Americans are awash in images of sexy, impossibly perfect bodies, and the sea of physical perfection is doing a number on how we see our own bodies.
Some people actually become convinced that they are horribly ugly or deformed - even when they look perfectly normal.
Could you be suffering from body dysmorphic disorder? Read on to learn the warning signs.
Social Situations Scare You
There's shy, and then there's BDD shy.
People with BDD are often so fearful of being seen that they avoid meetings, parties, and other gatherings. And when they do make an appearance, BDDers tend to avoid brightly lighted areas, preferring to "hang out in a dark corner," says Dr. Phillips.
Some are so ashamed of their appearance that they're shut-ins.
It's perfectly normal to do an occasional mirror check - for example, while brushing your teeth or before heading out for the day. But people with BDD become so obsessed with their reflection that they check the looking glass again and again.
Some BDD sufferers spend up to five hours a day gazing at their reflection.
All that mirror-gazing throws a big monkey wrench into daily life.
You're a Groom-aholic
Can't stop picking at your skin? Brushing your hair? People with BDD are so worried about their appearance that they simply can't stop grooming themselves.
"It's not about vanity," says Dr. Phillips.
People Say You Look Fine
People with BDD simply don't believe others' assurances that the look fine. They're absolutely convinced that they have some horrible physical flaw. And no one can convince them otherwise.
You've Had Work Done - but Were Disappointed
Having a nose job or face peel certainly doesn't make you mentally ill. But up to 15 percent of people who undergo cosmetic procedures are believed to have BDD, according to Dr. Phillips. And since there was nothing wrong with their appearance to begin with, these folks are often disappointed with the results. So they tend to go back again and again - without ever feeling satisfied.
Men Can Have it Too, Actually Many Do
Although it's often thought of as a problem that affects women, BDD affects men too. In fact, about 40 percent of BDD sufferers are male, says Dr. Phillips. And the disorder is a lot more common than many people realize. Up to 2.4 percent of the population may have it.
You're a Gym Rat
Do you seem to live on the treadmill or weight machine? People with body dysmorphic disorder often do, spending hours and hours doing cardio or strength training.
Men who suffer from a form of BDD known as muscle dysphoria, a.k.a. "bigorexia," often become compulsive weight-lifters.
"They think they're small or puny or inadequately muscular even when they look perfectly normal," says Dr. Phillips.
Often, she says, these men turn to anabolic steroids in a misguided attempt to bulk up.
You've Contemplated Suicide
It's no secret that depression can lead people to kill themselves. But people with BDD may be even more likely than depressed people to think about or attempt suicide.
"People with BDD truly suffer," says Dr. Phillips.
In one recent study, 50 percent of men suffering from muscle dysphoria had tried suicide. And nine out of 10 men with the condition had a drug or alcohol problem.
What Causes BDD?
No one knows for sure what causes BDD, though genetic factors seem to play a role. And evidence suggests that the disorder may grow out of emotional factors - for example, being teased a lot during childhood. And don't overlook the steady diet of impossibly buff men and women served up by the media for our consumption.
The good news?
BDD is highly treatable, typically responding to a combination of psychotherapy and antidepressant medication.
"Most patients can get better with the right treatment," says Phillips.