The Mood Effects of Body Dysmorphic Disorder

Medical Reviewer

When experts talk about body image, they aren’t referring to the way a person looks so much as the way they believe they look. We all have a personal view of the way we look. We might be quite happy with some parts, less so with others, but on the whole we get by secure in the knowledge that nobody is perfect. If, however, we become negatively preoccupied about some body part — that’s when the problems can start.

Body dysmorphic disorder (BDD) is the term used to describe large amounts of time and energy spent on one or more perceived physical flaws. Katherine Phillips, M.D., P.C., director of the Body Dysmorphic Disorder Program at Rhode Island Hospital, states that BDD affects around 1 in 50 people. That’s approximately 7.5 million people in the United States.

Do you have BDD?

Most of us have a facial feature, a scar, or maybe some aspect of body shape we’d prefer to see never see again. That’s perfectly normal. Where BDD differs is the level of fixation and distress these issues cause. People with BDD often spend a great deal of time looking in the mirror at their supposed problem. They become convinced that the flaw is the thing everyone focuses on. They feel hurt, ashamed, and full of self-hatred over the fact that their flaw is so prominent.

The most common part of the body to be affected is the head area, but any part of the body (arms, hips, legs, stomach) can be the focus of concern. Common symptoms include:

  • repeated mirror checking, worrying and concern
  • using makeup or clothing to hide or disguise the “problem”
  • seeking lots of reassurance from other people
  • avoiding social situations or going out at night to hide flaws
  • frequent appointments and plastic surgery procedures

If any of these aspects seems familiar, you may well have BDD, at least to some extent.

Emotional costs

BDD carries a heavy emotional burden. Sufferers frequently report depression, low self-esteem, anxiety, and disgust. Many will suffer in silence because they fear their concerns will be viewed as vain and superficial. It becomes a vicious circle because by talking to another person about their perceived flaws, they actively draw attention to them. They can almost guarantee that if they do say something, the other person will simply say, “You look fine.” If and when this happens, they simply feel misunderstood and become even more reluctant to speak out.

Emotions can spill over and directly affect a number of activities. Romantic or social relationships may be put off for fear the flaw is exposed. Work or study needs can suffer because of the time spent avoiding, grooming, covering over, or simply worrying about the problem. All enjoyment can be sucked out of life as anxiety and depression start to dominate. The things that give us a sense of achievement and direction become diminished because the dominant factor is the body problem. Even finances can suffer, because what’s available may be funnelled into expense procedures. In turn, this can result in increased borrowing and debt.


There’s no reason to allow BDD to dominate your life. Some simple adjustments to thinking can often put things into perspective. Depending upon the severity of BDD, various treatment options exist. For more severe cases, some specialist BDD services do exist, but they are also a little thin on the ground. More commonly, cognitive behavioral therapy, with or without medication, may be helpful. Medication is most likely to be prescribed for anxiety and/or depression.

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