Body dysmorphic disorder is defined by the Mayo Clinic as a type of chronic mental illness where you can’t stop thinking about a flaw in your appearance — a flaw that is either minor or imagined. But to you, your appearance seems so shameful that you don’t want to be seen by anyone. So, let me say that again in teen language. You think some part of your body is so hideous that you need to hide it constantly, obsess about it, and stare at it all the time.

Don’t get me wrong, all teens are concerned with the way they look. That’s just part of being a teen. Now, don’t confuse being a “typical” teen with having body dysmorphia. When a teen struggles with body dysmorphia, s/he focuses in on one or two particular parts of their body and obsesses over that area specifically on a constant basis. Like, “My nose is so crooked, I can’t go out in public!” Or, “My feet are huge, I could never wear those shoes!”  Usually, in these cases your friends will not understand what you are talking about because they don’t see it.  This can cause you to feel even more alone because no one sees what you see when they look in the mirror.

I’ve encountered many teens who have shared with me stories of their own body dysmorphia. For example, some can rationally identify that their present weight isn’t considered clinically overweight; however, their brains still tell them that they are obese. Some will honestly look in the mirror and still see that young girl who was overweight, or had braces, bad acne or glasses (usually in 4th, 5th or sixth-grade.)

One factor that always seems to go along with body dysmorphia is name-calling or teasing.  You were probably sensitive to your weight, the braces or being taller than the rest of the class and a bullied honed in on that.  The experience was traumatizing and you were never able to let it go. Being so young, you wouldn’t have the tools to deal with those feelings and most kids don’t tell their parents either, which is a huge mistake. Parents can help you process the experience and give you advice or tools to deal with the teasing and to let it go. Unfortunately, many teens carry the painful scars from being teased into high school.  Although in present-day, they know that they are not overweight, those nicknames still stick in their heads. The trauma from being teased doesn’t just go away and when they look in the mirror they still see their overweight self from a painful time.

I’ve never agreed with the saying “sticks and stones may break my bones, but names can never hurt me.” I’ve seen the opposite. Damaging name-calling that carries over to the teenage years.  Names that teens can’t get out of their heads and hear over and over like a broken record.  Some start to believe the name-calling and see themselves in a negative light.  Many teens have told me, that although they’ve lost the weight and the name-calling was years ago, they are still waiting for it to happen again. They walk down the halls in high school feeling like a fraud.  Scared that those names will come back to haunt them because maybe they deserve it. To me, that’s much more painful than breaking a bone because when you break a bone, you set it and it heals. For some of these teens, since the scars aren’t visible, no one else sees the pain, and they didn’t know how to release it to heal.  One thing is clear, if they don’t deal with the root of the problem the pain will remain and they will continue to be challenged every time they look in the mirror.