Diagnosis and Recognition of BDD
Diagnosing Body Dysmorphic Disorder (BDD) can be challenging because many individuals hide their symptoms or genuinely believe they have a physical defect. It is often mistaken for low self-esteem, vanity, or body image issues without realising it is a psychiatric condition. Read more about the diagnosis and recognition of BDD below.
Mental health professionals, such as psychologists or psychiatrists, typically diagnose BDD using clinical interviews and DSM-5 criteria.
Key diagnostic criteria include:
- Preoccupation with perceived defects in appearance that are not observable or appear slight to others.
- The individual engages in repetitive behaviours (e.g. mirror checking, excessive grooming) or mental acts (e.g. comparing with others) in response to concerns.
- The preoccupation causes significant distress or impairment in social, occupational, or daily functioning.
- The appearance concerns are not better explained by another disorder, such as an eating disorder.
Screening questions may include:
- “Do you spend a lot of time worrying about a specific part of your appearance?”
- “Do you avoid mirrors or obsessively check yourself in them?”
- “Has this affected your school, work, relationships, or confidence?”
BDD vs normal appearance concerns:
- Most people worry about how they look sometimes. But in BDD, these concerns become all-consuming, irrational, and disabling.
- The person remains distressed despite multiple cosmetic procedures or repeated reassurance from others.
Red flags to watch for:
- Avoiding photos, mirrors, or social settings
- Frequent visits to dermatologists or plastic surgeons
- Obsessive skin picking or hair removal
- Repeated “fixing” rituals before leaving home
- Decline in academic or job performance
- Suicidal thoughts due to appearance
Diagnosis and Recognition of BDD
In South Africa, stigma around mental illness and limited access to specialised psychological services often lead doctors to overlook BDD. Many individuals present first to GPs or beauty clinics, not realising the root is psychological.
Raising awareness among healthcare providers and communities is essential for early intervention.
👉 [Next: Treatment Options for BDD]
