Many people are concerned to a greater or lesser degree with some aspect of their appearance but for a diagnosis of BDD, the preoccupation must cause significant distress or handicap in at least one area of one’s life. For example, someone with BDD might avoid certain social and public situations to prevent themselves from feeling uncomfortable and worrying that people are rating them negatively.
Alternatively a person may enter such situations but remain very self conscious. He or she may camouflage themselves excessively to hide their perceived defect by using heavy make up, brushing their hair in a particular way, changing their posture, or wearing heavy clothes. They may spend several hours a day thinking about their perceived defect and asking themselves questions that cannot be answered (for example, ”Why was I born this way?”, “If only my nose was straighter and smaller”) They may feel compelled to repeat frequently certain time consuming behaviours such as:
- Checking their appearance in a mirror or reflective surface.
- Seeking reassurance about their appearance.
- Checking by feeling one’s skin with one’s fingers.
- Cutting or combing their hair to make it “just so”.
- Picking their skin to make it smooth.
- Comparing themselves against models in magazines or people in the street.