapy help those experiencing BDD?
If you are currently living with body dysmorphia or think you might have the condition, seeking help from an online therapist may help you find relief from your symptoms.
We do want to note that living with body dysmorphic disorder can be challenging. As a result, it might be difficult to find people to open up to who you’re sure won’t judge you if you seek therapy in an in-person setting. Online therapy, however, can empower you to you to speak with licensed counselors who can support and help you, possibly in a more attainable way.
Is online therapy with a mental health professional effective?
Online therapy can be an effective tool for treating a variety of mental health conditions, including body dysmorphic disorder. One study suggested that internet-based CBT reduced symptoms of BDD and improved existing symptoms of depression in the study participants. The majority of participants also reported being pleased with their treatment, with many saying they’d use it again.
Takeaway
How do you calm someone with body dysmorphia?
Because the symptoms of body dysmorphic disorder (BDD) can be painful and overwhelming, a solid support system of friends and family members can make a big difference for someone in treatment. There are a few ways you can serve as a refuge for calm and safety:
- Distract the individual and re-channel the focus to something besides their perceived flaws in appearance. Instead, encourage them to talk openly about how they feel.
- Take their feelings seriously, even if you can’t understand where they’re coming from. Avoid minimizing them or pointing out how they’re “wrong.”
- Avoid talking about your own insecurities and body image concerns. Even if your intentions are good, it can make things worse.
- Encourage them to seek counsel from a mental health professional.
- Let them know you’re there for them whenever they need you.
- Celebrate every win along their healing journey, no matter how small it may seem.
Can you beat BDD?
BDD is classified as an anxiety disorder similar to obsessive-compulsive (OCD) and eating disorders. As of yet, there is no cure— but there are many ways one can manage and treat body dysmorphic disorder:
- Psychotherapy—Common forms of therapy for treating BDD include cognitive behavioral therapy (CBT) and family-based therapy. Other methods of talk therapy, such as exposure therapy, are sometimes used in tandem with CBT treatment.
- Medications— Selective serotonin reuptake inhibitors (SSRIs) can help lessen BBD symptoms. In some cases, other medications like mood stabilizers.
- Self-Help Treatments— Some therapists recommend implementing self-care strategies to supplement other treatment options. For example, you may visit a support group for others with BDD outside of therapy. Your therapist may assign “homework” to review during your therapy sessions, such as keeping a journal to record your daily experiences. They may ask you to list things you like about yourself, such as skills, values, and character traits.
Part of self-help includes physical self-care. Getting plenty of rest, eating a healthy diet, and engaging in regular physical movement may be integral tools for recovery. Studies show that people with BDD and similar disorders are risk factors for substance abuse, so it’s vital to avoid drugs and alcohol.
Treatment for any mental illness should be guided by a mental health provider. A therapist can work with you to develop a treatment plan best suited to your specific needs.
Is BDD a form of OCD?
BDD is closely related to OCD, and they discuss many symptoms, including, but not limited to:
Compulsive and/or Repetitive Behaviors
Engaging in compulsive rituals and behaviors is a hallmark symptom of many anxiety disorders. In the case of BDD, these may include obsessive grooming, mirror checking (or avoidance), or approval-seeking behaviors.
Negative Thoughts
Compulsions are often internalized as well. People with BDD typically have repetitive negative thoughts about themselves and their appearance, or they may obsessively compare themselves to others. But they don’t always express these thoughts verbally. Sometimes, the people closest to them may not realize their loved one has BDD until they take extreme measures to “fix” themselves. For example, people with BDD may have excessive cosmetic procedures or develop an eating disorder.
Overwhelming Emotional Reactions
People with BDD may have strong emotional reactions to their appearance, such as self-hatred or disgust. Excessive worry and anxiety over appearance are common, as are feelings of shame and isolation from others.
What should you not say to someone with body dysmorphia?
It’s common for people offering BDD support to feel afraid they’ll accidentally say something to make it worse. Here are some things to avoid saying to someone with body dysmorphia:
- “Stop worrying about it.”
- “You shouldn’t care what other people think.”
- “I don’t know what you’re talking about; your (insert perceived flaw) is perfect.”
- “If you don’t like your (insert perceived flaw), do something about it.”
How do you uplift someone with body dysmorphia?
Start by letting them know you’re there to talk, but most importantly, listen and try to understand where they’re coming from. You’re not there to “fix” things but to be open-minded and support them by listening without judgment or giving advice.
You may also gently point out to them that “your experience is completely valid, but BDD often distorts peoples’ views of themselves. It’s possible the same may be true here.” You may also remind them that BDD is a common condition and that they’re not alone in their experience. Encourage them to contact a support group online or in their community for help.
How do people with body dysmorphia act?
Everyone exhibits symptoms of BDD differently, so there is no “template” for how one should act. Also, one symptom absent of any others may not be a sign of BDD— people typically display symptoms in clusters. That said, you may take note if someone you know:
- Compulsively checks their appearance in mirrors or goes out of their way to avoid looking in mirrors.
- Constantly compares themselves to others.
- Seeks constant reassurance from others about how they look.
- Exercises or grooms excessively.
- Puts themselves in financial jeopardy because they can’t stop spending money on beauty products, cosmetic procedures, etc.
- Goes out of their way to hide a body part they feel self-conscious about.
Does BDD get worse with age?
The average age of onset for BDD is between 12 and 16 years old. Research indicates that without early intervention, it does typically get worse with age. As the disorder progresses, individuals are more likely to develop comorbid conditions such as bulimia or anorexia nervosa and substance use disorders, as well as self-harming behaviors and suicidal ideation.
If you or a loved one are experiencing suicidal thoughts, reach out for help immediately. The National Suicide Prevention Lifeline can be reached 24/7 by dialing 988 or 1-800-273-TALK (8255).
Do people with BDD see others differently?
Research on perception in people with BDD shows they have neurological differences in how they perceive their own faces as well as the faces of others.
What are the two types of dysmorphia?
The two subtypes of BDD include muscle dysmorphia and BDD by proxy.
People with muscle dysmorphia may judge their body as insufficiently large or muscular. They may believe others are also judging their body in the same way. They typically have obsessive thoughts about their body that interfere with the person’s ability to function in daily life.
People with muscle dysmorphia may exhibit the following behavioral signs:
- Excessive weightlifting/exercising
- Compulsive calorie counting.
- Strict adherence to diet plans designed to promote muscle mass.
- Compulsively checking/avoiding the mirror.
- Wearing multiple layers of clothing or using other methods to make themselves appear larger.
- Using steroids or other performance-enhancing drugs.
People with BDD by proxy have a distressing fixation on perceived imperfections in another person’s (person of concern, or POC) appearance. Individuals with this type of BDD typically focus on a spouse or partner, but the POC may also be a parent, sibling, child, or stranger. Fixation most often involves the hair and skin, but they may target other body areas, too.
They may spend several hours a day preoccupied with their beliefs. They might also engage in repetitive behaviors to cope with the guilt and shame that people with the disorder often feel. These may include:
- Frequent comparisons of the POC’s appearance to others.
- Providing unsolicited reassurance to the POC about their appearance.
- Compulsively check or attempt to improve the perceived flaw.
- Going to great lengths to hide the perceived flaw.
- Isolating the POC or becoming overly defensive.
- Avoidance of situations that may reveal or highlight the POC’s perceived flaw.
Is BDD a form of schizophrenia?
While BDD is not a form of schizophrenia, it is possible to have both disorders at the same time.
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