BDD at Work and in Daily Life: Assessment Led Guidance

Specialist CBT therapy for anxiety, OCD, depression and more in West London

Body dysmorphic disorder can affect the working day in ways that are not always visible to others. A person may spend significant time before work managing appearance related worry, checking, camouflaging or avoidance. Meetings, presentations, commuting, open plan offices, video calls and social interactions at work may all feel more demanding. The effort required to manage distress while appearing capable can be exhausting. A guide cannot diagnose BDD or determine whether appearance related distress is clinically significant. Appearance concerns can be connected with BDD, low self esteem, social anxiety, eating difficulties, trauma, depression, OCD or other difficulties. Physical symptoms, medication, neurodivergence and other factors can all affect a person's experience. New, severe or changing physical symptoms, including any new skin, hair or physical concern, should be discussed with an appropriate medical professional before assuming a psychological explanation. The Equality Act 2010 uses a functional test. In broad terms, a mental or physical condition may fall within the Act where it has a substantial and long term adverse effect on normal day to day activities. Whether that applies to BDD in a particular situation depends on the facts. ACAS, a union, occupational health, an employer's people team, Citizens Advice or an appropriate employment solicitor may be useful sources of role specific information. A therapist can help a person understand how BDD is affecting them, but therapy is not legal advice or representation. Deciding whether to tell an employer about BDD is personal. A conversation might focus on a practical need, such as a quieter workspace, adjusted video call requirements, a different seating arrangement or a phased return after absence. There is no requirement to use a clinical label in every workplace conversation. CBT for BDD may be considered after individual assessment. It can involve exploring the links between an appearance related thought, an emotion, a checking or avoidance behaviour and the short and longer term effect. Behavioural experiments, where they are clinically appropriate, are planned collaboratively with a suitably qualified clinician after discussion of the rationale, alternatives, safety and pacing. A guide is not a self directed programme. For related information, see BDD therapy at https://lyceumclinic.co.uk/therapy/body dysmorphic disorder/, the BDD clinical guide at https://lyceumclinic.co.uk/guides/body dysmorphic disorder cbt west london/, BDD and relationships at https://lyceumclinic.co.uk/guides/bdd and relationships west london/ and BDD neuroscience at https://lyceumclinic.co.uk/guides/bdd neuroscience/. If there is immediate danger, thoughts of self harm, an inability to stay safe or a sudden marked deterioration, call 999, attend A&E or use urgent local crisis or medical support.