What is BDD?
BDD causes you to feel really upset or worried about your appearance. You might think about it a lot and start to avoid doing things you enjoy because of it. Below are some common areas people with BDD worry about. If this doesn't not reflect your experience of BDD, that is okay, everyone' experiences BDD differently.
- Your skin
- Your nose
- Your hair
- Your face
- Your stomach
- How big your muscles are
You are not alone, approximately 1 in 50 young people have BDD and it is roughly the same across genders.
Body Dysmorphic Disorder Foundation: What is BDD?
A video explaining what BDD is. Children, young people, parents and carers may find this helpful. This video is 4 minutes 41 seconds.
Body Dysmorphic Disorder Foundation: Because I'm Ugly BDD and Me
A video of young people sharing their experiences of BDD. This video is 5 minutes 50 seconds.
South London and Maudsley NHS Foundation Trust: What is BDD? Mind of the Matter - Hear from the Experts
A video explaining what BDD is. Children, young people, parents and carers may find this helpful. This video is 6 minutes 42 seconds.
It is normal to have some worries about the way that you look, however this becomes a problem if it is:
- Constant.
- Starts to feel out of control.
- Starts getting in the way of you living your life and doing everyday things.
- Making you feel very upset and anxious.
You may find it difficult to talk to someone about your appearance concerns for many reasons, some are listed below. If this doesn't not reflect your experience of BDD, that is okay, everyone' experiences BDD differently.
- You are worried about being perceived as vain, self-obsessed or feeling ashamed about your appearance concerns. This is something that many people with BDD experience, you are not alone if you feel this way.
- You don't want to draw attention to the parts of your appearance that you don’t like.
- You didn't realise that your problem might be a mental health condition.
Common symptoms, emotions and reactions
To make yourself feel better you might do some of the following. If this doesn't not reflect your experience of BDD, that is okay, everyone' experiences BDD differently.
- Hide or change your appearance
- Spending excessive time applying makeup, styling your hair or choosing your outfits
- Wearing certain clothes, e.g. baggy clothes to hide your body
- Constantly and frequently checking yourself in mirrors
- Avoiding mirrors
- Avoid certain activities that trigger your anxiety and worries
- Seeking reassurance from your friends, parents, carers and family
- Comparing yourself to others
You may find this YoungMind's real story about a young person's experience of BDD helpful to read.
How does therapy help with BDD?
You might feel that therapy will not help as you think the problem is a physical one. CBT can’t change the way that you look however we can help to reduce your distress and the amount of time your appearance worries take up in your life so you can get back to doing the activities that you enjoy.
The BDD cycle
These are some common examples; they may not reflect you experience of BDD. That is okay because everyone experiences BDD differently.
Acne
- Thought: My face is disgusting because of my acne
- Feelings: Anxious, worried, shame
- Body: Headache, feeling sick
- Behaviour: Spending an excessive time doing your makeup before school or college
- Consequence: You are late for school everyday
Muscle dysmorphia
- Thoughts: I look very small, I am so weak
- Feelings: Anxious, worried, shame
- Body: Headache, feeling sick
- Behaviour: Spending excessive time working out and exercising
- Consequence: You don't get your homework done and keep getting in trouble at school
BDD and family accommodation
Family accommodation describes the changes that families and parents make in their own behaviour to help their children avoid or lessen feelings of anxiety. This is a normal response; however you can play a role in supporting your child to overcome their BDD by being aware of your accommodations and making plans to change them. For example answering the same question over and over, buying lots of skincare and makeup for them and being late to leave the house.
Remember - you are likely accommodating your child's BDD but that is a normal response, and you are not to blame. Be compassionate with yourself. However, you can play a role in overcoming BDD by becoming aware of your accommodations and making plans to change them.
- Have a look at the Family Accommodation Scale to think about how you may be accommodating your child's BDD
- Start writing down ways that you accommodate their BDD and how often these happen
- Try to make small changes to these accommodations and be consistent
BDD and neurodivergence
Neurodivergent children and young people may be more likely to experience BDD. This may be because you have a greater attention to detail and so more likely to find parts of your experience you don't like. Or you might hyperfocus on your appearance and related concerns. If you would like more information, please click here for more information about BDD and autism and click here for more information about BDD and ADHD.
We encourage you or your parents and carers to talk to your clinician about adjustments you may need. We will make adaptations to support you to engage with the treatment we offer.
Below are some example of adjustments you could ask for.
- Movement breaks during sessions
- Turning bright lights off
- Using visuals or writing your thoughts down
- Session plans sent before and after sessions
How can I help myself?
If you have to wait for therapy or you can't access it for any reason, or if you just want to try things to help yourself here are some things you can do to manage anxiety.
- Talk to someone you trust about how you are feeling - you could use an emotion wheel and body map to help you identify and explain your feelings.
- Moving – walking, running or doing any form of exercise - especially if it is outside, you could listen to music or a podcast at the same time.
- Breathing – taking control of/slowing down your breathing can help you feel calmer. Try taking a slow deep breath in through your nose for 5 seconds, hold this breathe for 5 seconds, then slowly breathe out through your mouth for 5 seconds. You may find the West Sussex Mind video below helpful.
- Personal Coping Plan - you might find it helpful to do this with someone you trust, there is more information on this here.
- Self-soothe box - you might it helpful to make this, there is more information on this here.
- Distraction and grounding techniques - you might like to use the 5-4-3-2-1 technique. Name 5 things you can see, 4 things you can feel, 3 things you can hear, 2 things you can smell and 1 thing you can taste
- Relaxation and mindfulness - you can find guided relaxation and mindfulness videos on YouTube or there are some apps below.
Mind: 30 second breathing exercise
This video guides you through a short breathing exercise. The video is 31 seconds.
How can I help my child?
Talking them about their BDD cycle and support them to use strategies in the 'How Can I Help Myself' section.
You can also start to think about how you reduce how much you are accommodating your child's BDD. More information on this is above in the section 'BDD and family accommodation'.
Body Dysmorphic Disorder Foundation - Webinar
This webinar is 1 hour and 37 minutes, it provides more information on evidence based treatment, medication, setting goals and family accommodation.
Body Dysmorphic Disorder Foundation - Videos
Supporting someone with BDD
This video suggests ways you can support your child or young person. This video is 4 minutes 38 seconds.
Supporting a child with BDD
This video suggests ways you can support your child or young person. This video is 5 minutes 57 seconds.
Support while I am waiting
We know that it can be difficult waiting for therapy to start.
There are a number of different places that can offer some support whilst you wait, and there are places that you can go to learn more about BDD. Some of these support services and resources are outlined below.
Please note that none of these support services are a replacement for treatment, but they can be a good way to connect with others with common experiences and continue working towards your goals. They are also may not be able to provide urgent help.
If your life is in immediate danger, please call 999 or go to A&E.
- Text the word SUSSEX to 85258 (free NHS 24/7 mental health text-messaging support service)
- Call NHS 111 and select the mental health option (free 24/7 advice service for anyone concerned about their own, or someone else’s, mental health)
- Call Samaritans on 116 123 (free 24/7 listening service providing support and advice for anyone having thoughts of suicide). You can also email: jo@samaritans.org
- Call Hopeline247 on 0800 068 4141 (free 24/7 listening service offering support and advice for young people having thoughts of suicide). You can also email: pat@papyrus-uk.org or text: 88247
- Call Childline on 0800 1111 (free 24/7 support and advice for young people who want to talk about how they are feeling). You can also speak to a trained professional via web chat: https://
www. childline.org.uk/ get-support/ 1-2-1-counsellor-chat/
If you do not current have a lead practitioner within CAMHS and you are waiting for treatment, you can contact the CAMHS duty team if your mental health gets worse and you need some support. The duty team is not an emergency service, and you can expect to get a response within 2 to 14 working days, if you require more urgent help, you should call 111/999/attend A&E.
BDD Action Support groups
OCD Action offer a range of support groups providing a safe and welcoming environment where you can connect with others with similar experiences and offer mutual support without judgement. All support groups are peer led and facilitated by a dedicated team of trained volunteers.
For young people aged 16-20, with OCD/BDD/Trich & Derm: First and third Thursday of the month, 7pm via Zoom
For parents/guardians of people of any age with BDD - First Tuesday of the month, 7pm via Zoom
To join a support group, go to https://ocdaction.org.uk/online-support-groups/
For anyone who would like more information before they sign up please email sign-up@ebtsupportgroups.co.uk or call 020 7253 5272.
OCD Action Youth e-helpline
Complete form on https://
The Youth e-Helpline is for anyone between the ages of 14 and 25 who is affected by OCD or a related condition (such as BDD or a Body-focused Repetitive Behaviour). Whether you live with OCD yourself, or are concerned about a friend or family member, Youth e-Helpline volunteers are here to support you!
You don’t need to have a diagnosis of OCD to get in touch. In fact, about half of the young people who email are unsure about whether they have OCD or not. The Youth e-Helpline team is made up of volunteers who are mostly young people with OCD themselves, so they really understand the challenges of living with OCD when you’re young. They can chat to you about how you’re feeling and offer you support and information about OCD and how to access the recommended treatments. OCD can be exhausting and isolating, but it really can get better!
OCD UK Support Groups
OCD UK also provide a range of online support groups. Whilst these are primarily for those aged 18+, they do offer 'themed' support groups, often including one for young people aged 12-17 and one for families and friends. These are held via Zoom.
You can check upcoming groups and their dates, and sign up, on their website - https://
OCD UK Parent Project
OCD UK has been granted some funding from the National Lottery Community Fund to design and deliver online and in-person educational workshops for parents who have children with OCD. The project is specifically designed for parents who have children between the ages of 5-18 which is the CAMHS age bracket. Workshops cover an introduction to OCD, symptoms, evidence-based treatment, how to help at home, parent interaction and lived experience.
Book a place here - https://
For any questions about the project, email parents@ocduk.org
More information about BDD
Below are some links to additional information about BDD.
Please note: This is a collection of resources that children and young people often find helpful, and they are not authored by or owned by Sussex Partnership NHS Foundation Trust. We will attempt to keep these resources as up to date as possible, but you may find changes with the links and information given.
Websites
Body Dysmorphia Disorder Foundation
This website link explains what BDD is and has links to find out more about the symptoms of BDD and other young people's experience of BDD.
International OCD Foundation - BDD website
This website link explains what BDD is like in teenagers and young adults and has links to find out more about BDD and school, relationships and work.
Webinars
Body Dysmorphic Disorder Foundation - BDD webinars
The Body Dysmorphic Disorder Foundation has a series of webinars on various topics such as accessing NHS services, practical tips and personal stories.
Anna Freud - Supporting Children and Young People
The link below provide information on supporting children and young people with BDD. They give an overview of the BDD, signs to look out for and how to support them.
Supporting children and young people with body dysmorphic disorder (BDD) | Anna Freud
Webinars
Body Dysmorphic Disorder Foundation - BDD webinars
The Body Dysmorphic Disorder Foundation has a series of webinars on various topics such as accessing NHS services, practical tips and personal stories.
Please note some of these app may require payment or paid subscriptions to access certain features of the apps.
For BDD
What's Up? is a free app utilising some CBT (Cognitive Behavioural Therapy) and ACT (Acceptance Commitment Therapy) methods to help you cope with Depression, Anxiety, Anger, Stress and more!
Features include:
- Strategies to help with immediate distress management
- Advice on identifying unhelpful thinking patterns and challenging them, understanding your thoughts better and managing worries
- Information on anger, anxiety, depression, self-esteem and stress
- Diary feature
- Habit tracker
- Notes
MindShift aims to help you learn how to relax, develop more helpful ways of thinking, and identify active steps that will help your anxiety. This app includes strategies to deal with everyday anxiety as well as specific tools to tackle: Test Anxiety, Perfectionism, Social Anxiety, Performance Anxiety, Worry, Panic, Conflict.
For parents and carers
Combined Minds helps families and friends to find ways to provide the right environment to help the individuals they support affect their own change. This provides support to families and friends to help them understand and manage their loved one's difficulties including anxiety, depression, self-harm, eating disorders, digital addiction and safety planning.
For mindfulness and relaxation
Free mobile app with virtual “bells” to time and support your meditations, and access to lots of guided meditations by many different meditation teachers.
Chill Panda is a game-style app that incorporates breathing exercises and coping strategies to help manage anxiety in an interactive way. You can engage in the app by playing the full game mode or use the "Quick Chill" function to access skills quickly.
You may find other helpful apps on the Sussex Health and Wellbeing app library.
Please note that not all of these books may be available to loan at your local library.
Books for younger children
Ideal for children aged 10 years and above
This books uses Cognitive Behavioural Therapy and mindfulness techniques to help children understand the negative thoughts they are having and learn skills to develop positive body image. It uses stories, activities and games to support this.
Books for older children and teenagers
Ideal for children aged 13 years and above
This book helps young people to understand what BDD is and shares stories from young people and their families who have experienced BDD. It explains what treatment for BDD is and where you can get help.
Ideal for children aged 13 years and above
This is a story about Jemima Small and her struggles with body image and self-esteem and she learns skills to develop self-acceptance.
Ideal for children and young people aged 9 to 15 years old
This book helps children and young people to understand what may be affecting the way they view themselves and provides skills and strategies to develop positive body image.
Ideal for children aged 13 years and above
This book helps children and young people to understand what may be affecting the way they view themselves and provides skills and strategies to develop positive body image.
Books for parents and carers
This book helps young people to understand what BDD is and shares stories from young people and their families who have experienced BDD. It explains what treatment for BDD is and where you can get help. It has information about what parents and carers can do to support their child or young person