Body Dysmorphic Disorder vs. a Deficit in Self Confidence

At one point or another, all of us have felt insecure and lacked self-confidence. Throughout our lives, we have likely experienced dissatisfaction with at least one aspect of our appearance. This may have been particularly poignant during adolescence. 

Individuals who suffer from Body Dysmorphic Disorder, although exhibiting from similar body-image concerns, endure more pronounced symptoms than what is considered normal or expected. In many cases, individuals with the condition endure time-consuming thoughts that may be characterized as delusional. 

Overall, body dysmorphic disorder varies from normal concerns regarding body image in several ways. These include the degree of preoccupation, fixation and distress surrounding parts of one’s body, the engagement in repeated rituals to correct, fix or conceal flaws, and the degree to which concern regarding one’s appearance causes distress, or interferes with, day-to-day activities. 

What is Body Dismorphic Disorder?

Body dysmorphic disorder is a condition that involves an extreme preoccupation with one’s own perceived defects in physical appearance. Often, these “flaws” are minor and go unnoticed by others. Nevertheless,  to reduce the distress associated with the features, individuals may engage in the enactment of repetitive behaviours, including:

• Mirror checking: Individuals consistently check their reflection and fixate upon certain parts of their appearance 
• Excessive grooming: To mask their insecurities, individuals may wear makeup to the gym, or thick foundation to the corner shop
• Skin picking: Individuals may pull at their lips, fingertips, cheeks, or loose skin 
• Reassurance seeking: Individuals may feel the need to have their self-worth affirmed and reaffirmed by external parties such as their friends or significant others
• Physical comparisons: Individuals may find themselves comparing their appearance to people in real life and social media models

Individuals experiencing this condition may also engage in avoidance, manifesting as an extreme reluctance to partake in social situations wherein their perceived inadequacy may be noticed by others. 

Other safety behaviours employed include camouflaging, in which they attempt to hide or conceal their perceived imperfections. Individuals with body dysmorphic disorder may elect to hide behind makeup, attire or accessories such as hats and/or sunglasses to mask their insecurities. Others may elect to undergo cosmetic procedures in an attempt to permanently “fix” or “correct” their perceived blemishes. 

Those with body dysmorphic disorder usually involuntarily fixate upon several parts of their bodies. This area of fixation may change over time. The following features are commonly scrutinized: 

• Parts of the face
• Hair
• Skin
• Breast size
• Muscle size
• Genitalia 

Collectively, the symptoms of the condition are detrimental to one’s day-to-day life and may lead to considerable distress and impairment across important life domains, interfering with functioning (social, occupational or otherwise). Normal functioning is usually only maintained through conscious exertion and additional effort. 

Importantly, the symptoms of body dysmorphic disorder are not better explained by another mental health condition, medication or substance on the central nervous system. Further, symptoms are not better attributable to the the effects of withdrawal.