Examining the Link Between Body Dysmorphia and PTSD

Woman struggling with Binge Eating Disorder

Contributor: Kim DeVos, MA is a Licensed Clinical Professional Counselor at Timberline Knolls Residential Treatment Center

Mental illnesses, including bipolar disorder, major depression, seasonal affective disorder, and post-traumatic stress disorder, result from a number of complex factors. It is not uncommon for mental illnesses to co-occur with one another. For example, major depression can develop alongside an eating disorder, such as anorexia nervosa, bulimia nervosa, or binge eating disorder.

Mental illness that is left without professional treatment and intervention can cause severe physical, emotional, mental and psychological consequences.

Often, the stigma that continues to surround mental illness prevents many individuals from seeking out the help needed for recovery.

Currently in the United States, nearly 10 million adults experience a serious mental illness that interferes with or hinders one or more major life activities [1].

Understanding Body Dysmorphic Disorder (BDD)

Another serious but lesser known mental illness includes body dysmorphic disorder, a condition in which a person will spend a significant amount of time and energy obsessing about a perceived flaw related to their appearance [2].

While many people commonly express dissatisfaction about their body or unhappiness about the way they may look, BDD can cause severe emotional distress, triggering anxiety, low self-esteem, depression, and more.

Perceived defects can be anything from blemishes on the skin to nose size or anything in between that can be seen as a significant flaw. Individuals who suffer from BDD may display the following signs and symptoms:

  • Obsessive thoughts about appearance
  • Constantly attempting to “cover-up” the affected area
  • Avoid social situations due to perceived defect
  • Seeking reassurance from others about one’s appearance
  • Significant time spent fixating on a perceived flaw
  • Recurring appointments with professionals on how to “fix” perceived flaw
  • Repeated cosmetic and/or plastic surgery

Woman laying in grass thinking of treatment for PTSDSadly, body dysmorphic disorder is often misunderstood to be nothing more than “vanity,” which can prevent the individuals who are suffering from getting the help and care needed for recovery.

The reality is that BDD is a severe mental illness with devastating repercussions.

Individuals with body dysmorphic disorder are an increased risk of suicide in addition to having significant occupational and social interference [3].

There may be many factors that contribute to the development of BDD, including biological factors, such as genetics, and environmental influences, such as the experience of a traumatic event or childhood emotional conflict.

Influence of PTSD and Trauma on Body Image

The connection between trauma and poor body image is one that continues to be examined and understood. One research study found that individuals with body dysmorphic disorder self-reported having experienced more traumatic events compared to mentally healthy controls [4].

This included more experiences of physical and sexual abuse both in childhood and adolescence. Another study found that emotional neglect was the most common form of perceived maltreatment in both males and females with BDD who reported childhood abuse and neglect [5].

Findings like these have highlighted preliminary evidence of the need to examine traumatic experiences as a potential risk factor in the development of body dysmorphic disorder.

Individuals who experience any form of maltreatment, trauma, or abuse may be at increased risk for developing post-traumatic stress disorder (PTSD), as PTSD developed in about 1 in 3 people who experience some form of severe trauma.

A person with maladaptive coping skills may internalize their grief and pain related to their trauma, believing that something is wrong with them or their body. For a person who has experienced trauma and who also has other risk factors for mental illness, PTSD and BDD can possibly be triggered or coincide along one another.

Comprehensive Mental Health Treatment

While research is still evolving in the area and understanding of PTSD and BDD, it is important to examine possible connections between underlying trauma and body dysmorphia.

Woman holding lights

In some situations, PTSD may be the indicator for unresolved trauma that a person has not yet been able to work through. Determining how this may affect an individual’s body image is an important piece of the puzzle and for understanding how to treat these conditions effectively.

As with all mental illness, there are often many different aspects that need to be addressed and treated.

For this reason, comprehensive care can support the most effective approach for treating mental illnesses, such as body dysmorphic disorder and PTSD.

The most important thing is to reach out for help and treatment. It is common to suffer in silence due to feelings of shame, guilt or embarrassment, but connecting to specialized care can be a powerful step forward in the recovery process.

Kim DevosAbout the author: Kim DeVos, MA is a Licensed Clinical Professional Counselor who has been working with recovery issues for a decade, both in private practice and as a member of the Christian treatment team at Timberline Knolls. Her primary goal in counseling is to help others regain hope for a future and a sense of identity, particularly as it relates to their spirituality.

She completed both her undergrad and graduate studies at Governors State University and graduated with her Masters in Marriage and Family Counseling.


[1]: National Institute of Mental Health, “Serious Mental Illness (SMI) Among U.S. Adults”, https://www.nimh.nih.gov/health/statistics/prevalence/serious-mental-illness-smi-among-us-adults.shtml Accessed 27 July 2018
[2]: International OCD Foundation, “What is Body Dysmorphic Disorder”, https://bdd.iocdf.org/about-bdd/ Accessed 27 July 2018
[3]: Phillips KA, et al.  Suicidality in body dysmorphic disorder.  Am J Psychiatry (2006). 163:1280-1282
[4]: Buhlmann, Ulrike, et al.  Traumatic Experiences in Individuals With Body Dysmorphic Disorder. Journal of Nervous and Mental Disease. (2012) Volume 200, Number 1.
[5]: Didie, E. R., Tortolani, C. C., Pope, C. G., Menard, W., Fay, C., & Phillips, K. A. (2006). Childhood abuse and neglect in body dysmorphic disorder. Child Abuse & Neglect, 30(10), 1105–1115. http://doi.org/10.1016/j.chiabu.2006.03.007

The opinions and views of our guest contributors are shared to provide a broad perspective of eating disorders. These are not necessarily the views of Eating Disorder Hope, but an effort to offer discussion of various issues by different concerned individuals.

We at Eating Disorder Hope understand that eating disorders result from a combination of environmental and genetic factors. If you or a loved one are suffering from an eating disorder, please know that there is hope for you, and seek immediate professional help.

Published on September 8, 2017.
Reviewed By: Jacquelyn Ekern, MS, LPC on September 8, 2017.
Published on EatingDisorderHope.com