Humans’ views about their appearances are highly subjective. Though there is often agreement about the “beauty” of a particularly attractive individual, there are no absolute measures of beauty. Most people are more or less dissatisfied with aspects of their looks. Many people try to embellish/hide flaws via make-up, hair coloring, wearing wigs, building up their muscles, etc., in order to achieve maximum results toward a desired image. Some people have a higher degree of preoccupation with their looks and experience frequent and intense, but still manageable, discomfort.
Body Dysmorphic Disorder, on the other hand, is diagnosed when the distress is significant and the person does not function as well as they would like to. The person tends to engage in rituals, sometimes for hours, such as excessive grooming and mirror-checking, reassurance-seeking, skin picking to remove skin imperfections, etc. This can lead to arriving late at social events, even work, to car accidents by having been checking in the mirror, and to other undesirable outcomes. Some or many social situations, including dating, are routinely avoided. He or she fears being scrutinized, laughed at, thought less of, and rejected. It leads to feeling extremely self-conscious in a negative way. Further consequences are interference with school and work, besides other social situations.
With plastic surgery and other cosmetic invasive procedures becoming more common in the population at large, people with BDD are likewise more likely to seek “correction” via these methods. Unfortunately, satisfaction is rarelyachieved. It can lead to a new bout of despair.
Individuals with BDD suffer often intensely and in silence. Other people do not understand. They say, “You look fine.” Yet this is never reassuring, maybe other than for a moment. The person “knows” they look unattractive. Though he or she believes that other qualities are involved in a sense of self-worth, they cannot tap into it, with all their preoccupation centering on their looks. They are often isolated and feel depressed. Some feel so desperate that they have thoughts of suicide.
The areas of concern vary greatly. Typical areas involve the skin, hair, nose, eyes, baldness, legs, breasts, genitalia, muscle size, and others. Some areas are particularly hard for them to admit to others, again leading to suffering in isolation. Some people hate everything about their looks.