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Treatments and drugs
By Mayo Clinic staffTreatment of body dysmorphic disorder can be difficult, especially if you aren't a willing and active participant in your care. But treatment can be successful. The two main treatments for body dysmorphic disorder are cognitive behavioral therapy and medications. Often, treatment involves a combination of these.
Cognitive behavioral therapy
Cognitive behavioral therapy focuses on:
- Helping you learn about your condition and your feelings, thoughts, moods and behavior
- Using the insights and knowledge you gain in psychotherapy to stop automatic negative thoughts and to see yourself in a more realistic and positive way
- Learning healthy ways to handle urges or rituals, such as mirror checking or skin picking
- Teaching you other healthy behaviors, such as how to socialize with others
You and your therapist can talk about which type of therapy is best for you, your goals for therapy, and other issues, such as the number of sessions and the length of treatment.
Medications
Although there are no medications specifically approved by the Food and Drug Administration (FDA) to treat body dysmorphic disorder, psychiatric medications used to treat other conditions, such as depression, can be effective.
- Selective serotonin reuptake inhibitors (SSRIs). Because body dysmorphic disorder is thought to be caused in part by problems related to the brain chemical serotonin, SSRIs are typically prescribed. SSRIs appear to be more effective than other antidepressant medications for body dysmorphic disorder and may help control your obsessions and repetitive behaviors. Your doctor may increase your dose on a gradual basis to make sure you can tolerate the medication and possible side effects.
- Other medications. In some cases, you may benefit from taking medications in addition to your primary antidepressant. For instance, your doctor may recommend that you take an antipsychotic medication in addition to an SSRI if you have delusions related to body dysmorphic disorder.
Hospitalization
In some cases, your body dysmorphic disorder symptoms may be so severe that you require psychiatric hospitalization. Psychiatric hospitalization is generally recommended only when you aren't able to care for yourself properly or when you're in immediate danger of harming yourself.
- Body dysmorphic disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association: 2000. http://www.psychiatryonline.com. Accessed March 29, 2013.
- Body dysmorphic disorder. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/sec15/ch204/ch204b.html#sec15-ch204-ch204b-767. Accessed March 29, 2013.
- Prazeres AM, et al. Cognitive-behavioral therapy for body dysmorphic disorder: A review of its efficacy. Neuropsychiatric Disease Treatment. 2013;9:307.
- Fiora P, et al. Body dysmorphic disorder: A complex and polymorphic affection. Neuropsychiatric Disease and Treatment. 2009;5:477.
- Conrado LA, et al. Body dysmorphic disorder among dermatologic patients: Prevalence and clinical features. Journal of the American Academy of Dermatology. 2010;63:235.
- Body dysmorphic disorder (BDD). Anxiety and Depression Association of America. http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd. Accessed March 29, 2013.
- Wilhelm S, et al. Modular cognitive-behavioral therapy for body dysmorphic disorder. Behavior Therapy. 2011;42:624.
- Fisher JL (expert opinion). Mayo Clinic, Rochester, Minn. April 18, 2013.
- Hall-Flavin DK (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2013.
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