Impact on Daily Life
If you are struggling with BDD, you may be finding it more difficult to be around others, maybe because you want to hide your physical appearance from them.
Sometimes people find it hard to make eye contact, speak or interact with others; it may be a way to keep attention away from you and your appearance. You may find it hard to be in social situations because you feel self-conscious and your attention is on your appearance so you do not get to enjoy time with others.
Other ways people’s social lives are affected by BDD is that some people end up giving up activities they enjoy, giving them more time for their BDD behaviours such as going to the gym, spending time doing hair and make-up. At its worst, BDD may stop people from leaving their home or bedroom entirely.
As well as the visible symptoms of BDD, such as avoiding public spaces, checking or difficulty socialising, there are many symptoms of BDD which aren’t visible. These happen in the mind and are very harmful and distressing to those experiencing them. As well as impacting the person experiencing them, they can be difficult for family, friends and loved ones to notice. Below we have given a break down of some of the common hidden symptoms of BDD, as it can be helpful for family to understand what might be happening for their loved one inside their mind. These could include:
Intrusive thoughts are unwanted thoughts that may pop into our minds at any time, often without warning. They are usually disturbing and often repetitive – it may feel very difficult to make them stop. With BDD, these intrusive thoughts are often about appearance or other’s judgement of appearance. Intrusive thoughts can significantly impact quality of life and can eventually impact one’s behaviours too. If you are experiencing intrusive BDD thoughts, they may be distracting you from paying attention to daily activities or people. It may be very hard to concentrate and stop focusing on these thoughts.
Comparing yourself to others
Comparing is one of the most common mental actions in BDD. It’s often driven by people wanting to work out how their appearance rates against others, or as part of wanting to try and be sure of exactly how you look. The problem with comparing is that it almost inevitably leads to dissatisfaction, and of course fuels preoccupation with appearance. Those with BDD might also compare the way they are treated by someone to the way they treat others as a further way of assessing how attractive or unattractive people find you. Comparison can become a compulsive behaviour.
Planning and preparing
Here you might find that you are looking ahead and planning for how you might act, your posture, what angle you might be seen by, where to sit in relation to other people or to lighting. Often people with BDD will research new places before they visit or avoid places they don’t feel they can adequately control. These behaviours reinforce the idea that there is an appearance problem and will subsequently fuel the pre-occupation with appearance.
Excessive worrying and ruminating
Some people cope by trying to ‘put right’ or make sense of past events or their appearance by brooding, constantly mulling the problem over. They might ask questions like ‘why do I feel this way?’. If this sounds familiar, you are probably trying to solve problems that cannot be solved or answer a question that cannot be answered. This can lead your mind to feel defeated and helpless and significantly lower mood. BDD can often feel like an unsolvable problem, so it’s common to fall into this type of thinking, particularly if you are solution focussed.
Hyper vigilance of perceived threats
Hyper vigilance often involves looking out for people’s reactions to you. You might be on the lookout for facial expressions of disgust, staring, whispering, people looking away, people seeming to talk about you or laughing at you. Research shows that individuals with BDD are very prone to interpreting neutral expressions on people’s faces as disapproving or negative, meaning that vigilance is a very unreliable source of information when seeking to notice other people’s reaction to you. Hyper vigilance can be very exhausting and distracts from the world around you.
Negative mental images and a ‘felt-sense of self’
Pictures or felt impressions that we visualise in our minds can be just as powerful at fuelling pre-occupations as actually looking at or checking a perceived flaw. People with BDD often experience such images from an observer’s perspective, as if they are looking back on themselves. One of the problems is that we can end up ‘fusing’ our image with reality – misinterpreting a distorted or ‘worst case’ image as an accurate representation of reality. The solution is to understand that mental images are a product of your mind and to be more detached from them, treating them like passing events in your mind.
Impact on Family Life and Relationships
When you are struggling with BDD, it can be so overwhelming that it can change the way you respond to those around you, in particular family members.
Family members often get pulled into ways to try to help reduce the anxiety that people with BDD experience; this can include helping you with grooming routines or giving you lots of reassurance about your appearance. This can sometimes give you relief at first, but this often does not last, and the worries and anxiety often come up again. Alternatively, it may be that whatever others try to do to help does not work.
There are sometimes disagreements in families because you have different ideas about what is going on; they won’t be able to see what you see in terms of the perceived flaw. This can be frustrating for BDD sufferers and families as each cannot see what the other can. Some families have shared that disagreements can sometimes lead to physical aggression.
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