What I See in the Mirror Is Not What Others See: What's Happening?

According to the International OCD Association, at least one out of every 50 people in the United States has a mental health condition known as body dysmorphic disorder (BDD) If you have BDD, you focus on a real or perceived physical flaw to the point that it interferes with your enjoyment of life.

As it stands now, BDD is more common than the better-known obsessive compulsive disorder (OCD) or anorexia nervosa. However, the numbers may be even higher for BDD, because it’s underdiagnosed.

Not liking what you see in the mirror can have a negative impact on your 

self-esteem. It may also be a sign of an eating disorder, such as anorexia or bulimia.

Our team of expert counselors at The Soho Center for Mental Health want you to feel better about yourself so that you can pursue your goals with confidence and zest. We diagnose and treat mental health conditions, including BDD, at our offices in Greenwich Village, Manhattan, New York City, and through HIPAA-compliant teletherapy.

Do others see something different when they look at you than when you look at yourself? You may have BDD. Although you could focus on any area of your face or body, most people with BDD are troubled by things such as:

• Acne or other skin problems
• Nose shape or size
• Other things about their face they don’t like
• Thin or balding hair
• How their skin or veins look
• Muscle size
• Breast size
• Fatness or leanness
• Genitalia

Here are some signs that your “flaw” isn’t a flaw at all, but a treatable mental health disorder called BDD.

Do others agree with your perception?

The first sign that you may have BDD is that almost nobody else agrees that your flaw is as drastic as you perceive it to be. Even though it may be true that you have a longer-than-average nose or may be a few pounds heavier than your peers, most people you know think you look just fine.

If you get teased about your flaw, you may take that as confirmation that the flaw is a major defect. However, what proportion of the people you know actually bully you about your flaw? When you count up your supporters versus your detractors, you probably find that you have a lot more of the former.

Do you try to hide or fix your flaw?

Sometimes women and men with BDD try to fix their flaws through plastic surgery or cosmetic dentistry. Although a nose job or veneers can do a lot toward improving someone’s self-esteem and confidence, if you have BDD, it may not help at all. In fact, you may find yourself booking procedure after procedure or trying various cosmetic fixes without satisfaction.

If you don’t like your body, you may wear baggy clothes. If you don’t like your face or hair, you may hide behind sunglasses or under hats or scarves. You may also find yourself changing clothes or styles multiple times a day in an effort to “get it right” or camouflage your flaw.

Do you have compulsive behaviors?

BDD is similar to obsessive-compulsive disorder (OCD), but the obsessions and compulsions all revolve around your appearance. If you have BDD, you may:

• Check yourself in the mirror multiple times a day
• Or, conversely, avoid mirrors
• Pick at your skin
• Spend excessive amounts of time grooming

If you have BDD, you may also have other mental health disorders, including anxiety or depression. Sometimes BDD is accompanied by an eating disorder, in which you try to change the shape of your body by controlling your food intake.

Do you avoid social situations?

When you don’t feel good about the way you look, you may be reluctant to go to parties. Or, you may constantly seek assurance from others that you look fine.

By focusing excessively on your appearance and your perceived flaws, you may be reluctant to put yourself in the spotlight or take positive risks that could advance your social life or even your career. You may also find that the perfectionism that comes with BDD affects other aspects of your life, including your ability to finish projects.

Unfortunately, like most mental health conditions, BDD doesn’t go away on its own. In fact, it tends to worsen without treatment. 

If you’re unhappy with your appearance, you may find yourself spiraling into depression and anxiety, too. If you have any thoughts toward self-harm or suicide, seek help right away. Call the National Suicide Prevention Lifeline by simply dialing 988. 

Luckily, BDD responds to treatment, such as cognitive behavioral therapy (CBT) and other interventions. To get the help you need to feel better about how you look and to increase your self-esteem, contact our team for a consultation and customized treatment today. Our office also offers teletherapy.