A nose that is too big, an arm that is too long, uneven eyebrows or hair that "just isn't right" are some of the many issues that individuals with Body Dysmorphic Disorder (BDD) focus on, clinical social worker Kimberly Morrow said. Dr. Katherine Phillips, a BDD specialist, wrote in her book The Broken Mirror that many people suffer from the disease in silence.

"Preliminary estimates suggest that it may affect as many as 2 percent of the U.S. population, which translates into more than 5 million people in this country alone," Phillips wrote.

Phillips could not be reached for comment by press time.

According to the American Psychiatric Association, BDD is a preoccupation with an imagined defect in a person's appearance. If a slight physical anomaly is present, the person's concern is markedly excessive.

A common misconception is that BDD is associated with weight, said Ben Locke, assistant director for research and technology in Center for Counseling and Psychological Services at Penn State (CAPS). Weight, however, is not the issue at all, he said.

An obsession with a certain defect leads to compulsive behaviors, Morrow said.

"The amount of distress that causes you is so extreme that you believe you have to do something about it," she said.

Some common behaviors associated with BDD include mirror checking, skin picking, feature pulling and pushing, and feature measuring, according to bddcentral.com. These behaviors can go on for hours at a time.

BDD and the distress it causes can be so severe that it interferes with a person's functioning, Mary Anne Knapp, a clinical social worker with the CAPS, said in an e-mail message.

"This discomfort can involve an extreme and disabling obsession and feelings of insecurity," she said.

After a while, a BDD sufferer may realize that nothing can be done to fix their perceived defect, said Morrow. This realization can cause the sufferer to feel intense feelings of anxiety or depression. BDD has the highest incidence of suicide of all disorders, she said.

BDD is considered rare and is not common in college populations, said Locke. He said he has only seen about a handful of students for the disorder and that the numbers were very small.

According to Morrow, because students are away from home and on their own, their mental health can be affected.

"Many of the mental health disorders are concentrated in the college student age range," she said.

While BDD can affect many people at different ages, Morrow said she believes that a majority of people can become symptomatic as college kids.

BDD is a chronic, genetic disorder that can result in chemical imbalances in the brain, Morrow said.

"With someone with BDD, they were born with a brain that fires off a message that they have a defect in their body," she said.

Even though BDD is a genetic-biological disorder, environmental influences can exacerbate the disorder, said Morrow.

Medication is often used to fix the chemical imbalance and therapy can be used to alter the behavior when treating BDD.

Locke said treatment can be difficult and patients can be resistant.

"A person who has this preoccupation or dissatisfaction with a body part is usually going to be really, really resistant to changing those ideas that they have," he said.

Common treatments include antidepressant medications and psychotherapy, wrote Knapp.

Morrow treats outpatients of a number of disorders and has special training in BDD. She is the only BDD specialist in the tri-state area.

Treatment in the outpatient program can last from eight to 12 weeks, but patients must be on top of their therapy everyday, she said.

There is uncertainty as to whether the number of BDD cases is growing.

"It seems likely that BDD will continue to grow as our society focuses more and more on appearances and beliefs in 'infinite perfectibility'," Knapp wrote.

Because our understanding of BDD has only occurred in the last 15 years, Morrow said, she was unsure whether or not BDD cases were on the rise.

"I think we're just on the forefront of being able to diagnose [BDD] accurately and treat it," she said.