Body Dysmorphic Disorder, a body image disorder illustrated by delusional obsessions and compulsions aimed at neutralizing the type of “ugliness” normally reserved for horror films, goes undiagnosed for an average of fifteen years.  The afflicted (one to two percent of the world population) are 45 times more likely to complete suicide than the general population, more than twice as likely as those with major depression and three to four times more likely than those with bipolar disorder.   The suicidal ideation rate stands at 80%.

The affected are largely able to focus only on bodily imperfections although their perception of the “physical anomaly” is skewed and often delusional.   They are innately unable to perceive themselves objectively.  The more that a victim obsesses and enacts compulsions such as mirror checking and mirror avoidance, the more tainted the perceived image becomes. 

Common BDD symptoms include recurrent unwanted thoughts about a perceived defect, symptoms of major depressive disorder symptoms and anxiety, suicidal ideation, social phobia, social isolation, tumultuous personal relationships, alcohol and/or drug abuse, compulsive mirror checking and/or avoidance, and reassurance seeking.

Contributing factors include genetic predisposition, bullying, inconsistent parenting, and the irrefutable Western over-preoccupation with appearance. 

Body Dysmorphic Disorder acts similarly to an eating disorder but the obsessions and compulsions are disparate from weight concerns.  Akin to eating disorders, BDD can cause social isolation, severe depression, and occupational dysfunction. 

Sadly, this disorder is acutely treatable, with remission rates of 83% with Cognitive Behavioral Therapy.  It is both tragic and bizarre that the public is unaware of the occurrence of this common disorder and its blatant symptoms.  Clinician awareness of the disorder is infantile; the illness has only recently been added to the DSM IV. 

Dr. Katherine Phillips, director of the Body Image Program at Butler Histpial in Providence, R.I., told ABC News that “It’s a very secretive disorder.”  She added, “People tend to be very embarrassed and ashamed of their concerns. Most people don’t get treatment, and that’s really sad because it’s generally a very treatable illness.”