Body Dysmorphic Disorder

Management and resources

At home

Although people with BDD usually require professional treatment, there are some behavior changes individuals with BDD can try to improve their quality of life. These include mindfulness meditation, self-compassion, movement, nutrition, and sleep.

Mindfulness meditation

Many people with BDD have a hard time living in the moment due to their preoccupation and worry about their appearance. Developing a basic mindful “in-the-moment” attitude through meditation, yoga, or other therapeutic techniques may help people with BDD feel more present and able to be an active participant in their life. Meditation, and specifically mindfulness meditation, involves setting aside time during one's day to focus on the present, and not their jumbled stream of thoughts.

During this designated time, individuals try to keep their thoughts centered around this very moment: their sensations, an object, or a sound. When the thoughts stray, as they naturally do, meditation teaches us to acknowledge the distraction without judgement, and come back to the present. The repeated practice of meditation can be calming in the moment, but can also “build the muscle” that re-centers us through life’s ups and downs, even when we're not meditating.

Self-compassion

Individuals with BDD often have negative thoughts about themselves and their bodies. These thoughts, over time, can create a series of critical and negative thinking that lead one to hold themselves to different standards than they would of another. For example, one may look at someone's nose and see a beautiful nose, and when they look at their own nose (which objectively looks similar) will say harsh statements that they would never say to another. When people practice self-compassion and treat themselves like they would their best friend or partner, the “inner critic” becomes smaller and less judgmental over time.

Movement

Research shows that 30 minutes of walking per day can decrease overall anxiety. The proven benefits of exercise are vast. Exercise is one of the most effective ways to manage stress and anxiety that are sometimes associated with BDD. Starting a walking routine, taking the stairs, and yoga are just a few examples of low impact exercises that increase the heart rate, in turn releasing serotonin, and other brain chemicals that reduce anxiety. Even better, the anti-anxiety effects of exercise are both immediate and long term. Movement and exercise can be a great complement to a treatment plan and can even be social when a friend comes along.

Nutrition

Nourishing the body with fruits, vegetables, nuts, eggs, grains, and legumes may help to reduce anxiety and depression associated with BDD. Similarly important is the frequency at which one eats. Eating regular, well-balanced meals helps to maintain a steady blood sugar, which creates a feeling of calm and may reduce symptoms. It can also help to avoid substances such as alcohol or nicotine because they are more likely to increase (or at least maintain) BDD-related behaviors rather than to decrease them.

Sleep

Individuals with BDD may have intense periods of times where they feel like they are in overdrive, also known as the fight or flight response. This means that the body is always ready to escape danger, even if it may not actually exist. A full night of sleep, approximately 8 hours for most adults, helps the body control the fight or flight response associated with anxiety that can come with BDD. Creating a consistent and calming bedtime routine, avoiding blue light (that light from our phones and screens) one hour prior to bedtime, abstaining from daytime naps, and refraining from caffeine after noon all promote restful and continuous sleep.

At work

Going to work can be stressful for those with BDD. Individuals with BDD may feel self-conscious or notice low self-esteem affecting their job performance. The constant focus on their perceived flaws may make it hard to stay on task or focus on the work at hand. For some, socializing with colleagues can take a lot of energy. It can help individuals with BDD to keep in mind that others often are thinking more about themselves than they are thinking about them. This can be difficult to believe given the intensity of their thoughts, and their own focus on them. However, it can help to focus more on paying attention to others, and the contents of conversation and individuals may notice an improvement in their ability to stay focused on the work. With treatment, many with BDD find it easier to work effectively and with more confidence.

At school

Going to school can be stressful for those with BDD. They may feel self-conscious or notice low self-esteem affecting Their school performance. The constant focus on their perceived flaws may make it hard to stay on task or focus on Their studies. For some, socializing with peers can take a lot of energy. Remember that others often are thinking more about themselves than they are thinking about others. This can be difficult to believe given the intensity of thoughts, and the individuals strong focus on them. However, trying to pay attention to others and what they are talking about can help those with BDD notice an improvement in their ability to stay focused in class or in conversation. With treatment many with BDD find it easier to go to school and socialize with others.

In relationships

The symptoms and challenges associated with BDD can affect one's relationships. Feeling uncomfortable with parts of one's body can change behavior and how they interact with others. For example, some with BDD may spend hours thinking about their perceived flaws and gaze at themselves in the mirror for long periods or take a great deal of time applying makeup in the bathroom.

Other people in the lives of those with BDD may notice these behaviors, and can unfortunately perceive them as self-obsessed or self-absorbed. People with BDD are quite the opposite. Most with BDD are not vain at all, and are, in fact, dealing with a deeper struggle often not related to the perceived flaws. Being vulnerable and talking about their concerns with a beloved family member or trusted friend can make a difference.

Those with BDD may notice that once they share their condition with a trusted person, that person may quickly discount their concerns or say "you look great,” and despite the reassurance they may have a hard time believing loved ones when they say they do not see what the individual sees. This is normal for those with BDD, and they are not “crazy” for not believing them. One of the symptoms of BDD is not seeing oneself as others do. With proper treatment, individuals with BDD will slowly begin to see what others see in them.