When does concern with appearance become BDD?

The key difference between a mild appearance concern and BDD, is the distress and impact it causes on someone’s life. To be diagnosed with BDD, the preoccupation for appearance must last for at least an hour a day, cause significant distress and/or interfere with at least one area of life (E.G. school, relationships, home, family life).

You can take this test, used by clinicians, to find out whether you might have BDD.

If someone has been living with BDD for a long time, it may be difficult to identify which behaviours are BDD and which are ‘normal’.

Here are some common BDD behaviours which cause significant impact on someone’s daily functioning:

• Regularly checking appearance in a mirror or reflective surface or avoiding mirrors completely.
• Carrying out excessive and time-consuming beauty regimes.
• Comparing appearance to others.
• Asking for reassurance about appearance.
• Avoiding social situations.
• Spending hours a day thinking about a perceived flaw.
• Refusing to be photographed.
• Changing posture to disguise appearance.
• Checking by feeling skin with fingers.
• Cutting or combing hair to make it “just so”.
• Picking skin to make it smooth.
• Camouflaging appearance.
• Mentally criticising and self-attacking.
• Hyper vigilance of perceived threats.
• Negative mental images and a ‘felt-sense of self’.

These behaviours all make sense if you feel you look ugly as they are designed to make you feel safe (for example camouflage) or to determine whether you look as bad as you think you do (for example checking in a mirror).  However, they lead to an increase in worrying about how you look and distress with your appearance.

Find out more about BDD symptoms >