The relationship between anxiety and body dysmorphic disorder

Body dysmorphic disorder (BDD) and anxiety disorders are two distinct conditions that frequently co-occur. This means that many people who have BDD also live with an anxiety disorder, and vice versa. BDD causes a constant preoccupation with one’s physical appearance. People with BDD may struggle with self-confidence and constantly worry about how others perceive them. Research suggests that BDD is relatively common, affecting around 1 in 50 people in the U.S.

Similarly, anxiety disorders can negatively affect how a person sees themselves. These mental health conditions can cause extreme anxiety about doing or saying something that garners a negative response from others. For example, social anxiety disorder is known to cause a level of self-consciousness that can impact a person’s ability to be in public and participate in social situations. Anxiety disorders are common, even more so than BDD. They’re thought to affect about 19.1% of adults in the U.S. in a given year.

Because both BDD and anxiety disorders can lead to negative self-perception, chronic worry, and problems in social situations, it may be hard to tell the difference between them. Also, it’s possible that a person can be living with both conditions at the same time. But rest assured that both conditions are treatable. With the right support, you can learn to manage BDD, anxiety, or both.  

Is BDD a type of anxiety disorder?

Researchers and mental health professionals have debated the best way to categorize BDD. This may be due to its many similarities with anxiety disorders, like obsessive-compulsive disorder (OCD) which also shares some traits of anxiety disorders. BDD is categorized as an OCD-related disorder currently, not an anxiety disorder. 

OCD causes intrusive, upsetting, and unwanted thoughts called obsessions. In response, people with OCD engage in compulsions. These are thought or behavior rituals intended to reduce the stress brought on by obsessions. For example, a person with OCD who obsesses about cleanliness may feel compelled to spend hours on elaborate cleaning rituals before doing anything else. 

Similarly, people with BDD experience obsessions that cause anxiety and distress, typically related to their physical appearance. In response, they also engage in compulsions. For example, a person with BDD might obsess about a certain part of their body, like their arms. So they spend hours exercising their arms, refuse to wear sleeveless shirts, or constantly check themselves in the mirror. These compulsions are designed to reduce the anxiety brought on by obsessive thoughts. Like with OCD, people with BDD feel that they can’t control their obsessions and compulsions, and they don’t enjoy participating in them. 

Another reason why some people might think of BDD as an anxiety disorder is because it is the fourth most common co-occurring disorder among individuals with social anxiety disorder. Like BDD, social anxiety disorder can cause intense fears of being negatively perceived by others and, in response, social avoidance. These shared symptoms can make it difficult to differentiate between BDD and social anxiety disorder.

How to recognize body dysmorphic disorder and anxiety

BDD is a brain-based disorder that causes errors in one’s visual perception of their body and appearance. In other words, it’s not about vanity or a desire to attain a certain standard of beauty. People with BDD really see themselves as deeply physically flawed or unattractive. Research shows that this experience can be a significant predictor of anxiety. But having BDD isn’t the same as having an anxiety disorder. 

With anxiety disorders, distress can manifest due to fears of being negatively evaluated by others. But this doesn’t necessarily have anything to do with one’s physical appearance. For example, a person with social anxiety disorder might have a debilitating fear of public speaking. These fears arise because the person is terrified of embarrassment or saying the wrong thing, not because there’s something related to their body or appearance.

Eight ways to cope with body dysmorphia and anxiety

If you have BDD and anxiety, helpful ways to manage your symptoms and improve your mental health include:

1. Strengthen your self-esteem. Look for ways to honor your positive, non-physical attributes and talents. These can be any big or small things that matter to you.
2. Join a group. There are many support groups you can join either in person or online to help you make connections with people who understand what you’re going through.
3. Take care of your physical health. Prioritizing your physical well-being can help you strengthen your mental health. Try to get plenty of rest, eat a balanced diet, and make time for regular exercise.
4. Get outside. Research shows that spending time outdoors can have a positive effect on your overall well-being. So find some time for a walk in a park, go for a hike, or sit on your back porch.
5. Manage your worries. With anxiety, it’s easy for worrying to get out of control. But instead of trying to eliminate them completely, give yourself a specific amount of time for worrying and then move on to other things.
6. Speak up. Talking to a trusted friend or loved one about what you’re experiencing can help you feel supported and less alone. The person might also share some strategies they use to manage their mental health that could work for you.
7. Take a breath. Breathing exercises are a quick, easy way to calm your body and quiet your mind when anxiety rears its head. Just pause, take a slow, deep breath, and then slowly release it. Notice any changes that occur, and repeat this until you feel more calm.
8. Talk to a professional. Self-care can be an important part of your recovery from anxiety and BDD. But it won’t take the place of professional help. If you’re having trouble managing your symptoms on your own, consider working with a therapist.

How are anxiety and BDD treated?

When anxiety and BDD co-occur, treating both conditions at the same time can provide the best outcome. This typically involves a combination of self-management strategies, talk therapy like cognitive behavioral therapy (CBT), and, at times, medication. It’s important to work with your provider to determine what treatment options are right for your unique circumstances and needs. 

Find care with Rula

Living with co-occuring conditions like BDD and anxiety can be a complicated experience. Both conditions can cause problems with self-image, chronic worry, and deep-seated fears about how others perceive you. In response, you might wonder which condition is causing your symptoms or feel unsure where to turn for help. Just know that if you have anxiety and BDD, you’re not alone and support is available. 

With Rula, you can access convenient, affordable mental health care from the comfort of home. Our extensive network makes it easy to find a provider who takes your insurance and offers the specialized care you need, no matter your diagnosis. To start the process today, head over to our therapist-matching program. In just a few clicks, you can select an in-network therapist and schedule your first appointment for as soon as tomorrow.

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