Recognized for over 100 years, body dysmorphic disorder is coming under expanded study in the world of psychiatry. The term, body dysmorphic disorder, refers to a condition in which people perform excessive, repetitive behaviors or have repetitive mental thoughts due to a perceived or actual defect in their appearance. The flaw or defect is usually nonexistent or very slight, but people suffering from BDD place excessive attention on the imagined flaw. (Wondering, "Do I have BDD? Take the body dysmorphic disorder test.)

What is BDD?

Just what is BDD, exactly? Body dysmorphic disorder, or BDD, is a mental illness that the DSM-5 classifies as a type of obsessive-compulsive disorder (OCD). It's different than pure OCD in that this severe psychiatric disorder manifests in significant physical symptoms. The body dysmorphic disorder definition states:

BDD sufferers experience extreme anxiety over a real or imagined physical flaw.

This mental illness stands apart from typical insecurities about appearance in that the person who suffers is obsessed and chronically anxious about the perceived defect to the extent that quality of life is impaired.

Body Dysmorphic Disorder Examples

Men and women suffer equally from body dysmorphic disorder. They obsess over individual physical features, combinations of features, or even the entire body and appearance. Features such as one's nose, hair, skin, weight or body shape may represent the focus of obsession. Beginning as a nagging insecurity, this illness can lead to compulsive symptoms such as hair plucking, skin picking, excessive grooming, eating disorders, repeated cosmetic surgeries, and varying degrees of clinical depression.

Individuals with BDD typically spend many hours each day attempting to conceal or modify the perceived flaw. They may use excessive makeup or try to use clothing to camouflage the imagined defect. As the insecurity grows, the attempts to hide the flaw can lead to obsessive ritualistic behavior in the preparation for each day. If unchecked, this behavior can create an inability to maintain employment or a social life, which can ultimately lead to the sufferer becoming housebound with anxiety and even attempts at suicide.

Body Dysmorphic Disorder Statistics

Body dysmorphic disorder statistics show that although BDD can begin in childhood, it typically starts at the age of 13 when the body changes rapidly and ignites bouts of teasing from peers. Studies report that two percent of the national population suffers from this type of obsessive-compulsive disorder, with only a slightly higher number of diagnoses for females over males.

Typically, people suffering from BDD can spend anywhere from three to eight hours a day performing the rituals involved in concealing the perceived flaw or flaws. These physical and mental rituals can include excessive and repeated mirror checking, skin picking, reassurance seeking, comparison of self with others, frequent changing of clothes and more. This mental illness can lead to severe clinical depression, often resulting in suicide attempts. Nearly one-third of the people with BDD attempt suicide, while preliminary studies suggest that as many as one-third of those attempts are successful.

Effective body dysmorphic disorder treatments are available for those who suffer from this and other types of OCD. Experts usually recommend a combination of psychotherapy and medication. Specifically, doctors prescribe selective serotonin reuptake inhibitors (SSRIs) and cognitive-behavioral therapy (CBT) tailored specifically to address body dysmorphic disorder. Unfortunately, for BDD sufferers and the people that love them, due to the shame involved over "imagined ugliness", many would-be patients never seek professional assistance. Therefore, it's critical that those who see the symptoms of BDD in themselves or a loved one take appropriate action by seeking medical or psychiatric aid immediately.

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If a person is suicidal, it's critical to not ignore the situation. You will have to talk to the suicidal person. While this may seem like a scary thought, often people who are suicidal need someone to reach out and talk to; this may make some of the feelings of suicide abate. Additionally, by talking to the suicidal person, it may also be what the person needs in order to find the strength to get help.

The First Thing to Talk About With a Suicidal Person

The first and most important reason to talk to a suicidal person is to determine if his or her life is in immediate danger. For example, you might ask:

• Are you thinking of taking your life right now?
• Have you put a suicide plan into action (such as ingesting alcohol or drugs)?

If there is an immediate threat to the suicidal person's life or anyone else's, you must call 9-1-1 immediately. Emergency responders are there to save any life that is at risk. You cannot handle a situation like that alone.

Things to Remember When Talking to a Suicidal Person

When you're talking to a suicidal person you want to be calm and make the person at ease as much as possible. Even if you find talking about suicide very difficult, it's best not to act shocked when a person tries to talk to you about it. What you need to remember is that the suicidal person is reaching out and that is the first step anyone can take to getting better.

Remember these things when you talk to a suicidal person:

• Listen to the other person. Don't be judgemental. Accept the suicidal person's feelings.
• Don't dare the person to do it.
• Don't be sworn to secrecy. You need to ensure professionals get involved so that the person can get long-term help for his or her suicidal feelings.
• Offer hope that alternatives to suicide are available; however, do not be glib or trite about it.

How to Talk About Suicide

In addition to the above tips, remember that speaking openly and honestly about suicide will not increase the likelihood of suicide and, in fact, often helps. Try to avoid judgemental language and use the term, "die by suicide," if possible (rather than "commit suicide"). Do not glorify suicide nor dwell significantly on suicide methods. (For example, asking a person how they might kill him or herself is fine, but describing a suicide method in detail is not necessary nor helpful.)

Talk about a suicidal person's feelings with open-ended questions. Some examples include:

• When did you begin feeling like this?
• Did something happen that made you start feeling this way?
• How can I best support you right now?
• Have you thought about getting help?

Helpful things to say to a person who is suicidal include:

• You are not alone in this. I'm here for you.
• You may not believe it now, but the way you're feeling will change.
• I may not be able to understand exactly how you feel, but I care about you and want to help.
• When you want to give up, tell yourself you will hold off for just one more day, hour, minute - whatever you can manage.

The Results Talking to a Suicidal Person

The end result in talking to a suicidal person should always be that the person gets professional help. Calling the National Suicide Prevention Lifeline is one way to facilitate this as the operators can direct you to local suicide help resources.

• National Suicide Prevention Lifeline (available 24/7): 1-800-273-TALK (8255) http://www.suicidepreventionlifeline.org/

While it's scary to talk about suicide, especially with someone who is suicidal, remember that talking to a suicidal person can save his or her life. People who are suicidal often feel alone and, by talking to him or her, you remind the person that you care and will help the person in his or her fight against suicide.

Dermatillomania, also known as compulsive skin picking (CSP), is a mental illness wherein sufferers feel very strong urges to pick at their skin to the point of damaging it. Some experts call it excoriation disorder or neurotic skin picking. Regardless of what your mental health professional or family doctor calls it, it's a real disorder and people suffering from it usually can't stop on their own.

Dermatillomania Symptoms and Causes

To recognize dermatillomania, you need to understand what the signs and symptoms look like. Some telltale symptoms of dermatillomania include:

• Compulsive and frequent picking at the skin to the point of causing tissue damage
• The picking and tissue damage results in significant distress for the individual engaging in skin picking behavior
• The skin picking causes the person considerable issues at work, school, in his or her social life, or other regular activities

It's also not uncommon for people with dermatillomania to have comorbid (simultaneously occurring) mental disorders, such as depression, anxiety, or obsessive-compulsive disorder.

Additionally, people with dermatillomania symptoms don't necessarily have to suffer from an underlying skin problem (i.e. acne, bug bites, scrapes, rash) to feel the urge to pick. People suffering from this condition will often pick and tear at the skin and actually create sores on the body part of the body they are focusing on, or even all over their bodies.

Researchers don't have enough information to come up with a clear set of causes for dermatillomania, but they theorize a number of factors could contribute to its development in susceptible people:

• Genetics – people who have a parent or sibling with excoriation disorder or other related disorders are more likely to develop the condition
• Stress – current research suggests another cause of dermatillomania may be life stressors that result in anxiety that the person copes with by skin picking
• Trauma – sometimes a single, very traumatic event can trigger the onset of this condition

Dermatillomania Treatment

Much more research is needed on dermatillomania treatment, but some studies suggest that cognitive behavioral therapy (CBT) may provide some relief to those suffering from it. Other mental health professionals use acceptance and commitment therapy (ACT), a type of mindfulness-based CBT, wherein the person simply accepts the stresses and anxieties that trigger the behavior and then commits to refraining from the picking behavior.

Research also indicates that selective serotonin reuptake inhibitor (SSRI) medications may prove helpful in dermatillomania treatment. Some common SSRIs include:

• Fluoxetine
• Fluvoxamine
• Escitalopram

Since each individual reacts differently to medication, more research is needed to determine which, if any, works best in the treatment of dermatillomania.

Many people suffering from the shame and embarrassment of this disorder do not know that help exists, so they continue to hide their condition and suffer from it in silence.

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There is no scarier place to be in the world than in the head of someone who is suicidal. And thinking about how to help a suicidal person is likely something people don't do until they're sitting next to someone who is thinking about ending his or her life.

But there are things you can do to help someone who is suicidal. They don't have to be left alone in that scary place and neither do you.

The First Thing To Do When Someone is Suicidal

The first thing you need to do if you know someone is suicidal is to assess the situation. If there is any immediate danger to the suicidal person or anyone else call 9-1-1 immediately or take the person to a hospital emergency room.

The suicidal person might initially be angry with you for involving emergency responders but remember, it's much better that they be mad at you then they not be there at all.

What Else To Do If Someone is Suicidal

There are many things you can do if someone is suicidal. The National Suicide Prevention Lifeline lists these dos and don'ts when helping a suicidal person:
Do:

• Be direct. Talk openly and matter-of-factly about suicide.
• Be willing to listen. Allow expression of feelings. Accept the feelings.
• Be non-judgmental. Don't debate whether suicide is right or wrong, or whether feelings are good or bad. Don't lecture on the value of life.
• Get involved. Be available. Show interest and support. Tell the person he or she is not alone. Tell the person you can about him or her.
• Offer hope that alternatives are available but do not offer glib reassurance.
• Take action. Remove means, such as guns or stockpiled pills.
• Get help from persons or agencies specializing in crisis intervention and suicide prevention.
• Encourage him or her strongly to call the Lifeline. Lifeline operators help suicidal people feel better every day. (1-800-273-8255)

Don't:

• Dare the person to do it.
• Act shocked. This puts distance between the two of you.
• Be sworn to secrecy. Always seek help and support.

Where to Get Help for Suicidal People

You cannot deal with a suicidal person alone – you must reach out and find help and support, both for you and for the person who is suicidal.

You can learn where to get help for a suicidal person by calling Lifeline. Lifeline calls are routed to local areas and the operators can tell you about nearby resources like crisis or treatment centers.

• National Suicide Prevention Lifeline (available 24/7): 1-800-273-TALK (8255) http://www.suicidepreventionlifeline.org/

Other numbers that may be able to help a person considering suicide include:

• The Trevor Project line (for LGBTQ youth): 1-866-488-7386 http://www.thetrevorproject.org/
• United States Veterans Crisis Line: 1-800-273-8255  http://www.veteranscrisisline.net/

Additionally, you can do an online search for mental health services thought the American Mental Health Services Locator. https://findtreatment.samhsa.gov/ 

If you're not in the United States, go to Befrienders Worldwide for international information: http://www.befrienders.org/

Remember This When Helping a Suicidal Person

Always remember that while suicide really may seem like the best option to a person in a crisis, there are many other options out there to help the suicidal person choose life. There is always another way.

OCD skin picking, called excoriation disorder in the Diagnostic and Statistical Manual for Mental Health, Fifth Edition (DSM-V), involves the repetitive picking of one's skin resulting in damage to tissue. People engage in compulsive skin picking in an attempt to relieve some type of emotional distress. Frequently, these people feel a strong, persistent urge to pick their skin, but it's an unconscious habit for many sufferers. Those suffering from the condition report a feeling of relief or even pleasure following the skin picking behavior.

Relationship Between OCD and Skin Picking

The DSM-V lists OCD and skin picking (excoriation) in a new chapter called Obsessive-Compulsive and Related Disorders. It's estimated that about 3 percent of Americans suffer from some level of compulsive skin picking or excoriation. Researchers aren't clear on skin picking causes, but many believe OCD and skin picking are related. Some even believe excoriation to represent the physical manifestation of OCD.

Skin picking shares some features with OCD in that people with the disorder pick their skin over and over in response to persistent thoughts or urges to touch and pick their skin. This often serious mental illness also shares similarities to other obsessive-compulsive spectrum disorders like trichotillomania (hair pulling disorder), body dysmorphic disorder, and some tic disorders. People with excoriation (skin picking) disorder are at greater risk than those without it to have OCD or another OC spectrum disorder.

Skin Picking Causes

As with many mental illnesses, scientists and mental health professionals suspect that the causes of OCD skin picking may involve a combination of biological and environmental factors, which could include:

• Genetic predisposition – those with first-degree relatives who are suffering or have suffered from skin picking or another body focused repetitive disorder are at greater risk of developing the condition.
• Environmental triggers – a person's family environment and childhood experience may influence who develops the disorder. Perfectionism in the family, physical violence, emotional abuse, and other trauma may trigger skin picking behavior.

Before diagnosing a person with skin picking OCD, doctors need to rule out other causes. For example, certain drugs like amphetamines (often prescribed for ADHD) can cause OCD skin picking. Kidney disease, iron deficiency anemia, scabies, and a number of other health issues can cause skin picking as well. A physician will need to test patients for these other medical causes of skin picking before diagnosing them with skin picking OCD.

If you, or someone you love, experience significant emotional distress due to their OCD skin picking behaviors, help is available. An experienced mental health professional can evaluate the problem and develop an effective treatment plan. It's important for sufferers to seek help and stand up for their own mental health.

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More people than you might think have a disturbing habit of picking scabs, including face picking or scalp picking. Those that do this to the extreme may suffer from dermatillomania, also known as excoriation disorder. If scab picking, face picking or scalp picking are so bad that they make a person feel embarrassed, ashamed or alone; if any of these habits feel more like an obsession or hold a person back from social interaction; if doing these things causes scars or disfigurement, then dermatillomania is the most probable cause.

Scab Picking, Face Picking, Scalp Picking

All the forms of skin picking: scab picking, face picking, and scalp picking, fall under the umbrella of dermatillomania. Small children pick their scabs, often eventually growing out of the habit. But some continue to do it well into adulthood. A few of those adults go even further and ingest the scabs they have picked.

Face picking can begin with typical hygiene. Squeezing pimples, blackheads or whiteheads leads to scratching at every dry patch of skin, picking at every bump, or even digging at imagined flaws.

People who pick their scalps sometimes do this absent-mindedly. Other times, they do it with a sense of purpose. They eagerly await or actively seek out private time to indulge their habit. Collecting and/or ingesting the picked skin is also common.

Many times, these behaviors stand as separate manifestations. Other times, they overlap with coexisting conditions, such as obsessive-compulsive disorder. However, engaging in just one type of compulsive skin picking behavior that causes significant emotional distress is all it takes to receive a diagnosis of dermatillomania aka excoriation disorder.

Skin Picking Fingers

If you suffer with dermatillomania, you may see your skin picking fingers as the enemy. You cannot seem to stop them from scanning over your skin for imperfections. In moments of relaxation, you find them working through your hair to find a flaw to scratch. Moments of anxiety bring those fingers tensely to the scabs you have created before. Why, you may ask, can those skin picking fingers just not stop?

Dermatillomania patients often feel alone and peculiar, even unlovable at times. They go to great lengths to conceal their habit and the physical signs of it. Frequently, people around them find the behavior distasteful and disgusting, which adds to their feelings of shame and exacerbates the problem. Shame and embarrassment represent added anxieties that can lead to more episodes of scab picking, face picking, or scalp picking. Sufferers hide their habit, hide the physical evidence, and create a life of isolation, frequently leading to clinical depression.

Doctors have classified dermatillomania as a mental illness that often accompanies obsessive-compulsive disorder. As such, self-control issues in the patient, even if in only this one area of life, represent an obstacle of unusual complexity, requiring medicine and therapy. Numerous people have lived with this illness in shamed silence, but with better understanding and newer treatments, these people can come out of hiding and find some relief.

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Compulsive skin picking can negatively impact a person emotionally, physically and socially, interfering with school, work, or daily activities. Also called excoriation disorder or dermatillomania, the effects of this disorder can range from mild to severe. Episodes of obsessive skin picking are often preceded by some sort of trigger, such as an irregularity on the skin, anxiety, or other uncomfortable internal feelings.

Experts believe that people engage in chronic skin picking behavior to cope with high levels of stress or anxiety. The act of compulsive skin picking then provides relief from the mounting tension in the person with some people reporting feeling a rush of pleasure after picking.

Complications of Compulsive Skin Picking

You may wonder if your compulsive skin picking will result in scars or if you could develop an infection from it. After your picking sessions, your skin may look like a battleground with scabs and lesions all over. This may cause you to feel deeply ashamed, starting the cycle of tension and anxiety over again, causing another bout of chronic skin picking. You may even know that your picking makes your skin worse, but your brain tells you that if you just do it one more time, your skin will finally be flawless. Whatever your individual experience with your skin picking compulsion, left unchecked, it can lead to some serious complications.

Complications due to compulsive skin picking include:

• Tissue damage
• Infection at picking site
• Scarring and disfigurement
• Epidural abscesses – a collection of pus around a wound on the skin that emerges during an inflammatory process in response to an infection or the presence of foreign matter, such as splinters
• Septicemia – a potentially deadly illness involving a systemic inflammatory response due to severe infection

Some very severe cases of skin picking can require surgical repair of the picking site or even skin grafting procedures to repair the damage. In addition to physical complications, compulsive skin picking can cause intense guilt, shame, and embarrassment, increasing the likelihood that they will engage in even more self-mutilating behaviors. People suffering from compulsive skin picking have a recognized mental illness and should seek help from a mental health professional before they experience some of the potentially catastrophic effects of the condition.

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Many people do not know how to stop skin picking once it becomes a true disorder. The disorder, also called dermatillomania or neurotic excoriation, causes significant emotional distress and embarrassment due to the lesions and wounds caused by the picking. Sadly, most people do not seek treatment to stop skin picking because of the stigma associated with it. Foregoing skin picking treatment can lead to severe and even life-threatening complications.

Treatments – How to Stop Skin Picking

You may have tried to stop skin picking on your own many times, but failed. Perhaps you try to conceal your condition by picking only areas that you can cover with clothing. You spend considerable amounts of time in isolation engaging in compulsive picking sessions. You cannot get past the intense urges and anxiety associated with the disorder without professional help. Effective treatment for skin picking is available:

• Cognitive behavioral therapy (CBT) – therapists typically employ a combination of different types of CBT (cognitive behaviorial therapy), but the most commonly used is Habit Reversal Training (HBT). With HBT, the therapist teaches the patient to become more self-aware of triggers to skin picking sessions. Next he or she teaches the patient alternative ways to cope with these triggers. Another effective way to help individuals stop skin picking involves Mindfulness-Based CBT. Mindfulness helps the individual simply learn to accept internal stress caused by thought processes or outside events as a part of life. The therapist will teach the individual that the discomfort is not the real problem, his or her coping mechanism (i.e. the picking) is.
• Medications – certain medications have been found effective in treatment for skin picking. Selective serotonin reuptake inhibitors (SSRIs), such as clomipramine, fluoxetine, and sertraline have helped many people stop skin picking. In certain cases, physicians may prescribe dopamine blockers (i.e. risperidone and clozapine) and other drugs, like lithium and naltrexone, to treat the condition.
• Individual and group therapy led by a licensed health care professional – these sessions help to reinforce concepts of CBT and augment any medications the patient may take to help stop skin picking.

You may also find it helpful to join a support group that focuses on helping people refrain from picking at their skin. The International OCD Foundation has an online search tool you can use to locate a support group in your area. If you'd rather participate in an online support group, they include an online and phone support group listing as well.

Quick tips to stop skin picking:

• Keep your hands busy, especially when you feel the urge to pick. If you can hold off on the urge for 15 minutes or more, you can get past it. Next time, try to hold off for longer.
• Keep your skin as blemish free as possible by using anti-bacterial soap or oil-free cleanser. You might consider seeing a dermatologist. The clearer you skin, the less likely you are to pick it.
• Avoid looking at yourself in the mirror, especially if your face is the focus of your picking. You may have to go as far as covering your mirror with fabric or paper.
• Discard all tools that you may use for skin picking (i.e. tweezers, pins)
• Replace skin picking with another activity when the urge arises, such as squeezing a stress ball.

These tips on how to stop picking at skin can help you with your disorder after you've gotten help from a professional. Employ these tips in addition to any medication or CBT therapy tools you've learned.

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What is the definition of trichotillomania? What does this hair pulling disorder look like?

Lately, you've noticed hair pulling behavior in yourself (or a loved one) and it's causing concern. Lately, you have an urge or fascination with pulling out strands of your own hair. It could be the hair on your head, your eyebrows, eyelashes or anywhere else on your body. Moments of anxiety lead to this urge and relief only comes after you have done it. What could this behavior mean? Does it have a name? Experts have recognized and named this hair pulling disorder as trichotillomania.

Trichotillomania – A Serious Mental Condition

Although the name sounds strange and is hard to spell, trichotillomania is not a laughing matter, especially for those who have it. (Learn about the effects of pulling out hair.) The term, trichotillomania represents a serious mental disorder. Specifically, mental health professionals describe it as a sort of impulse control disorder consisting of pulling hair from any part of the body including the scalp, eyebrows, eyelashes, beard, chest, pubic area, arms and legs. (What causes trichotillomania?)

This condition represents body-focused repetitive behaviors (BFRBs), such as skin picking (excoriation), nail biting, and biting of the insides of one's cheeks that can lead to physical and emotional harm.

The Diagnostics and Statistical Manual for Mental Health, Fifth Edition (DSM-V), lists trichotillomania in the new chapter entitled Obsessive-Compulsive and Related Disorders. Although it was also included as a disorder in the DSM-IV, the DSM-V has added the term "hair pulling disorder" as a parenthetical detail to its name.

Hair Pulling Disorder Leads To Bigger Problems

This hair pulling disorder can start small, but eventually blooms into a life altering hair pulling disease. You may have seen girls twisting their hair with their fingers, from nerves, concentration, or even while flirting, but the urge to actually pull strands out in order to feel relief from anxiety can develop into this serious mental condition.

Patients, predominantly female adults, describe a tenseness that leads up to the strong desire to pull out their hair. Once the patient acts on the impulse, he or she feels relief or even pleasure. The act of hair pulling then becomes a habit in order to feel this sense of relief or pleasure again and again.

Unfortunately, the repeated action of pulling out one's own hair can create further problems. Not surprisingly, a bald area can develop where the plucking occurs. Inflammation, infection, skin damage and permanent hair loss can also result from compulsive hair pulling.

Another offshoot from this disorder is trichophagia, or eating the hair. The physical complications from this are nausea, weight loss, vomiting, intestinal obstruction, and death.

Most of the physical complications of trichotillomania can often lead to emotional ones. The patient eventually suffers from lowered self-esteem and social isolation resulting from the physical damage and embarrassment surrounding the condition. In an attempt to avoid discovery, the patient feels he or she must hide the disfigurement that trichotillomania causes. They typically achieve this by avoiding people altogether - causing relationships and job performance to suffer. Left untreated, trichotillomania can lead to clinical depression.

Reading the Signs of Trichotillomania

Although patients often deny the existence of their trichotillomania, you can look for a few strong signs of the disorder. Patchy eyebrows or sparse eyelashes are visible clues, as well as bald or thin patches on the scalp, especially in persons too young for typical pattern baldness.

The disturbing habit of chewing, eating, or playing with pulled out hair represents a red flag, as well. However, the most telltale sign that you, or a loved one, may have this condition involves feeling a strong urge to repeatedly pull out hair, feeling tenseness just before doing it and feeling a sense of pleasure or relief afterwards. If you or someone close to you is exhibiting any of these symptoms, seek professional assistance. A combination of psychotherapy and medication can help alleviate the suffering. You can read more about trichotillomania treatment and how to stop pullling out hair here.

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Body dysmorphic disorder symptoms involve a person's preoccupation with a real or perceived flaw in his or her appearance. (read: What is BDD?) Listed in the DSM-V as a type of obsessive-compulsive disorder (OCD), people with BDD perform repetitive, ritualistic or mental acts in response to preoccupation with these perceived flaws. These rituals, which are part of the BDD symptoms, become so pervasive and take up so much time as to significantly interfere with daily life.

Specific Body Dysmorphic Disorder Symptoms

It's important to understand that body dysmorphic disorder symptoms differ from the typical insecurities about appearance healthy people experience. As a type of OCD, BDD causes obsessive preoccupation with physical appearance in sufferers, focusing on perceived flaws or barely noticeable real ones.

Effective treatment for body dysmorphic disorder is available, however, because of the shame surrounding the symptoms of BDD, many sufferers do not take advantage of it.

General body dysmorphic disorder signs include:

• The flaw or flaws are either imagined, or distress over a very slight actual physical asymmetry is excessive.
• The preoccupation causes the person considerable and excessive anxiety that negatively affects his or her daily life.
• No other mental disorder, such as anorexia nervosa, can account for the person's preoccupation with these imagined or very slight physical flaws.
• People with BDD may or may not have insight that their preoccupation is excessive.

Specific body dysmorphic disorder symptoms for people with the condition include:

• Strong belief that the flaw or physical abnormality makes him or her ugly
• Strong belief that others view his or her physical appearance as ugly
• Constant need for reassurance about physical appearance from others
• Undergoes frequent plastic surgery or non-invasive cosmetic procedures
• Performs excessive grooming rituals
• Excessively self-conscious
• Refuses to appear in photographs under any circumstances
• Avoids social situations
• Uses excessive make-up and goes to great lengths to camouflage the imagined defects with clothing

BDD obsessions and compulsions can focus on any part of the body, but some of the common body parts and features include:

• Overall facial area
• Nose
• Eyes
• Skin and complexion
• Wrinkles
• Acne
• Baldness
• Body shape
• Muscle size (What is Muscle Dysmorphia, Bigorexia, Reverse Anorexia?)
• Genitalia (size and appearance)

How BDD Symptoms Play Out

Individuals with BDD may change the body part or feature they focus on over time. These people usually perform ritualistic acts, either physical or mental, to relieve anxiety arising from their obsessive thoughts about appearance. For example, a person who imagines that their nose sticks out too much or is too wide may constantly check and recheck its appearance in the mirror before they leave the home. The checking and rechecking is typically excessive, resulting in the person arriving late to work or other activities.

He or she may also cover the nose, using a hand or (weather permitting) a winter scarf when forced to communicate directly with others. As they age, they may become preoccupied with wrinkles or abdominal shape, abandoning their focus on the nose.

Just imagine if you became so preoccupied with a certain feature of your body or face that it significantly impacted your quality of life, happiness, and well-being. Such is the life of someone suffering from this often-debilitating disorder.

Causes of Body Dysmorphic Disorder

A type of obsessive-compulsive disorder, experts do not fully understand the causes of body dysmorphic disorder. As with many mental health disorders, the causes of BDD could include one or a combination of the following:

• Genetic causes – people who have biologically related family members with the disorder have a greater risk of developing BDD. This indicates that genetics may play a role in the development of the condition.
• Brain differences – studies show that people with BDD may have structural brain differences or may have insufficient levels of certain neurotransmitters in the brain, such as serotonin.
• Environmental causes – a person's environment while growing up as well as certain culturally-based beliefs involving a negative body image or self-perception may contribute to the development of the disorder

Body dysmorphic disorder causes significant stress and anxiety in sufferers, resulting in low quality of life and, often, severe chronic depression. If you or anyone you love exhibits body dysmorphic disorder symptoms, it's important to seek help from a medical doctor or mental health specialist.

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