Body Dysmorphic Disorder (BDD) in Aesthetic Practices
Body Dysmorphic Disorder (BDD) is a common problem in aesthetic practices, yet the condition remains under-recognised and under-diagnosed.
It is normal to fixate on a large pimple or the size or your thighs from time to time. But if your preoccupation with your appearance causes you significant distress or interferes with your day-to-day life, those are signs that you may be dealing with a bigger problem.
When you look in the mirror, is there a particular feature that jumps out at you that you would like to change?
Do you feel the need to seek constant reassurance from your family or friends, even though you do not believe them when they tell you it looks fine?
If the drive to improve your body or erase a particular “flaw” dominates your thoughts and actions, you may have BDD.
Even when their problem is recognised as BDD, it is important for me to be aware that many clients may be resistant to engage with mental health professionals. Instead, they may consult other aesthetic practitioners in the battle to achieve the image of ‘perfection’ and this can be very detrimental to their mental well being.
An article in this June 2020 Aesthetics Journal records that 7-15% of patients presenting for cosmetic treatments may exhibit symptoms of BDD when screened. Does that figure surprise you? It really surprised me!
If this sounds like you, know that you are not crazy, self-obsessed, or vain.
BDD is a real psychological disorder that can improve with treatment. The first step is recognising the signs, and then ensuring you get the right support for you.
What is Body Dysmorphic Disorder (BDD)
According to the NHS, Body Dysmorphic Disorder (BDD), or Body Dysmorphia is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. The flaws are often ‘perceived’ but are often unnoticeable to others.
People of any age can suffer with BDD, but its most common in teenagers and young adults; it affects both men and women. Having BDD does not men you are vain or self-obsessed, it can be very upsetting and have a big impact on your life.
Many of us have something we do not like about our appearance, it could be the bump on our nose, or that uneven smile. We may worry about our imperfections, but for most of us they do not interfere with our daily lives.
People who suffer with Body Dysmorphic Disorder (BDD) think about their real or perceived flaws for hours each day. They cannot control their negative thoughts and do not believe it when people tell them that they look fine. Their thoughts may cause severe emotional distress and interfere with their daily functioning. They may miss work or school, avoid social situations, and isolate themselves from family and friends, because they fear others will notice their flaws.
Symptoms of Body Dysmorphic Disorder (BDD)
Examples include:
- Worrying a lot about a specific area of your body (particularly your face)
- Spending a lot of time comparing your looks with other people’s
- Looking at yourself in mirrors a lot, or avoiding mirrors altogether
- Go to a lot of effort to conceal flaws, for example… by spending a long time combing your hair, applying make-up or choosing clothes
- Picking at your skin to make it ‘smooth’
BDD can seriously affect your daily life, including your work, social life and relationships. BDD can also lead to depression, self-harm and even thoughts of suicide.
Getting help for Body Dysmorphic Disorder (BDD)
It is important to recognise clients with BDD in aesthetic practice for the following reasons. Source Aesthetics Journal:
- The prime pathology is psychological rather than physical
- Psychosocial co-morbidities and suicidal ideation are common
- Patients with BDD are rarely satisfied with the results of their aesthetic procedures
- Special attention should be paid to the problem with informed consent in BDD patients undergoing plastic surgery/dermatological procedures. The question that practitioners should address is: do the patients with BDD have full capacity to give a truly informed consent for cosmetic procedures?
This last point prompted a full review of my client consultation forms, which now includes a number of additional questions to help me better screen for BDD. Please don’t hesitate to get in touch if you have any comments or questions.
For more information head over to NHS Body Dysmorphic Disorder
Love Katie x