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Learn more about body dysmorphic disorder
Body dysmorphic disorder (BDD) is a mental health condition characterised by preoccupying, distressing thoughts about a perceived defect or flaw in physical appearance, which others typically cannot see or consider minor. Classified in the DSM-5 within the obsessive-compulsive and related disorders group, BDD involves repetitive behaviours such as checking, mirror-gazing, comparing, or concealing, performed in an attempt to manage the distress, which typically makes it worse. BDD is not vanity or insecurity about looks; it is an intrusive, hard-to-control preoccupation that interferes significantly with daily life, relationships, and the ability to function.
BDD is often kept hidden because of shame, which means it frequently goes unrecognised for years.
Common signs
- Persistent, preoccupying focus on one or more perceived physical flaws, most commonly skin, nose, hair, or weight
- Spending significant time each day checking, comparing, or thinking about the perceived flaw
- Compulsive behaviours such as mirror-checking, excessive grooming, skin-picking, or seeking reassurance
- Avoiding situations, relationships, or photographs because of appearance concerns
- Distress and impaired functioning caused by appearance preoccupation, not by the feature itself
- Strong belief that others notice or judge the perceived flaw, despite evidence to the contrary
Other common experiences
- Repeated cosmetic procedures that do not resolve the distress
- Significant time lost to appearance-related rituals
- Shame, social withdrawal, or reluctance to seek help
BDD responds to psychological treatment, particularly approaches with a specific evidence base for obsessive-compulsive spectrum conditions.
- CBT (Cognitive Behavioural Therapy) CBT for BDD combines work on distorted appearance-related beliefs with exposure and response prevention (ERP), gradually reducing compulsive checking and avoidance behaviours.
- ACT (Acceptance and Commitment Therapy) ACT helps you change your relationship with intrusive appearance-related thoughts rather than trying to suppress or disprove them, allowing fuller engagement with life despite ongoing thoughts.
- CFT (Compassion-focused therapy) CFT directly addresses the shame and self-criticism central to BDD, building a more compassionate internal response to perceived flaws.
- Schema therapy Schema therapy is useful when BDD is rooted in deeper beliefs about being fundamentally defective or unlovable, working to change these core patterns rather than surface behaviours alone.
It's Complicated is a therapist-founded mental health platform connecting clients with verified practitioners across Europe and globally, in over 60 languages. We work with over 2,500 vetted therapists, with in-person availability in Berlin, Amsterdam, Barcelona, Lisbon, Vienna, and other major cities, alongside online sessions worldwide. It's Complicated is free to use, and you pay your chosen therapist directly at rates they set.
Finding a therapist who understands BDD specifically, rather than treating it as a general confidence issue, is important for effective treatment. Our matching service is built to remove that friction. You complete a short survey, our psychologists combine data-driven insights with human judgement to identify the right therapists for your situation, and you choose from a shortlist of strong candidates. You can also browse our directory directly if you'd prefer to choose yourself.
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