Body Dysmporphic Disorder and the OCD Spectrum

There are numerous known similarities between obsessive compulsive disorder (OCD) and body dysmorphic disorder (BDD). BDD is said to be on the OCD spectrum. So, why is this the case?

What are some of the key similarities?

  • Like obsessive compulsive disorder, body dysmorphic disorder is largely made up of the individual experiencing negative, unwanted and intrusive thoughts that come loaded with an emotion. These thought are often described as being loud, unpleasant and induce a deep sense of negative emotions.
  • Regularly there are cases of someone with body dysmorphic disorder as being preoccupied with perfectionism, things having to feel just right and an over importance on symmetry.
  • Compulsive behaviours are often present in both conditions. Although on obsessive compulsive disorder, the compulsion may be almost anything, and therefore can be extremely varied, someone with body dysmorphic disorder partake in more specific compulsions such as checking their own appearance in the mirror, asking for reassurance that they look ok and repetitive skin picking.
  • The treatment for both obsessive compulsive disorder and body dysmorphic disorder are known to be similar due to such close similarities in the way the condition displays itself in a sufferer’s life.

With body dysmorphic disorder, the imagination plays a pivotal role in the continual suffering. It is likely that you feel isolated, and wrapped up in your own head. Thoughts come fuelled with anxiety and negative feelings about your own appearance. Rather than objectively, and rationally being able to see your reflection in it’s true form, feelings of doubt, anxiety and self-scrutiny cloud your own judgement. The compulsive act of repeatedly checking whether you look ‘good enough’, is one that brings about temporary relief from your own suffering, without much long term effect. Although in reality the your body image is fine, that doubt, uncertainty and low self-esteem around how you perceive yourself is likely to lead to a depression. Thoughts of suicide can also become more prevalent, as you feel that daily life is now so tough, what the point in trying to carry on. If this is the case, please make contact with a member of a crisis team on one of the links below.

With body dysmorphic disorder, the concern about one’s own appearance is a disproportionate one, often about something that is minor, and unimportant. Although you my know that this is completely irrational, the urge to keep checking and needing reassurance becomes all encompassing, and in the end it is likely that without the right help or treatment, you’ll be unable to resist such urges. Reportedly, manifestations of body dysmorphic disorders concentrate on flaws around both the head and face regions, although this isn’t always the case. Due to the nature of the condition, being that our doubting brain is so prevalent is anxiety disorders, it is likely that the reassurance, and countless amounts of checking will never quite be sufficient in taking away those negative and intrusive feelings.


Compulsions

The key similarities between OCD and BDD largely relate to the act of performing a compulsion to make yourself feel better, below are some examples of common compulsions of someone experiencing BDD:

  • Using mirrors to check how they look. Often checking once or twice just isn’t enough, whereby in extreme cases they could spend up to several hours a day checking their own reflection.
  • Avoiding mirrors, as they fear seeing a reflection that will trigger anxiety and self- depreciating thoughts.
  • Asking loved ones, close relatives or friend of they look OK. This is also known as reassurance. It is likely that no matter how much reassurance the person gets, it’s never quite enough.
  • Continuous picking of the skin until it feels just right, or smooth to the touch.
  • Performing acts to make themselves feel like the look just right.

Within the United Kingdom as many as 0.6% of the population reportedly suffer from BDD. Anyone can appear to suffer from the condition, and with 6 out of every 1000 people experiencing BDD, it may just be more common than you first thought.


A list of compulsive acts for someone with BDD may look something like this:

  • A need to follow rigid routines. This can be applied to almost anything, such as watching the same episode of their favourite TV program very morning, or listening to the same song over and over again.
  • If things change in their daily routine, it is likely to cause distress and result in some tantrum being thrown
  • There can often be an unusual attachment to objects. Objects could include toys, a DVD, books, door handles, light switches, almost anything.
  • Likes to have things in a certain order, such as lining things up in their bedroom.
  • Tunnel vision about the things that they care about. This is likely to happen with things that include numbers or stats, such as the odds around a sports event, train and coach numbers or map reading
  • Repeated behaviours, including hand flapping, rocking or twirling around. These behaviours are commonly known to help those with Autism relax and feel stimulated, rather than cause more distress.

Someone experiencing BDD can become entirely wrapped up in their own appearance, thoughts and worries. From an outside perspective, people often criticise sufferers of BDD as being self-obsessed and self-centred, yet neither are truly the case. The reason someone with BDD struggles to concentrate on others is not because of selfishness, but because anxiety and other negative emotions are incredibly distracting, and the idea that they are not ‘perfect’ in appearance feels like a genuinely dangerous threat. More often than not the quality of a person’s life when living with BDD can be heavily reduced, without the right skills to overcome the condition. People with BDD are not vein, rather the opposite. They are consumed with feeling ugly and experience persistent intrusive thoughts that they are not as good as other people. Sometimes a fear that others will think they are vein people can lead to the sufferer becoming secretive about their condition.


How can our program help?

Our treatment can provide in depth knowledge about the internal processes of the mind, the physiological responses, such as anxiety and how behaviour can keep up stuck in the same unhelpful routines on a daily basis. In relation to BDD we would concentrate on a number of very relevant factors. Whilst looking at the development of the condition, and some of the likely causes for you as an individual, we would also help to educate you around your own condition so that you can in essence become ‘your own specialist’, and begin to take positive steps towards recovering from the condition. Whilst walking with you every step of the way, we would work with you to look at your short and long term goals, relapse prevention techniques to help support life-long wellness, and offer continual support after the post treatment for the best possible results. We have worked closely with many sufferers of BDD, and have helped them take the necessary steps to live a life free from BDD, and begin to enjoy happy and much more stress free lives again.