BDD the basics
People with BDD remained convinced despite family an friends trying to reassure them that they look OK.
BDD leads to a number of behaviours that they use to help them cope with the anxiety and self disgust. They will often spend excessive time checking their appearance in the mirror. Sometimes spending hours studying their reflection. They also try to disguise or cover up their flaws using make up or clothing to hide their 'ugliness'. People often avoid going out at all or avoid social situations where they fear they will be noticed.
They often seek out surgery or other interventions to improve their appearance. The problem is though that they are very rarely happy with any procedures outcome. It usually makes their BDD worse as they feel they have done themselves harm. They may then have repeated procedures desperately seeking some escape from how they see themselves (Michael Jackson probably had BDD). This can lead to depression and hopelessness. The suicide risk with BDD suffers is high as they cant see how to change their situation.
People are usually concerned with their face especially their nose and skin. It can though be any part of their body. They will see it as too big or small or distorted in some way. They have an image in their head of how they think they look and this is what they see when they look in the mirror. They also are convinced that this is what everyone else thinks - a common thing that the patients I see is that they look like "a freak".
BDD can be successfully treated with a specialised programme of Cognitive Behavioural Therapy.