Mirror, mirror

For most people, a quick glance in the mirror provides assurance that they're ready for a big meeting or a fun night out on the town. But for people with body dysmorphic disorder (BDD), the mirror is anything but casual.

What is body dysmorphia?

“BDD is a mental health disorder where you obsess about the way you look, constantly evaluating yourself in the mirror and fixating on a perceived flaw that is often minor and isn’t noticed by anyone else,” said Dallas Webb, PsyD, a licensed clinical psychologist with Baptist Behavioral Health.

More than 5 million people in the United States are affected by BDD. Some feel so embarrassed and ashamed that they avoid social situations and become isolated and depressed. The disorder affects women more than men and symptoms typically first appear around age 12.

“People with this disorder fixate on a specific body part or facial feature,” said Dr. Webb. “In some cases, a person will stare into the mirror repeatedly to analyze his or her face, perhaps thinking their nose is enormous. Others are preoccupied with the perceived size of their thighs, stomach or other body parts."

There is an association between frequent social media use and BDD, according to the National Institutes of Health. Pressure to project a certain image on social media can lead to body perception issues, especially due to the use of apps that can alter the size or shape of your features.

Signs you might have BDD

Most people have experienced times when they don’t like what they see in the mirror. So how can you tell the difference between BDD and a bad day?

“Body dysmorphia is an obsessive-compulsive disorder, where you have repeated unwanted thoughts about the same thing over and over again,” Dr. Webb said. “The disorder can become unmanageable and start to control your life.”

A person may have BDD if he or she:

• Thinks others view his or her physical appearance negatively
• Believes other people make fun of a perceived flaw
• Tries to fix or hide a perceived flaw
• Checks the mirror, grooms or picks skin frequently
• Compares his or her looks to others
• Seeks constant reassurance about appearance
• Has perfectionist tendencies
• Has had cosmetic procedures with little satisfaction

How therapy can help

If left untreated, BDD can become serious. Eating disorders, like anorexia and bulimia, often go hand in hand with BDD, and many people become so obsessed with their appearance that it takes over their lives.

Cognitive behavioral therapy is usually effective in treating obsessive-compulsive disorders like BDD. This type of therapy helps change thinking and behavior patterns.

“It retrains your brain so you start to recognize negative thoughts and stop allowing them to take hold,” said Dr. Webb. “You have to start challenging your thinking to break the cycle of negative self-talk.”

Dr. Webb tells his patients to imagine a gate: “When a negative thought enters your mind, you can choose to open the gate and let it in or keep the gate shut.”

He knows patients are making progress when they no longer focus solely on body image during a session.

“That negative voice becomes less prevalent,” Dr. Webb explained.

Helping your child cope

Because body dysmorphia usually develops around age 12, parents can play a positive role if they notice signs early on.

“My best advice is not to be punitive when speaking to your child. It’s easy to get frustrated and want to tell your child to stop looking in the mirror and stop obsessing, but these words aren’t helpful and can make the condition worse,” he said.

Instead, keep the lines of communication open and express concern, support and love. If your child confides in you, show that you take those concerns seriously, and don’t hesitate to get professional help when needed.

As with overcoming any obsession or addiction, making progress is the main objective, even if it’s just baby steps.