It might be the arm flab we can’t help but notice when put on a sports bra, or the way our thighs look in shorts. It might be how we want our hair to be curly instead of straight, or how we wish that one mole would just relocate to a less obvious spot.

woman looking at body in mirror

We are all human, and we all have things we don’t like about our bodies; however, the majority of us are able to move past our imperfections and not dwell on the little things we can’t change. People with body dysmorphic disorder (BDD), have these thoughts about their flaws as well, but unlike the rest of us, they are unable to simply accept and move on, often spending countless hours obsessing about their flaws every day.

According to the Anxiety and Depression Association of America, people with BDD have no control over these negative thoughts plaguing their mind, and deny any claims from family and friends that they’re perfect the way they are. Their thoughts interfere with daily functioning causing emotional distress, missed school days and missed social events. Those who suffer from the condition often separate themselves completely from family and friends, all in fear that people will notice their flaws.

Jeannette Raymond, a licensed psychologist at Los Angeles Westside Therapy, said the disorder is very difficult to treat because the individual is exaggerating their defect or maybe even imagining one where it doesn’t exist. Psychologists use the term “externalizers” to describe these individuals. “Their neurosis about not being good, or good enough, or perfect in some way is dealt with by focusing on what they can change and control,” Raymond said. “Usually the person feels bad inside, but can’t tolerate feeling it. It is a defense against acknowledging the human parts of oneself that may not be so pretty and ideal.”

BDD is seen most frequently in adolescents and teens and is caused by certain biological and environmental factors such as genetic predisposition, malfunctioning of serotonin in the brain, personality traits and life experiences. According to the Anxiety and Depression Association of America, symptoms of BDD include; skin picking, excessive grooming, excessive exercise, a desire for unnecessary surgeries, constant checking in a mirror, changing clothes excessively, camouflaging with body position, makeup, hair or hats and comparing body parts to others’ appearance. Individuals with BDD may also suffer from obsessive-compulsive disorder (OCD), social anxiety disorder, depression and eating disorders. According to licensed marriage and family therapist Alisa Ruby Bash, BDD is extremely dangerous because these individuals can develop other issues such as a desire to self-mutilate as well as drug and alcohol abuse, all in an effort to avoid the pain of what they see as imperfect.

Cognitive-behavioral therapy and antidepressant medications are most commonly used to treat BDD, but Raymond said treating an individual with this condition takes years because they need constant reassurance that their flaws are not, “leaking out all over the place”. “They believe that their appearance becomes a canvas on which their ‘badness’ is painted for everyone to see and it’s shameful,” she said. “So they don’t want to give it up. They use it to control what they would have otherwise been swamped by – feelings of imperfection and badness that would make them unable to have relationships.”

While we all have bad days and times when we never seem to see ourselves in the same positive light that others do, this disorder is far more serious and should not be ignored. If you or someone you love is displaying symptoms of Body Dysmorphic Disorder, please seek treatment immediately.