How Body Dysmorphic Disorder can affect you and your workplace

Body Dysmorphic Disorder Foundation
Kitty Wallace

Head of Operations, Body Dysmorphic Disorder Foundation

Body Dysmorphic Disorder (BDD) is an anxiety disorder characterised by a preoccupation with one or more perceived flaws in appearance, which are unnoticeable to others. This perceived flaw is sometimes noticeable, but is usually a normal variation (e.g. male baldness) or is not as prominent as the sufferer believes. This causes not only anxiety, but shame, self-disgust, depression, and high rates of suicide.

Most people who experience this are focussed on some aspect of their face, and many believe they have multiple defects. The most common complaints (in descending order) concern the skin, nose, hair, eyes, chin, lips, and overall body build. People with BDD may complain of a lack of symmetry, or feel that something is too big, too small, or out of proportion to the rest of the body. Any part of the body may be involved in BDD including the breasts or genitals.

Individuals with BDD will repeatedly check on how bad their flaw is (for example in mirrors and reflective surfaces), attempt to camouflage or alter the perceived defect and avoid public or social situations or triggers that increase distress. Some may totally avoid mirrors or reflective surfaces. They may at times be housebound and frequently their ability work, socialise, pursue education, or have relationships is significantly affected.

Some, but not all, individuals with BDD have needless cosmetic and dermatological treatments, but these do not help the problem.

A woman looks at her face in the mirror

It is estimated that 2% of the adult population are living with BDD. This is around 1 in 50. However, this prevalence is thought to be underestimated due to the stigma and shame​Tools for raising awareness and tackling stigma Web page Line managers and supervisors are the frontline of wellbeing management. This resource shows managers in the railway industry where to find information to promote awareness of mental health in the workplace.FreeSign up for free to access By: RSSB View resource internalised by people with the condition – this also leads to an average of a 10-year delay from symptom onset to help seeking. Prevalence is higher amongst adolescent females. However, it is important to remember that BDD can affect any gender and at any age.

Half of people with BDD are currently unemployed

A study in the UK showed that 50% of people with BDD were currently unemployed. BDD can have a huge impact on someone’s working life because when the condition is at its worst, it can make regular employment, education, or family life impossible. The high levels of anxiety​Workplace anxiety and work-related anxiety Web page Anxiety can be caused by issues inside or outside the workplace, and it's worth employers making efforts to look out for signs that an employee might need support. This page from Acas has a range of tips.Free By: Acas View resource and intrusive thoughts often coincide with time consuming behaviours such as grooming, concealing perceived flaws, mirror checking (just to name a few) which can make working life very difficult. Those in regular employment or who have family responsibilities would almost certainly find life more productive and satisfying if they did not have the symptoms of BDD.

A man works with a computer and a tablet.

BDD is often a hidden problem as many individuals with it feel great shame. However, common signs of BDD to look out for are:

  • Obsessively worrying about one or more features for more than an hour a day (usually far more),
  • Checking mirrors/reflective surfaces a lot, or avoiding them altogether,
  • Frequent trips to the bathroom for checking or concealing perceived flaws,
  • Going to a lot of effort to conceal perceived flaw/s (e.g. with make-up, clothes, postures or other means),
  • Avoiding pictures or only posting pictures of yourself using a filter,
  • Constantly comparing one’s appearance to others,
  • Frequently seeking reassurance about appearance,
  • Avoiding social situations,
  • Spending a lot of time spent researching cosmetic or dermatological treatments online, or
  • Being frequently late for work.
Their grooming routines can take up a lot of time

It may be quite difficult to pick up on some of these common signs in a workplace, but they are helpful to bear in mind.  Someone with BDD may be repeatedly late for work, as their grooming routines take up a lot of time and they may be struggling to leave the house even after they have completed those routines. They may struggle to have their camera on during zoom calls​Ways to make video calls less stressful Web page Video calls can be more stressful than a face-to-face chat. This quick guide from Leapers offers tips and hints on reducing anxiety before and during these calls.Free By: Leapers View resource. They could spend increasing amounts of time in the toilets at work – this could be due to grooming routines or anxiety around seeing others. They may be repeatedly checking a handheld mirror at their desk and in other reflective surfaces or be avoiding them in the office. Avoidance of reflective surfaces and mirrors can also lead to distraction and anxiety at work. Those struggling with BDD may take repeated sick days​Everything you need to know about sickness absence: mental health Web page A really quick primer for NHS line managers to give you confidence in managing sickness absence. This page focuses on staff who have been absent due to mental health issues.Free By: NHS Employers View resource or even feel that they have to quit altogether.

A woman lies under a blanket on her sofa.

We hope that employers can be sensitive to the difficulties their employees with BDD may face in the workplace.  It takes a great deal of bravery for someone with BDD to disclose that they have BDD, so it is important that they are supported and treated fairly. There are many things that employer could do to help someone struggling with this condition and enable them to continue working whilst they seek professional help and support.  This can involve reasonable adjustments​Reasonable adjustments at work PDF What's reasonable at work? Whether you're looking for work or are already employed, this guide has information on rights at work for people with a mental health problem. Free By: Rethink Mental Illness View resource such as:

  • Allowing them to take time for therapy appointments,
  • Enabling them to start the day a bit later,
  • Giving them access to a private toilet, if feasible,
  • Removing mirrors if they are impacting the employee on a regular basis and distracting from work,
  • Allowing them to keep their camera off for zoom calls,
  • Considering any other reasonable adjustments that the individual thinks would improve their ability to work effectively

These adjustments are intended to help someone with BDD maintain employment and feel more comfortable in the work environment. However, we would hope that with the right help, support, and treatment they may not be needed in the long term.

BDD is treatable and beatable

If you are worried that you may have BDD please do visit the BDD Foundation website for more information on the condition and the treatments available.  The good news is, that with the right help and support, BDD is treatable and beatable.  We also have our ‘BDD Test’ which will give you a percentage likelihood on whether you have the condition whilst pointing you in the right direction for more support.  You can also contact our email helpline: support@bddfoundation.org

Please remember, you are not alone, and help is available.

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