6 Signs You Could Have Body Dysmorphic Disorder

For the longest time, I’ve had misgivings about how my body looks. But whenever I’ve mentioned some of my concerns to other people, they look at me like I’m crazy.

“You’re gorgeous,” they tell me, though I have a hard time seeing it. Many people are dissatisfied with their bodies. In fact, I believe that it is one of the commonalities that all humans share to some degree. Some people think, I could be better-looking, but who cares! while others think, I could be better-looking, and everyone knows that and judges me for my lack of beauty. For some, their body dissatisfaction is mild, while for others it’s crippling.

When it’s crippling, it’s probable that you are actually suffering from a clinical disorder, called body dysmorphic disorder (BDD). BDD is severely underdiagnosed. This happens in part because clinicians are not aware of the disorder and because those who suffer from it feel shame and hide the actual source of concern, leading BDD to be misdiagnosed as major depressive disorder or social phobia.

Here are some signs that perhaps your body-image dissatisfaction deserves a deeper look:

1. You believe that others take note of your appearance in a negative way.

Growing up, I assumed that everyone knew what I believed to be true: that I’m tall, fat, and ugly. I thought that was why people were mean to me and why I didn’t have many friends. It validated every instance of cruelty or teasing. In my mind, I deserved it all because I was ugly.

It took moving to New York City to begin to understand that I’m actually pretty. It may have been the fact that there’s so much more diversity here, or the men will tell you exactly how sexy you are. One way or another, the message started to sink in, and the way that I perceived myself began to change.

2. You avoid social situations.

If you think people are going to be mean to you, or judge your looks, you’ll probably elect to avoid certain kinds of situations. Social avoidance can lead to another symptom: the need to stay housebound. How many times have you passed up a Friday night event because you felt too “fat” to go out? This sort of behavior can escalate into missing work or school because you feel too self-conscious to leave the house.

3. You seek reassurance from others about your appearance.

There was a girl on my high school swim team who asked multiple times daily if what she was wearing that day made her look fat. Certainly, this is not an uncommon question among women, but what struck me at the time was the incessant and interminable nature of her need for reassurance.

Looking back, I’m certain that she had BDD more severely than I can imagine. She exhibited another sign: preoccupation with physical appearance with extreme self-consciousness. Sometimes this preoccupation will lead a person to have cosmetic procedures. But instead of feeling better once they're done, he or she experiences no relief and little satisfaction.

4. You compare your appearance to others.

Do you do this? Do you know anyone who doesn’t? Comparison is one of the tools we have to understand whether we ourselves are “normal.” It is a faulty tool, however, and one that is influenced by what we see around us and in the media.

Another tool we have to understand what we look like is a mirror. People with BDD may examine themselves excessively, or avoid mirrors altogether. Similarly, a BDD sufferer might also be reluctant to appear in photos, because doing so encourages the urge to compare.

5. You feel a need to grow a beard or wear excessive makeup or clothing to camouflage perceived flaws.

Because I was teased for having big breasts, for much of my adolescence and young adulthood, I wore baggy clothes to hide my body.

6. You practice excessive grooming or exercise in an unsuccessful effort to improve the flaw.

I was a compulsive over-exerciser. As an athlete, I was already steeped in the idea that exercising was compulsory, and after I stopped competing, I cranked up the intensity dial, certain that I was going to become fatter if I stopped. I began working out seven days a week, two or three hours a day — which was crazy.

Today I have learned how to live with BDD and recognize the symptoms when they begin to flare up. The lessons that I have learned through my own study of yoga and Buddhism have been tremendously helpful in controlling the severity of my own experiences. As with most mental disorders, BDD can flare up and then go away, only to return later.

The most important piece of advice I can offer is to recognize that perfection is a poison. The pursuit of perfection is a waste of time, because it doesn't exist. Even if you obtained what you thought to be “the perfect body” it engenders a new prison: maintaining perfection. One way or another, the professionals agree that BDD does not get better over time, and will not go away if you ignore it. It’s best to tackle it NOW. If you identify with a few of the symptoms, please reach out to a doctor.

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