Body Dysmorphic Disorder

Diagnosis

After a medical evaluation to help rule out other medical conditions, your health care provider may make a referral to a mental health professional for further evaluation.

Diagnosis of body dysmorphic disorder is typically based on:

• A psychological evaluation that assesses risk factors and thoughts, feelings, and behaviors related to negative self-image
• Personal, social, family and medical history
• Signs and symptoms

Treatment

Treatment for body dysmorphic disorder often includes a combination of cognitive behavioral therapy and medications.

Cognitive behavioral therapy

Cognitive behavioral therapy for body dysmorphic disorder focuses on:

• Helping you learn how negative thoughts, emotional reactions and behaviors maintain problems over time
• Challenging automatic negative thoughts about your body image and learning more-flexible ways of thinking
• Learning alternate ways to handle urges or rituals to help reduce mirror checking, reassurance seeking or excess use of medical services
• Teaching you other behaviors to improve your mental health, such as addressing social avoidance and increasing engagement with healthy supports and activities

You and your mental health provider can talk about your goals for therapy and develop a personalized treatment plan to learn and strengthen coping skills. Involving family members in treatment may be particularly important, especially for teenagers.

Medications

Although there are no medications specifically approved by the U.S. Food and Drug Administration (FDA) to treat body dysmorphic disorder, medications used to treat other mental health conditions — such as depression and obsessive-compulsive disorder — can be effective.

• Selective serotonin reuptake inhibitors (SSRIs). Because body dysmorphic disorder could be caused in part by problems related to the brain chemical serotonin, SSRIs may be prescribed. SSRIs appear to be more effective for body dysmorphic disorder than other antidepressants and may help control your negative thoughts and repetitive behaviors.
• Other medications. In some cases, you may benefit from taking other medications in addition to an SSRI, depending on your symptoms.

Hospitalization

In some cases, your body dysmorphic disorder symptoms may be so severe that you require psychiatric hospitalization. This is generally recommended only when you aren’t able to keep up with day-to-day responsibilities or when you’re in immediate danger of harming yourself.