Written by:

Danny Smith

Last Updated:

September 30th, 2024

BDD and Addiction

Body Dysmorphic Disorder (BDD) is a mental health condition deeply connected with our relationship with our body. Whilst most people have ‘good’ and ‘bad’ days with regard to their body image, BDD is an overwhelming condition that can be very difficult to control. It is more than just identifying flaws or issues with our physical appearance. It is a deep-seated condition that can restrict an individual’s day to day life. Over time, this can begin to take its toll, potentially leading to the development of a secondary mental health condition such as an addiction.

What is BDD?

Body Dysmorphic Disorder occurs when concerns about our appearance become ‘excessive and are either significantly distressing or having an impact on the individual’s quality of life.’ We might think of BDD as a condition of contemporary times; however, it was first written about in 1891 by an Italian psychiatrist called Enrico Morselli. Morselli described BDD as:

‘the sudden appearance and fixation in the consciousness of the idea of one’s own deformity; the individual fears that he has become deformed (dysmorphos) or might become deformed, and experiences at this thought a feeling of an inexpressible disaster…’

BDD is a two-pronged condition. The first component is the ‘obsession’ with bodily flaws. The second is the subsequent deterioration of mental health that accompanies this.  When we are so critical of ourselves for so long, we can begin to feel ground down. Morselli suggests that individuals with this condition are ‘veritably unhappy,’ experiencing an onslaught of ‘fear, distress, anxiety, and anguish,’ ultimately ‘compelling the individual to modify his behaviour.’

In diagnostic manuals, BDD is considered to be a specific kind of obsessive-compulsive and related disorder.

How Common is BDD?

An estimated 1 in 100 people deal with BDD. BDD is experienced across all genders, races and ages, but it commonly develops in childhood and adolescence.

BDD Symptoms

Symptoms of body dysmorphic disorder can be very personal. It is important to remember that the following signs are general symptoms, and your (or a loved one’s) experience with BDD may look slightly different. For example, some people with BDD may consistently look in the mirror to check and assess their appearance. Other people with the same condition may avoid mirrors altogether, for example, brushing their teeth with their back to the sink or avoiding changing rooms. Whilst these are opposite behaviours, they both have their roots in the same condition.

Common signs include:

• ‘body checking’
• avoiding mirrors
• covering specific parts of your body
• excessive exercising
• excessive grooming, beauty and self-care routines
• comparing your body to others
• asking other people how you look
• social withdrawal and avoidance
• difficulty leaving the house
• seeking medical advice for your appearance
• trichotillomania (hair pulling)
• dermatillomania (skin picking)
• plastic and cosmetic surgeries
• high anxiety
• depression
• feeling embarrassed or ashamed
• self-harm
• suicidal thoughts

How Do I Know If I Have BDD?

We have all found ourselves criticising a specific flaw. BDD is deeper than that. When BDD develops, these kinds of thoughts become constant and exacerbating. There are specific characteristics that may distinguish BDD from low self-esteem and poor body image. These include:

• specific appearance preoccupations
• compulsive behaviours
• associated intense emotional distress

Appearance Preoccupations

People with BDD often hyperfocus on specific areas of their body. Common areas of the body associated with BDD are:

• skin
• hair
• nose

Individuals with this condition may find themselves obsessing over the health of their skin, becoming overly concerned with blemishes or scars, especially on their faces. There can also be a concern that the hair on their head is balding or that there is too much hair on the body and face. The nose shape and size of the nose are also a common concern.

Compulsive Behaviours

BDD is often marked by specific repetitive actions that aim ‘to fix, hide, inspect or obtain reassurance about the disliked body parts.’ These behaviours can take up to 3 and 8 hours a day. Completing these behaviours means compulsive – this means that pleasure is often not derived from attending to these tasks.

Emotional Distress

There are a lot of complex emotions associated with BDD. These include:

• anxiety 
• depression
• shame
• guilt
• disgust
• inadequacy
• embarrassment

These types of feelings can drive potentially harmful behaviours that can potentially lead to addiction.

What Causes BDD?

Clinicians cannot say for certain what causes BDD. However, the development of this condition is quite often linked with:

• a neurochemical imbalance
• a traumatic experience
• a genetic inheritance
• specific personality types

BDD and Addiction: What’s the Link?

Feeling so negatively about ourselves for so long will inevitably take a huge toll on our mental health. This can lead to the development of dual diagnoses such as anxiety and depression, as well as catalysing maladaptive behaviours such as:

• self-harm
• excessive exercise
• impulse spending
• heavy drinking
• recreational drug use

These behaviours may, at first, be used to quell difficult thoughts and feelings. Over time, however, engaging in these types of activities can risk our health and lead to increased harm. They can also lead to a developing dependency on specific things – such as drugs and alcohol – in order to cope with prolonged periods of distress. Given the compulsive behaviours associated with BDD in general, there is a significant chance that individuals with this condition may have a natural tendency towards addictive behaviours, which also increases addiction potential.

What Addictions are Associated with BDD?

BDD can be linked with a lot of different addictions – both behavioural addictions and substance use disorders. Frequently, though, individuals with this diagnosis may deal with:

• Shopping addiction
• Spending addiction
• Internet addiction
• Prescription addiction
• Exercise addiction
• Plastic surgery addiction
• Recreational drug addiction
• Alcohol addiction

Specific drugs associated with this condition include sedatives, cannabis, cocaine, hallucinogens, opiates and steroids.

BDD and Addiction Treatment

Accessing support for BDD can be difficult – especially as individuals with this condition may initially mask their symptoms to clinicians. However, without treatment, BDD can become debilitating. Finding the right kind of support can help you to regain control and rebuild your quality of life.

How to Get Help

If you are struggling with BDD symptoms, you may benefit from contact with a primary care provider. In some cases, this may lead to a formal diagnosis.

Therapy for BDD

Treatment for BDD is often two-pronged – it can consist of medication and psychological therapies. Potential medications for managing BDD include:

• SSRI antidepressants
• Sedative anxiety medications

There are a range of therapeutic options for BDD, such as:

• Cognitive behavioural therapy
• Exposure and response presentation therapy
• Counselling
• Group therapy
• Support groups

Addiction Rehab

If you are dealing with an addiction alongside BDD, then you may benefit from a comprehensive rehab plan that incorporates treatment of both. This could include discussing your core beliefs and emotions during CBT or addressing your relationship with yourself in addiction counselling. If required, your rehab programme can incorporate a detox phase to combat physical dependency alongside underlying psychological causes and effects.

Seek Help Today at Oasis Bradford

Dealing with addiction is challenging, but you don’t have to face it on your own. If you have a dual diagnosis, we can help you conquer your addiction. Get in touch with us today to begin your recovery journey. At UKAT, we believe everyone deserves stable mental health and a substance-free life. Our expert team is ready to help you take the first step towards that future.