Most of us have something we’d change about our face or bodies given half the chance, and we all get self-conscious at times. It might be that we don’t want to go in to a meeting or out to a party because we think that the spot which has just broken out is like a beacon; or our hair is lank and unmanageable or that we are not as thin as we used to be. These awkward appearance-related moments of discomfort are a very common experience, and one that most people can get over after a while. Body dysmorphia is those worries supersized to nuclear strength. If looks-related insecurities are a bout of rain that lowers your mood, body dysmorphia is a hurricane that can rip up your whole life.

Body Dysmorphic Disorder (BDD) is defined as an obsessive preoccupation with a flaw in your image. Sometimes it starts with a slight imperfection, such as a mole or scar on your face. And sometimes it is a distorted perception of one part of you, such as the perceived spread of your thighs. This ‘defect’ most commonly is not visible to others, but to you it becomes an obsession so persistent that it can interfere with your ability to go about your daily life.

One client described looking in the mirror and being overwhelmed with the urge to scream or cry and then feeling the need to hide away because the thought of anyone seeing her looking “so hideous” was incredibly distressing and painful. She said she felt “How will someone else be able to look at my ugly face all day when I can’t even look at it for a few seconds in the mirror?”

Nobody knows why some people can brush off these negative thoughts about their looks and others go on to develop BDD. There is some research pointing to a genetic link, because it has been shown to run in families, but there is also research showing that other factors such as bullying or other abuse during your childhood can lead to it. BDD is estimated to affect about one per cent of the population, so is actually more common than other, better known, disorders such as schizophrenia. And unlike anorexia and bulimia, the rate of body dysmorphia is almost equal between male and female sufferers. The only difference is that women tend to focus on facial features and men on body shape or muscle mass.

And as, with so many things, the modern obsession with posting filtered selfies on social media is not helping. In fact, it is thought to be increasing rates of Body Dysmorphia in young people. A recent article in the Journal of the American Medical Association said that Instagram, Snapchat etc, “Can act as a trigger and lead to body dysmorphic disorder (BDD).”

What does Body Dismorphia really look like?

Here are the most common symptoms of BDD:

• constant mirror-checking
• strong feelings of guilt and shame
• isolating yourself to avoid situations that cause stress anxiety or discomfort
• attempts to cover or hide your features
• the desire for plastic surgery to change your looks
• eating disorders
• use of alcohol or drugs to manage the feelings
• self-harm and suicidal thoughts

What can you do to tackle BDD?

If you have Body Dysmorphic Disorder, chances are you will think the only way of improving your confidence and mood is to change your looks. Here are some ways to start to accept that it is the interior —your thoughts and feelings — that you need to work on, and not the exterior – your appearance.

Don’t mirror-check, reality check

Take the belief you currently have, such as “My skin is disgusting, it will revolt people” and test it for evidence. Start looking for facts to back up this belief. You might think, for example, that you felt somebody gave you a funny look on the tube on the way to work one morning. But if you begin to really examine this evidence you will come to realise that these thoughts are all internal, and that it is your interpretation of others and what they think, rather than identifiable fact that this is what they thought.

Mind over matter

If you are struggling with sadness or panic invoked by seeing yourself in the mirror, mindfulness can really help. Close your eyes, breath, practice the mindfulness techniques that work best for you and bring yourself back into the here and now.

Create new safety nets

One helpful strategy is to start to swap out your “safety behaviours”. So, for example, if you wear heavy foundation or a scarf to hide your skin when you go out, try to cut down on doing this. And instead of physically hiding yourself, find other non appearance-related ways to manage your distress. This could be putting on music, or finding a friend to walk out the house with so that you can talk to someone you trust and reassure yourself that they are comfortable looking at you.

Find the emotion

The first part of the battle with dysmorphia is recognising that your preoccupation with your looks comes from within. It is an internal feeling not related to the external facts or to the way you actually look to others. Once you have started to understand this, it can help you to manage those feelings. It could also be really helpful to work out what lies beneath this idea of you as imperfect so that you can also process that.

If you would like some support or need a safe space in which to open up about your feelings about your appearance, then therapy could be a good option for you. Just call 020 8673 4545 or email info@theawarenesscentre.com for a confidential appointment.