Body Dysmorphic Disorder

We all spend time in front of the mirror — dressing, grooming, or checking our appearance. This is especially true for teens, who are undergoing rapid growth and appearance changes, and taking new interest in the way they look. How they feel about their appearance is important, since body image can be such a big part of self-esteem during the teen years.

As a parent, you want to teach that there's much more to people than appearance. You want your teen's self-image to include personality, character, abilities, and his or her unique strengths and interests. Parents want their teens to appreciate and care for their bodies, and to take pride in how they look.

But feeling satisfied isn't always easy. Many kids who have positive body images become self-conscious or self-critical as they enter the teen years. It's not uncommon for teens to express dissatisfaction about their appearance or to compare themselves with their friends, celebrities, or people they see in the media. Ads for everything from makeup and clothing to hair products and toothpaste send messages that a person needs to look a certain way to be happy. It's hard not to be influenced by that.

While many teens feel dissatisfied with some aspect of their appearance, usually these concerns aren't consuming and don't cause extreme distress. They don't constantly occupy their thoughts or torment them and keep them from thinking about other things.

But for some teens, concerns about appearance become quite extreme and upsetting. They become so focused on imagined or minor imperfections that they can't seem to stop checking or obsessing about their appearance.

If your teen is constantly preoccupied and upset about body imperfections or appearance flaws, it may be a sign of body dysmorphic disorder.

What Is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is a condition that involves obsessions, which are distressing thoughts that repeatedly intrude into a person's awareness. With BDD, the distressing thoughts are about appearance flaws. Teens who have BDD might focus on what they perceive as a facial flaw, but they can also worry about other body parts, such as short legs or breast size or body shape. Just as people with eating disorders obsess about their weight, teens who have BDD worry about an aspect of their appearance. They may worry that their hair is thin, their face is scarred, their eyes aren't exactly the same size, their nose is too big, or their lips are too thin.

The disorder has been called "imagined ugliness" because the appearance flaws usually are so small that others consider them minor or don't even notice them. But for a person with BDD, the concerns feel very real because the obsessive thoughts distort and magnify any tiny imperfection. Because of the distorted body image caused by the disorder, a person may believe that he or she is too horribly ugly or disfigured to be seen.

Besides obsessions, BDD also involves compulsions. A compulsion is something a person does to try to relieve the tension caused by the obsessive thoughts. For example, a girl with obsessive thoughts that her nose is horribly ugly might constantly feel the need to check her appearance in the mirror, apply makeup, or ask someone many times a day whether her nose looks ugly.