Diagnosing and Treating

Diagnosing and Treating BDDBDD is diagnosed through an interview with a psychiatrist or psychologist, and a questionnaire may be used to help the doctor determine if a teen has BDD. The Body Dysmorphic Disorder Questionnaire, a nine-item quiz, focuses on a person's concerns about his or her physical appearance. Another questionnaire used to diagnose BDD, the Body Dysmorphic Disorder Examination (BDDE), contains 34 questions that evaluate six tendencies in a teen:
1) the preoccupation with and evaluation of appearance
2) the degree of self-consciousness and feelings of discomfort in public
3) the tendency to overvalue appearance in determining overall self-worth
4) the avoidance of social situations and physical contact with others
5) the altering of one's appearance through grooming, dress, or cosmetics
6) the tendency to frequently check one's appearance, perform repetitive grooming, and seek reassurance from others
But all the assessment tools in the world don't make it easy to diagnose BDD. "People with BDD tend to be ashamed and secretive and will seek a dermatologist's or a plastic surgeon's help before going to a psychiatrist," Dr. Watkins says.
Teens who do seek treatment from mental health professionals are likely to report feelings of depression and anxiety and may not talk to the health professional about their feelings about their bodies. As a result, the condition may actually go undiagnosed.
Once BDD has been diagnosed, however, there are effective treatments, including medication and cognitive behavior therapy. The medications sometimes used to treat BDD are also sometimes used to treat depression and anxiety. These medications are usually not habit-forming and can significantly relieve BDD symptoms.
Cognitive behavior therapy - when a therapist helps a teen examine and change faulty beliefs, resist compulsive behaviors, and face stressful situations - has also been found to be an effective treatment for BDD. "If they think their hair is thinning and everyone is looking at them, you send them into a social situation where they think people are looking at their hair and coach them on how they should respond," Dr. Watkins says. "You start with baby steps - first you cover up mirrors, then you teach them not to look in mirrors."