BDD and Addiction

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Last Updated:

May 6th, 2024

Statistical estimates suggest that over one million people in the UK live with Body Dysmorphic Disorder (BDD), representing approximately 2% of the population. Furthermore, among people with substance use disorders, 68% identified BDD as a significant factor in their continued drug use. This connection underscores a worrying relationship between BDD and substance use disorders. This page covers the link between BDD and addiction and how you, or someone you love, can get help for both disorders.

What is BDD?

Body Dysmorphic Disorder, or BDD, is when a person struggles to stop thinking about one or more perceived defects or flaws in their appearance. These perceived ‘flaws’ can be minor or not visible to others when observed. But for someone with BDD, the concern is real and consuming, often leading the person to resort to constantly checking themselves out in the mirror, hiding or fixing what they think is wrong and sometimes even undergoing multiple cosmetic procedures. BDD has the potential to take over someone’s life, making everyday activities and interactions incredibly challenging.

What are the signs of BDD?

Due to BDD being a mental health disorder, it’s key to focus on the behavioural signs that arise. This is so those with BDD and those around them can identify the key signs of the disorder to seek further help.

Behavioural signs

Excessive grooming and self-care routines: Spending hours grooming, such as combing hair, applying makeup, or using skin care products, in an attempt to hide or fix perceived flaws.

Mirror checking or avoidance: Frequently checking mirrors’ reflective surfaces or avoiding them altogether due to distress about appearance.
Compulsive skin picking: Trying to remove or improve perceived skin defects through picking, which can lead to skin damage.
Seeking reassurance: Repeatedly asking for reassurance about their appearance from others.
Frequent cosmetic procedures: Undergoing multiple cosmetic procedures with little satisfaction with the outcomes.
Clothing and covering: Wearing excessive clothing or makeup to cover up perceived flaws, regardless of the weather or appropriateness of the situation.
Social withdrawal: Avoiding social situations, work, or school because of perceived appearance flaws.
Comparing appearance with others: Constant comparison of one’s appearance with that of other people, often leading to distress and feelings of inadequacy.

Psychological beliefs

Again, with BDD being a mental health disorder, it’s also key to focus on the thought processes a person with BDD may encounter. This is key to identifying damaging thought patterns.

Perceived ugliness or defectiveness: A person with BDD may strongly believe that they have significant flaws in their appearance, even if these flaws are nonexistent or minor to others.
Overvaluation of appearance: Someone with BDD may place an excessively high importance on appearance and base their self-worth on how they look.
Preoccupation with appearance: A person with BDD may have persistent and intrusive thoughts about the perceived flaws that can last for hours each day, causing significant distress or impairment in daily functioning.
Belief in others’ notice or mockery: Someone with BDD may hold the belief that others take special notice of or mock their appearance flaws, leading to significant social anxiety and avoidance.
Perfectionism: Those diagnosed with BDD may have a tendency towards perfectionism in appearance, where the person is never satisfied with how they look, leading to an endless cycle of distress and attempts to fix perceived flaws.

Is there a link between BDD and addiction?

Research has shown that there could be a link between BDD and addiction, and it can manifest in several ways. Below, we take a look at how addiction can interact with BDD, making symptoms worse and vice versa:

Substance use as a coping mechanism

People with BDD may turn to drugs or alcohol as a way to self-medicate and alleviate the distress and anxiety associated with their perceived appearance flaws. Substance use might provide a temporary escape from negative thoughts and feelings, but it has the potential to lead to addiction over time. A study found that out of 122 inpatients with substance use disorder (SUD), 26% of them had BDD.

Co-occurring disorders

BDD and addiction may co-occur with other mental health disorders, such as depression or anxiety, which can complicate the relationship between BDD and addictive behaviours. People may use substances to cope with symptoms of BDD as well as these co-occurring disorders.
Research has indicated that those with BDD are also more likely to show signs of PTSD, depression and anxiety compared to those who don’t have BDD.

Impact on treatment and recovery

The presence of BDD can complicate the treatment of addiction and vice versa. Addressing one condition without treating the other might not lead to successful outcomes, highlighting the need for integrated treatment approaches that address the spectrum of a person’s mental health needs.

Is BDD linked to behavioural addictions?

Research indicates a correlation between substance abuse and BDD, but recent findings suggest a strong link between BDD and behavioural addictions.

Exercise addiction

This condition is characterised by an overwhelming urge to engage in excessive physical activity, which can become detrimental to health.

Considering the hallmark symptoms of BDD include an intense focus on physical appearance, repetitive behaviours and excessive self-scrutiny, it’s understandable that a significant connection between exercise addiction and BDD has been observed.

For instance, a study involving international gym attendees identified a substantial risk of exercise addiction, appearance anxiety and BDD. It was discovered that 11.7% of participants met the criteria for exercise addiction, with notable rates in the Netherlands and the UK. Among those identified with exercise addiction, 38.5% were also considered at risk for BDD.

Cosmetic surgery addiction

People addicted to cosmetic surgery might constantly seek to change their appearance. Despite undergoing numerous procedures, they often remain dissatisfied with the outcomes. This compulsion for cosmetic surgery could be linked to underlying psychological issues, such as BDD.

Studies into this area of addiction have found that in patients with BDD, irregularities in visual processing and frontostriatal systems of the brain may relate to the presence of obsessive thoughts and compulsive behaviours concerning their physical appearance. This could fuel the pursuit of repeated cosmetic procedures.

BDD and addiction treatment options at Sanctuary Lodge

While Sanctuary Lodge does not have a rehab programme specifically designed for BDD, many of our treatments for addiction are also effective for you if you’re experiencing BDD.

Counselling for personal and group support

At Sanctuary Lodge, our counselling services aim to address the underlying issues of addiction and BDD on personal and group levels. These sessions are tailored to allow you to explore and work through your feelings. By utilising Dialectical Behaviour Therapy (DBT), we equip you with crucial skills for emotional regulation, aiding in the management of BDD alongside addiction. This approach ensures that therapy meets your unique needs.

Holistic therapies for enhanced well-being

At Sanctuary Lodge, we incorporate holistic therapies such as yoga and meditation into our treatment plans to support your overall well-being. These practices improve self-awareness and enhance emotional resilience, which forms an essential part of the treatment for BDD and addiction. By providing a nurturing environment, we aim to use these holistic methods side by side with traditional therapeutic techniques.

Continued aftercare for sustained support

Aftercare is crucial in maintaining support for you along your journey to recovery. A cornerstone of our aftercare is group therapy, which cultivates a community atmosphere and shared understanding. These sessions are vital for reinforcing coping mechanisms, helping you manage BDD and maintaining your recovery commitment. The ongoing nature of aftercare is essential for you to face post-treatment challenges and preserve the achievements of the therapy stage of your treatment plan.

What’s next?

If you’re struggling with Body Dysmorphic Disorder (BDD) and addiction, there’s hope. Sanctuary Lodge offers a compassionate, understanding environment tailored to address both your mental health and addiction challenges. Our expert team is ready to support you on your journey towards healing and recovery. Embrace the first step to a happier, healthier life. Contact Sanctuary Lodge today for more information on our treatment options.

(Click here to see works cited)

“BDD Statistics.” BDDF, bddfoundation.org/information/statistics/. Accessed 1 Apr. 2024.
Grant JE, Menard W, Pagano ME, Fay C, Phillips KA. Substance use disorders in individuals with body dysmorphic disorder. J Clin Psychiatry. 2005 Mar;66(3):309-16; quiz 404-5. doi: 10.4088/jcp.v66n0306. PMID: 15766296; PMCID: PMC2504687.
Phillips KA. The Presentation of Body Dysmorphic Disorder in Medical Settings. Prim psychiatry. 2006;13(7):51-59.
Grant JE, Lust K, Chamberlain SR. Body dysmorphic disorder and its relationship to sexuality, impulsivity, and addiction. Psychiatry Res. 2019;273:260-265. doi:10.1016/j.psychres.2019.01.036
Higgins S, Wysong A. Cosmetic Surgery and Body Dysmorphic Disorder – An Update. Int J Womens Dermatol. 2017;4(1):43-48. Published 2017 Nov 20. doi:10.1016/j.ijwd.2017.09.007