When do the little imperfections we notice about ourselves turn into obsessions?

"People with BDD spend so much time preoccupied with their perceived defect and trying to hide it, that their lives are really limited - it fills their days," said Robin Rosenberg, a clinical psychologist and co-author of the psychology textbook "Abnormal Psychology" (Worth Publishers, 2009). "They might have repeated surgeries for something that no one would notice; then, of course, they end up getting noticed because the repeated surgeries make them look weird.".

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The Mayo Clinic sights body dysmorphic disorder as a type of chronic mental illness in which 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.

Body dysmorphic disorder was included in the previous edition of the mental health manual Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and with the release of the new edition, DSM-5, it's still classified as a diagnosis, but with some changes. The new DSM-5, released on May 22, includes a new emphasis on the compulsions associated with BDD - for example, repeatedly combing one's hair to cover up an imagined scalp problem, or spending hours applying and reapplying makeup to cover a few pimples. As there is quite the range of differing imperfections, being simply obsessed with a perceived defect is no longer enough for a diagnosis, according to Rosenberg.

This disorder shows the extreme end of a continuum of behavior that focuses on bodily appearance, according to Rosenberg. It's not considered abnormal for some women to change outfits several times before going out or covering up zits with makeup, but when someone feels they need plastic surgery to prostetically enhance a feature they are obsessed with, it isn't a pathological one, according to Rosenberg.

To suffer from BDD, someone must perceive some aspect of his or her body as significantly "defective" (even though the "defect" is minor, if it exists at all). In addition, that perception must cause significant distress and impair his or her ability to function.

For instance, if someone refuses to leave the house because of a zit, that could be a flag for a mental health professional to consider whether or not that person has BDD.