You’re overly self-critical. You spend hours obsessing over physical flaws that may or may not exist. You hate buying or trying on clothes and you loathe looking in mirrors. You wear excessive amounts of make or you wear baggy clothes –– out of embarrassment and paranoia, not fashion. Essentially, regardless of which method you’re using, your daily priority is hiding a part of your physical appearance out of shame.

Everyone tells you they don’t understand what you’re talking about, but you can see it and that makes all the difference. This sounds like low self-esteem and on the surface, it seems like a correct assessment. But when it starts to hinder you socially and cause constant unending feelings of worthlessness and depression, it might actually be Body Dysmorphic Disorder.

As described by the Mayo Clinic “[BDD] is a mental disorder in which you can’t stop thinking about one or more perceived defects or flaws in your appearance — a flaw that, to others, is either minor or not observable. But you may feel so ashamed and anxious that you may avoid many social situations.” Low self-esteem might make one avoidant of social situations like parties or romance-related things, but BDD creeps into every aspect of your life, following you into the workplace, tailing you at family gatherings and in academic settings as well.

Common symptoms include changing clothes an inordinate amount of times per day, skin-picking, using clothes to hide your body and even making drastic changes to the body like excessive weightlifting and exercising or tanning and bleaching of the skin. It’s been linked to eating disorders, including bulimia, anorexia or binge-eating disorder.

It also causes irrational behavior, like seeking validation from people about your appearance as well as avoiding social situations or certain occupational settings out of fear of judgement. Plastic surgery is also a common occurrence amongst people with the disorder. In extreme cases where those negative habits like skin picking or other forms of body modification occur and can actually make the flaw more noticeable.

It is a serious condition but there are people out there who consider it to be just another “made up” mental illness so that people can feel special. So many people buy into this argument, including the people who have been affected by the disorder. This is dangerous because this discourages people from seeking help. Also, there are so many studies done on the matter, validating this condition. Healthfund.org says the first reference to it happened in 1891 when Enrique Morselli called the condition “dysmorphophobia” and in 1987, it was officially deemed a disorder.

There is no central cause, unfortunately because then it might be an easier thing to cure. It can come from social expectations, genetics, chemical imbalances in the brain and other physical or emotional traumas. Much like anxiety, BDD not only stands as its own disorder, but is also a symptom of other mental illnesses and has many of the same consequences.

Research from healthfund.org has found that people suffering from BDD are 45 percent more likely to commit suicide and according to Katharine A. Phillips, MD, those afflicted have a 22 percent higher suicide completion rate than those afflicted with depression only.

Though women are more inclined to have BDD, the numbers in term of gender don’t matter considering the number of people in general are so high. But there are go-to methods in terms of treatment. Cognitive Behavior Therapy, in which the therapist and patient work together to analyze and challenge a certain behavior or thought pattern, is considered one of the best courses of action according to bdd.iocdf.org.

One of the other top treatments is the prescription of serotonin reuptake inhibitors. These medications are the same as antidepressants, but their main purpose is to help get rid of obsessive thoughts and compulsive behavior.

Positive affirmation is helpful for those with BDD and esteem-challenged individuals as well.

There is hope. And it’s not as hard to distinguish between low self-confidence and BDD as some might think. If you start questioning your self-worth in direct correlation with how you perceive yourself, it’s time to talk to a professional. Just know, you aren’t the only one.