Body Dysmorphic Disorder (BDD) is a mental health condition characterized by an obsessive focus on flaws in one’s appearance. Flaws that, to others, may be minor or even nonexistent. Individuals with BDD often spend significant amounts of time scrutinizing their looks. They engage in repetitive behaviors like mirror checking, or seeking constant reassurance about their appearance.

While the distress and anxiety caused by BDD can be overwhelming, there’s another layer of complexity that often goes unnoticed. It’s the connection between BDD and substance abuse. Many individuals with this disorder resort to drugs or alcohol in an attempt to alleviate their distress. Or to cope with the intense feelings of shame and self-loathing. 

This intersection of BDD with addiction creates a challenging scenario, requiring specialized understanding and care. As we look deeper into this topic, we’ll uncover the intricate relationship between these conditions and explore the path to healing.

A person looking in the mirror suffering from body dysmorphic disorder fretting over perceived cosmetic flaws

Understanding Body Dysmorphic Disorder (BDD)

Body Dysmorphic Disorder (BDD) is classified under the umbrella of obsessive-compulsive and related disorders. It’s marked by an intense preoccupation with one or more perceived defects or flaws in physical appearance. 

Common focuses include skin, hair, nose, eyes, or the shape of a specific body part. Along with these fixations, people with BDD may:

  • Engage in repetitive behaviors, such as checking their reflection, camouflaging with makeup or clothing, and seeking frequent cosmetic procedures.
  • Avoid social situations or public places due to fear of scrutiny or judgment.
  • Exhibit extreme dissatisfaction with their appearance, regardless of reassurances from others.

Emotional and Psychological Effects of BDD

The emotional toll of BDD is profound. Individuals may experience:

  • Consistent feelings of shame, anxiety, and self-consciousness about their appearance.
  • Depression or even suicidal thoughts due to their perceived flaws.
  • Significant distress or impairment in social, occupational, or other crucial areas of functioning.
  • An insatiable need for validation or reassurance from others.

It’s important to note that BDD isn’t a case of being concerned about appearance in the way many people occasionally feel. It’s an intense, debilitating obsession that can dominate one’s thoughts and actions.

Common Misconceptions about BDD

BDD is often misunderstood, leading to various misconceptions:

  • “It’s Just Vanity”: One of the most common misconceptions is that BDD is about vanity or being overly self-absorbed. However, BDD stems from deep-seated feelings of worthlessness and anxiety, not vanity.
  • “Cosmetic Procedures Will Help”: While it might seem like getting cosmetic surgery would alleviate the concerns, usually, it doesn’t. They might move on to obsess over another body part or feel that the surgery didn’t “fix” the perceived flaw.
  • “It’s Rare”: BDD is more common than most people realize. Studies indicate that it affects about 1 in 50 people, making it as prevalent as conditions like schizophrenia or bipolar disorder.

By understanding the true nature and implications of BDD, we can approach it with empathy and provide the specialized care needed.

The Link Between BDD and Substance Abuse

For many individuals with Body Dysmorphic Disorder, the constant and overwhelming distress related to their perceived physical flaws becomes unbearable. This distress can manifest in various ways – from anxiety and depression to severe feelings of isolation. 

To cope with these intense emotions and perhaps to escape the persistent negative self-image, some individuals might turn to substances:

  • Self-Medication: Drugs or alcohol might offer a temporary relief from the obsessive thoughts and distressing feelings associated with BDD. They can provide a fleeting sense of confidence or numbness that shields them from their perceived imperfections.
  • Social Facilitation: Social interactions can be particularly challenging for someone with BDD due to fear of judgment or scrutiny. They might use alcohol or drugs to ease social anxiety, making interactions seem more manageable.
  • Distraction: Engaging in substance use can also serve as a distraction from the persistent, intrusive thoughts about their appearance.

Statistics or Studies on BDD and Substance Abuse

While specific statistics linking BDD directly to substance abuse rates are limited, research does indicate a significant overlap. Studies have found that individuals with BDD are at a higher risk for developing substance use disorders. 

For example, a study from the Journal of Clinical Psychiatry found over 40% of individuals with BDD reported substance abuse. This emphasizes the profound connection between these two conditions.

The Dangers of Co-Occurring BDD and Substance Abuse

When BDD co-occurs with substance abuse, the dangers are compounded:

  • Increased Health Risks: BDD’s psychological distress combined with the physical and mental health risks of substance abuse creates a perilous situation.
  • Aggravation of BDD Symptoms: While substances might offer a temporary reprieve, they often exacerbate BDD symptoms in the long run. Alcohol or drugs can increase feelings of depression, anxiety, and paranoia – all common among those with BDD.
  • Treatment Challenges: Addressing co-occurring BDD and substance abuse can be more challenging than treating either disorder alone. The intertwined nature of these conditions means that relapse in one can trigger relapse in the other.

Understanding the profound connection between BDD and substance abuse underscores the need for integrated treatment that address both disorders simultaneously.

Treatment Considerations for Co-occurring BDD and Substance Abuse

When an individual faces both Body Dysmorphic Disorder and a substance use disorder, it is crucial to address both conditions simultaneously. A dual-diagnosis approach is pivotal in such cases, ensuring that the treatment provided is comprehensive and holistic. 

Addressing just one condition can leave underlying issues unresolved. This may lead to relapse or exacerbation of the untreated disorder. 

Tailoring Treatment to Address Both BDD and Addiction

Each individual’s journey with BDD and substance abuse is unique. Thus, treatment should be personalized to fit their specific needs, experiences, and challenges. Factors to consider include:

  • Severity of Both Disorders: The intensity of BDD symptoms and the extent of the substance dependency can influence the treatment approach.
  • Substances Used: Different substances may require varied detox and treatment strategies.
  • Underlying Causes and Triggers: Recognizing the factors that contribute to or exacerbate both conditions can guide treatment plans and strategies.

Therapies and Approaches Effective for Co-occurring Conditions

Several therapeutic approaches have been found effective for treating co-occurring BDD and substance use disorders:

  • Cognitive Behavioral Therapy (CBT): Cognitive Behavioral Therapy can help individuals recognize and challenge the negative thought patterns associated with BDD. It can also equip them with skills to resist the urge to use substances.
  • Exposure and Response Prevention (ERP): ERP involves exposing the person to their body image fears. This teaches them to refrain from compulsive behaviors such as repeatedly checking their appearance or using substances to cope.
  • Medication: Certain antidepressants, especially selective serotonin reuptake inhibitors (SSRIs), have shown effectiveness in treating BDD. When used in conjunction with therapies, they can also assist in the treatment of substance use disorders.
  • Group Therapy: Participating in group therapy sessions can offer support and understanding from peers experiencing similar challenges. It fosters a sense of community and shared healing.
  • Holistic Approaches: Techniques such as mindfulness, meditation, and yoga can be incorporated into the treatment plan. This is to address the emotional and psychological aspects of both conditions.

To achieve long-term recovery, it’s crucial to seek a facility of professionals experienced in handling Dual Diagnosis. This ensures a comprehensive and nuanced approach to healing.

A first person point of view of a person standing on a beach with their hands in front of them holding out a cutout of the word hope with sunlight shining on it at sunset.

How Retreat at Sky Ridge Can Help

Retreat at Sky Ridge is more than just a treatment facility. It’s a sanctuary for individuals seeking to heal and rediscover themselves. At the heart of our mission is a commitment to holistic recovery

We believe that for genuine healing to occur, all facets must be nurtured. This means we don’t just focus on alleviating symptoms but strive to address the root causes of disorders.


Body Dysmorphic Disorder is more than just a concern about appearance. It’s a deep-rooted psychological challenge that can have crippling effects on an individual’s quality of life. When coupled with substance abuse, the complexities multiply, amplifying the pain and suffering experienced by those affected. Recognizing the profound link between BDD and substance abuse is the first step towards a comprehensive solution.

Yet, in the face of these challenges, there is undeniable hope. Comprehensive treatment approaches, like those offered at Retreat at Sky Ridge, have proven transformative. These programs not only target the symptoms but delve deep into the root causes. 

If you or someone you care about is wrestling with these intertwined conditions, remember that you’re not alone. Help is available, and it can make all the difference. 

Don’t let another day go by under the shadow of substance abuse. Reach out to Retreat at Sky Ridge and take the first step towards a brighter, healthier tomorrow.

For more information on addiction treatment services, please give us a call at (877) 693-6010 or complete or short inquiry form at the bottom of this page.

adapt & transform. overcome.

If you or someone
you know needs help,
contact us.

Get started today! Ask a question, inquire about insurance benefits, or request that someone from the admission's team contact you. Complete the short form or call us anytime at (877) 693-6010.

Fill out my online form.