The severity of BDD varies. Some sufferers obsess about perceived flaws from the moment they wake up. They check mirrors frequently, perform lengthy and elaborate grooming rituals before leaving the house, and frequently seek plastic surgery. Others are prisoners in their own homes, refusing to work, socialize, or even be seen in public. Cases documented in The Broken Mirror include people who missed family weddings, birthday parties and funerals because of their fears.
Most sufferers think about their appearance more than three hours a day.
In extreme cases, they have committed suicide. Phillips devotes much of her time now to learning more about the disorder and finding a treatment. She has treated her own patients with some success, using various antidepressants and cognitive-behavioral therapy. Phillips is internationally known for her pioneering work on BDD, which only entered psychiatry's classification manual of disorders in 1987. Yet vivid case descriptions written during the last century testify to its history and presence in a variety of cultures.