What is Body Dysmorphic Disorder (BDD)?

Mar 15
7 min read

Have you ever looked at yourself in the mirror and felt unhappy? Have you ever felt as if there was something wrong with your body? With your face? Have these thoughts ever become so uncontrollable that you cannot stop yourself from checking yourself again and again in the mirror? If yes, then you might be experiencing Body Dysmorphic Disorder (BDD).

Body Dysmorphic Disorder is when a person feels unhappy and unsatisfied with their face or body. They start believing something is wrong with their appearance, even when other people do not see any problems. These thoughts become so real that they start constantly checking themselves in the mirror, comparing themselves to others, or trying to hide parts of their body. This can make them feel sad, stressed and lack confidence. It is a real mental health problem, and people who experience it need care, support and understanding (American Psychiatric Association, 2022).

Symptoms

● Constantly worrying about a part of your body that looks normal to other people

● Thinking about this “flaw” for many hours every day

● Constantly checking yourself in the mirror or comparing your looks to others

● Trying to hide your appearance with clothes, makeup, or filters

● Feeling very anxious, embarrassed, or sad about how you look

● Avoiding school, social events, or photos because you are scared of being judged

These symptoms are paraphrased from the DSM-5 (American Psychiatric Association, 2022)

Risk Factors

Body Dysmorphic Disorder isn’t usually something that a person develops from a single factor. BDD is a mental disorder that usually comes from a mix of genetics, life experiences, and social pressure (American Psychiatric Association, 2022).

Genetics & Family History

Body Dysmorphic Disorder is a mental health disorder that tends to run in families. People are 4 to 8 times more likely to have BDD if their parents also have it, which proves that there is a genetic component to the disorder (Phillips et al., 2008).

Life Experiences

Experiencing bullying, teasing, or trauma are just a few life experiences that can lead to BDD. Being bullied for your weight, acne, skin tone, or facial features, especially during your childhood or teenage years, can trick you into believing that these comments are true, causing BDD. (American Psychiatric Association, 2022).

Social Media & Social Pressure

Like most teenagers, you probably have a phone. On that phone, you are probably constantly scrolling through TikTok, Twitter, or Instagram, exposing yourself to edited and filtered photos of influences with your dream body. Constantly comparing yourself to these influencers can lower your self-esteem and can make you feel less happy with your body. There is research that tells us that more time spent on social media is linked to higher body image anxiety in teens (Ryding & Kuss, 2020).

Desire to be Perfect

Everybody wants to be perfect at something. For people with BDD, what they want to be perfect is their appearance. They set really high standards for themselves, overthink very tiny details, and are typically overly critical of themselves. These traits make small imperfections of their body to be really big problems, making them think they are worse than they actually are (American Psychiatric Association, 2022).

Other Mental Health Conditions

People with Body Dysmorphic Disorder tend to have other mental health disorders like depression, anxiety, obsessive-compulsive disorder, and eating disorders. 70-80% of body dysmorphic teenagers have also dealt with depression at some point in their life (American Psychiatric Association, 2022).

Note. Image generated using prompt “Generate a symbolic image of a teen with body dysmorphic disorder looking into the mirror,” by Microsoft, Microsoft Copilot, 2025, (https://copilot.microsoft.com/). — *Note.* Image generated using prompt “Generate a symbolic image of a teen with body dysmorphic disorder looking into the mirror,” by Microsoft, *Microsoft Copilot,* 2025, (https://copilot.microsoft.com/).

Neural Basis

Visual Processing Differences

People with BDD focus too much on very tiny details and do not see their whole appearance accurately. Their brain acts like a microscope, zooming in on little, imperfect details, which makes you focus more on these tiny details instead of looking at your whole self. An example can be a small pimple on their face. To you, this pimple may look huge, but in reality, any other person will barely be able to notice it (Feusner et al., 2010).

Orbitofrontal Cortex and Caudate Nucleus

These are areas of the brain whose job is to check for mistakes, repeating the same thoughts, and can trigger any compulsive behaviour. If you have Body Dysmorphic Disorder, these two areas will be working way too hard, and way too much. Some examples of how a very active orbitofrontal cortex and caudate nucleus can impact a teen with BDD includes constantly checking themselves in the mirror and looking for reassurance (American Psychiatric Association, 2022).

Amygdala

The amygdala is the part of the brain that deals with emotions and fear. It can react strongly to what you view as flaws or imperfections. For example, instead of thinking “My nose looks weird”, someone with BDD will think, “There is something seriously wrong with my nose, and I need to fix it.” This creates really bad anxiety and shame in the person (Feusner et al., 2010).

Serotonin

BDD is linked to problems with a chemical messenger in the brain called serotonin. Serotonin is important for managing your mood, anxiety, and obsessive thoughts. This is why antidepressants, which are selective serotonin reuptake inhibitors (SSRIs), are a treatment option that can help with BDD symptoms (American Psychiatric Association, 2022).

Treatment Options

Body Dysmorphic Disorder can make life challenging, but it is treatable. If you or someone you know is struggling with Body Dysmorphic Disorder, please seek help and look for treatments. Treatments for BDD typically involve a combination of therapy and medication (Mayo Clinic, 2022).

Cognitive Behavioural Therapy (CBT)

CBT will help you and your friends deal with BDD by teaching you how to control and reduce your negative thoughts, behaviours, and emotions by:

Informing you on how these negative thoughts, emotions, and behaviours will continue and increase your problems (Mayo Clinic, 2022).
Teaching you ways to deal with and reduce those negative thoughts through learning another way of thinking that is more flexible (Mayo Clinic, 2022).
Teaching you other actions to take to reduce your urges of checking yourself in the mirror, looking for reassurance, and excessive use of health care services. Some of these actions can include participating in healthy activities and support groups (Mayo Clinic, 2022).

CBT is both helpful and pretty successful. Around 52% of people with BDD symptoms have decreased after six months of therapy (Nonacs, 2021).

Medications

Medications will definitely sound a little bit scary at first, but they are very beneficial in the long run. The main medication that can help treat BDD is selective serotonin reuptake inhibitors (SSRIs) (Mayo Clinic, 2022). As you know, BDD causes an imbalance of serotonin in the brain. SSRIs are very useful because they will stop your brain cells from cleaning up serononin too soon, giving your brain more available serotonin to increase your mood and decrease your obsessive thoughts (Mayo Clinic, 2024). SSRIs can decrease symptoms by 40-50% for people with BDD (Body Dysmorphic Disorder Foundation, n.d.).

Closing

Body Dysmorphic Disorder is a struggle that many teens face behind closed doors, thinking they are the only ones who feel this way. By learning what BDD really is, how it works, why it happens, and what it does to your brain, you can see that it is much more than just being insecure. It is a legitimate mental health issue that needs to be addressed and treated with the care and attention it deserves. By learning the symptoms and risks, you can better understand when something is going on beneath the surface, whether it be in yourself or in someone you love. And the best part is that there is help available, and it works! By staying informed and looking out for one another, we can build a world where teens feel comfortable talking about their issues and confident in seeking help. No one should have to suffer from BDD alone, and with awareness and action, no one will.

Call-to-Action

Body Dysmorphic Disorder can impact every aspect of a teenager’s life, but the most important thing to remember is that you do not have to suffer from it alone. If you or someone you care about is experiencing these symptoms, do not simply try to hide them or tell yourself that it is just a “normal teen insecurity.” Instead, turn to someone you trust, whether it is a friend, a parent, a teacher, or a school counselor, and let them in on what is happening.

Talking to a mental health professional can be a huge help, and simply taking that first step is a sign of strength. Even small steps, such as cutting back on how much you compare yourself to others online or trying to be a little kinder to yourself, can help you feel more grounded. When we speak out, support one another, and provide an opportunity for real conversation about mental health, we can build a community where teenagers feel understood, valued, and empowered to get the help they deserve.