Body Dysmorphic Disorder (BDD) in Kids and Teens
What Is Body Dysmorphic Disorder?
Body dysmorphic disorder happens when kids and teens spend a lot of time worrying that parts of their body are flawed in some way. They may keep checking, fixing, or covering themselves up, or asking others about their appearance. The disorder is related to obsessive-compulsive disorder (OCD).
Kids and teens with the disorder focus on flaws that others wouldn’t notice and may feel sad, alone, or depressed. Often, they spend time alone to avoid others judging these "flaws." But treatment can help kids and teens replace negative thoughts, be more social, and learn coping skills.
What Causes Body Dysmorphic Disorder?
There’s still much to learn about the exact causes of body dysmorphic disorder. But experts believe that these things play a role:
Genes. Body dysmorphic disorder may be partly inherited, and tends to run in families.
Serotonin. This is a chemical in the brain that’s linked to mood and energy. A low supply of serotonin helps explain why body dysmorphic disorder happens.
Brain differences. Some areas of the brain look and work differently in people with body dysmorphic disorder.
The disorder isn’t due to anything a parent or child did or said. It’s not anyone’s fault.
What Are the Signs & Symptoms of Body Dysmorphic Disorder?
Kids and teens with body dysmorphic disorder:
Focus on their looks to an extreme. They find it hard to stop thinking about the parts of their looks that they dislike. They focus on specific things — like a pimple or the shape or look of their nose, eyes, lips, ears, teeth, or hands. They may seek out extreme treatments like plastic surgery.
Feel upset about their appearance. They feel worried, stressed, and anxious about their looks almost all the time. They may get angry and be easily irritated.
Check or fix their body part often. Kids and teens with the disorder feel the strong need to check their appearance over and over. For example, they may look in a mirror, ask others how they look, or “fix” their appearance many times a day.
Try not to be seen. Some kids and teens feel so bad about their looks that they don’t want to be seen. They may stay home; keep to themselves; or use makeup, hats, or clothes to cover up. They may also avoid looking in mirrors because it’s so stressful.
Have false ideas about their looks. Kids and teens with body dysmorphic disorder don’t see their body as it really is or as others see it. The "flaws" they focus on are things that others can hardly notice. They exaggerate them, so things seem worse in their minds.
How Is Body Dysmorphic Disorder Diagnosed?
Mental health providers, like psychologists, social workers, or therapists who understand body dysmorphic disorder can diagnose it. They’ll ask kids questions and listen carefully to the answers to figure out if it’s the disorder or something else. Your child’s doctor should be able to recommend a provider.
How Is Body Dysmorphic Disorder Treated?
Body dysmorphic disorder treatments can include:
- Cognitive behavioral therapy (CBT). This type of talk therapy helps kids learn to manage worry, fear, and anxiety. CBT teaches them that what they think and do affects how they feel. They learn that when they face a fear, the fear gets weak and goes away. They find out how to change the way they see their body. Slowly, and with lots of support, they focus less on perceived flaws. They learn to stop checking and fixing their looks.
- Medicine. Medicines that help serotonin work well are used to treat the disorder. These are sometimes called SSRI medicines.
Most of the time, cognitive behavioral therapy and medicine are used together.
How Can Parents Help?
If your child has body dysmorphic disorder:
Know how to talk with your child. Avoid saying things like, “There’s nothing wrong with your appearance” or “You look fine.” And try not to answer the same question over and over again. Instead, if kids mention their looks, say something like:
- “I know that upsets you, but I’m here for you.”
- “It sounds like you have a lot of worries popping up today.”
- “I know you feel this way, but your body dysmorphic disorder is making you see things differently from what’s really there.”
It’s OK if kids don’t feel like talking, but be a good listener when they do. Small gestures to show you care (like a hug) helps kids feel supported and help with recovery.
Be patient. Having body dysmorphic disorder can make your child irritable or withdrawn. Though this can be frustrating, stay calm and try to be patient. Sometimes a little time and space can help. You can’t fix their concerns on your own.
Encourage family time. Spending time together is important, even if it’s just while doing chores. Encourage your child to leave their bedroom for a bit to be with the rest of the family. Eat together when you can. This can be a relaxing time to share good things that happened that day.
Support other interests. Help your child focus on things that aren’t related to appearance, like school, friends, and hobbies.
Monitor screen time. Some kids and teens may look online to research treatments they don’t need, hoping to “fix” a flaw. Social media can have content about unrealistic bodies that leads kids to compare themselves with — and obsess over — other people. Watching or reading upsetting content can cause feelings of depression, helplessness, or anxiety. Be aware of how much time your kids spend online and what they see.
Learn more about it. You can find more information about body dysmorphic disorder and support online at:
- OCD (Obsessive-Compulsive Disorder)
- Feeling Good About Your Body
- Feeling Good About Yourself (Self-Esteem)