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‘Imagined Ugliness’ is a Very Real Disorder

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For better or worse, a teen’s self-confidence is often linked to body and physical image. Teenagers experience appearance changes with each growth spurt and as a result, are often concerned with how they look. However, if you have noticed that your teen is going to the extreme — obsessing and fretting over the smallest of flaws — he or she could be experiencing body dysmorphic disorder. (BDD)

According to the Northern Counties Psychiatric Association in Maryland, BDD causes preoccupation or obsession over a minor or even imagined physical defect. This obsessive concern usually centers on facial features like nose, teeth, scars, but can also center on hair or body odor. BDD also involves compulsions.

According to the Mayo Clinic, a compulsion is a repeated action that a person performs to relieve tension caused by obsessive thoughts. A teen with BDD may worry that her nose is disfigured and ugly. As a result, she will repeatedly check in a mirror, apply cosmetics, and even ask, “Does my nose look ugly?”

If BDD is not successfully treated, it can lead to depression and suicidal thoughts, substance abuse, and difficulty concentrating in school. As adults, BDD patients may seek unnecessary, costly and painful cosmetic surgeries, which only make the symptoms of BDD worse.

If you believe your teen is showing symptoms of BDD, speak to your family doctor who will recommend a mental health professional. Since BDD involves obsessive thoughts and compulsive behaviors, treatment typically includes cognitive-behavioral therapy, which focuses on ending the behaviors and thoughts causing the distress. Since support from family can be helpful to a teen during treatment, family counseling may also be recommended.

There is no prevention against the “imagined ugliness” disorder. However, the Mayo Clinic reminds us that early diagnosis makes it easier for the teen to overcome it. Also, helping a child manage stress and working to boost his or her self esteem will guard against a relapse.


Body Dysmorphic Disorder. Northern County Psychiatric Associates. Web. 12, Sept. 2011.

Body Dysmorphic Disorder. Mayo Clinic. Web. 12, Sept. 2011.

Reviewed September 13, 2011
by Michele Blacksberg R.N.
Edited by Jody Smith

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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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