People with BDD often find themselves trapped in a cycle of obsessive behaviors. For instance, they might constantly check their reflection in mirrors, windows, or any reflective surface, spending excessive time scrutinising every detail of their face. They also frequently compare their appearance to friends, celebrities, or strangers, scrolling through social media and feeling envious or inadequate. This constant comparison and self-scrutiny can be exhausting and emotionally draining.

Repetitive behaviours like excessive grooming, i.e. spending hours applying makeup to cover perceived flaws or constantly plucking eyebrows, are common in BDD. Individuals might also excessively use skincare products or pick at their skin to smooth out blemishes, often causing scabs and scars. Additionally, they frequently seek reassurance from friends and family, asking if they look okay or if their "flaws" are noticeable, which can strain relationships and perpetuate their distress.

People with BDD often experience a distorted self-image that manifests through negative self-talk and refusal to believe compliments. They might constantly tell themselves they are ugly or deformed, focusing on perceived flaws like a supposedly large nose or imperfect skin, despite these perceptions being unfounded. Compliments about their appearance are often dismissed as mere politeness or dishonesty, making it hard for them to accept that others genuinely find them attractive.

Avoidance of social situations is a common manifestation of BDD. This can include social withdrawal, where individuals avoid parties, gatherings, or any social events out of fear of being judged for their appearance. They might make excuses to stay home, isolating themselves from friends and family. Additionally, it can lead to missing work or school, with frequent sick calls or reasons to skip important meetings or classes due to anxiety about their looks.

Impaired daily functioning is a significant consequence of BDD. This can manifest in work or school performance, where preoccupation with appearance affects concentration, leading to poor performance and missed deadlines. Additionally, it can strain relationships, as friends or family may notice the person is often preoccupied, distracted, or irritable due to their appearance concerns, causing conflicts and tension.

High levels of anxiety and depression are common in BDD. This can manifest as persistent anxiety, where the individual constantly fears judgment or criticism about their appearance, possibly leading to panic attacks or chronic anxiety. Depressive episodes can also occur, bringing deep sadness, hopelessness, or even suicidal thoughts, driven by the belief that they'll never look "normal" or be satisfied with their appearance.