What you see isn’t always what you get: Dancers with body dysmorphic disorder have a distorted perception of their appearance. (Illustrations by Lealand Eve)

When dance student Monica developed hips a few years ago, she began struggling with new insecurities. Now 15, Monica remembers staring unhappily at her body in the mirror. "Eventually, I didn’t even want to put on a leotard, because I didn’t want anyone else to see the part of me I was so insecure about,” she says. “I felt like I stuck out because my body looked so different.”

Monica’s experience is common in the dance world, where self-esteem issues are widespread. But for some dancers, the feeling that their body isn’t right goes much, much deeper. People with a condition known as body dysmorphic disorder see defects where there aren’t any, and view physical differences from their peers as major flaws. They can experience symptoms of depression or anxiety just from looking in the mirror or seeing a photo of themselves.

“Body dysmorphic disorder involves an excessive preoccupation with one or more body parts,” says Dr. Linda Hamilton, a psychologist who works primarily with dancers, including those at New York City Ballet. “A minor or imagined defect will cause acute stress that’s ongoing—you’ll almost never feel comfortable with your appearance in some places, like class.” How can you know if your body image issues are leading you in this dangerous direction? Read on.

What Causes Body Dysmorphic Disorder? 

While eating disorders such as anorexia and bulimia also concern body image issues, Dr. Nadine Kaslow, a psychologist who works with dancers, explains that body dysmorphic disorder is not about overall body size or feeling fat, but rather about a specific body part feeling “wrong.” Not every dancer with a poor body image is at risk of developing BDD.

In many cases, BDD goes hand in hand with clinical depression or an anxiety

disorder. The condition might be triggered by experiencing multiple traumatic events, such as harsh comments from a teacher about a disliked body part. BDD symptoms can emerge when combined with factors like self-criticism and low self-esteem. That’s what happened to 22-year-old dancer Danielle, who developed mild body dysmorphia as a teen. “I’m taller than most girls I’ve danced with, with long, lanky legs but a short, squatty torso,” she says. “I feel gangly and chubby at the same time. I hate to watch videos of myself dancing. I’ll deliberately look at anyone else in the frame.” At her lowest point, Danielle even experienced panic attacks about her appearance. Only when she shared how she was feeling with a friend did she discover that her body concerns went beyond the average dancer’s experience.

What Are the Symptoms? 

Warning signs of body dysmorphia include:

Obsession with certain body parts. People with BDD can’t stop thinking about their “problem area.” The specific obsession will differ from person to person: It could be the shape of their nose, the thickness of their thighs, the size of their breasts, or almost anything else.

Preoccupation with an imagined defect or deformity. BDD sufferers often genuinely believe something is wrong with them, or that they are deformed, even if they look completely normal.

Distorted perception of appearance. People with BDD can seem out of touch with reality when it comes to their bodies. Kaslow explains, “If you ask a person with severe body image distortion to close her eyes and move her hands to where she thinks her hips are, she might put her hands way wider than her hips. She’s perceiving something different than what’s actually there.” While people with anorexia or bulimia may also experience this distortion, with BDD it will be focused on one or more specific body parts.

Desire to have surgery. It’s very common for people with BDD to fantasize about having surgery to correct their “defect.” Unfortunately, BDD sufferers who do have cosmetic surgery often aren’t satisfied with the outcome, and may become even more depressed or anxious as a result.

For dancers, these symptoms can be devastating. You might avoid dance classes and auditions, afraid to have people look at and critique your body. You might change how you dress or experience extreme anxiety about having to wear form-fitting dancewear. You might suffer panic attacks, like Danielle did. As the condition progresses, you might be unable to go to school or even leave the house, thanks to concerns about your “ugly” or “deformed” appearance. People with severe BDD also often have suicidal thoughts. That’s why it’s so important to catch symptoms early and take steps to resolve body image issues before they become worse.

Overcoming body dysmorphic disorder isn’t easy—but with proper treatment, you’ll begin to see what everyone else sees (your gorgeous reflection
in that mirror!).

How Is BDD Treated? 

The most effective treatment for BDD is psychotherapy. “The goals are to try to improve self-esteem, introduce a more realistic perception of the body, address perfectionism and stop self-punishment,” Kaslow says. If you’re also diagnosed with depression or anxiety issues, you may be prescribed medication for those conditions.

If you’re suffering from BDD, or if you realize you’re heading in that direction, there are a few steps you can take on your own, as well. Be aware of when you feel most anxious or depressed and try to avoid those situations if possible. Distract yourself when you’re getting obsessive about your body; when Danielle feels anxiety coming on, she’ll shift her focus to another activity, like watching a movie.

Most importantly, don’t keep your pain to yourself. Tell a friend or a trusted adult how you’re feeling. They can help you find the professional treatment you need. Talking to someone can mean the difference between a life-long struggle and a healthy, fulfilling relationship with your dancing body.

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