CISGENDER OR CIS
Someone whose gender identity is the same as the sex they were assigned at birth.
 
GENDER DYSPHORIA
Used to describe when a person experiences discomfort or distress because there is a mismatch between their sex assigned at birth and their gender identity. This is also the clinical diagnosis for someone who doesn’t feel comfortable with the sex they were assigned at birth.
 
GENDER RECOGNITION CERTIFICATE (GRC)
This enables trans people to be legally recognised in their affirmed gender and to be issued with a new birth certificate. Not all trans people will apply for a GRC and you currently have to be over 18 to apply. You do not need a GRC to change your gender markers at work or to legally change your gender on other documents such as your passport.
 
GP ALLY
A General Practitioner who is supportive of LGBTQ inclusive healthcare, and are actively championing and advocating for all their LGBTQ patients.
 
INTERSEX
A term used to describe a person who may have the biological attributes of both sexes or whose biological attributes do not fit with societal assumptions about what constitutes male or female. Intersex people may identify as male, female or non-binary
 
LGBTQ
The acronym for lesbian, gay, bi, transexual and queer
 
PrEP
PrEP stands for Pre Exposure Prophylaxis. It is the taking of an oral prescription drug as a means of preventing HIV infection in an HIV-negative person.
 
TRANSGENDER (OR TRANS)
An umbrella term to describe people whose gender is not the same as, or does not sit comfortably with, the sex they were assigned at birth. 
 
TRANSGENDER MAN
A term used to describe someone who is assigned female at birth but identifies and lives as a man. This may be shortened to trans man, or FTM, an abbreviation for female-to-male.
 
TRANSGENDER WOMAN
A term used to describe someone who is assigned male at birth but identifies and lives as a woman. This may be shortened to trans woman, or MTF, an abbreviation for male-to-female.

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While many of us are prone to thinking a little too much about certain flaws or blemishes on our bodies, for those living with body dysmorphic disorder (BDD) , these negative thoughts are overwhelming and cause significant distress.
With the right diagnosis and treatment, it is possible to manage body dysmorphic disorder and make daily life easier. With that in mind, let’s take a look at everything you need to know about diagnosing and treating body dysmorphia.&nbsp;
<h2>What is body dysmorphia?&nbsp;</h2>
Body dysmorphic disorder (BDD) is a mental health condition that affects both men and women. Those who suffer from body dysmorphia develop obsessions about flaws in their physical appearance. These perceived flaws may be minor or may not even exist at all.
Body dysmorphia is more than simply disliking certain physical attributes and body parts. In fact, people with body dysmorphia spend so much time fixating, worrying, and obsessing about their perceived defects that it prevents them from functioning in daily life.1&nbsp;
<h3>What causes body dysmorphic disorder?</h3>
There is no one specific cause for body dysmorphic disorder. In fact, medical experts believe it is a combination of numerous environmental, biological, and psychological factors.2
Some possible contributory factors include:
<ul>
 <li>Family history of body dysmorphic disorder</li>
 <li>Life experiences such as bullying or teasing at school</li>
 <li>Personality traits such as perfectionism or comparison to others&nbsp;</li>
 <li>Cultural influences such as diet culture</li>
 <li>Co-existing mental health diagnoses like depression, anxiety or OCD</li>
 <li>Low self-esteem or loneliness</li>
</ul>
<h2>What are the signs and symptoms of body dysmorphic disorder?&nbsp;</h2>
Like any mental health disorder, there are many possible symptoms of body dysmorphic disorder. Some people who suffer from BDD may display most of the common symptoms while others may only experience one or two. In order to receive an official diagnosis of body dysmorphia as per the Diagnostic and Statistical Manual of Mental Disorders, the patient’s preoccupation with a perceived flaw or imagined defect must cause significant distress and impact their ability to function day-to-day.
Common symptoms of BDD can include:3
<ul>
 <li>Avoiding mirrors</li>
 <li>Obsessive mirror checking</li>
 <li>Excessive grooming</li>
 <li>Compulsive behaviours like skin picking</li>
 <li>Exercising excessively or obsessively</li>
</ul>
<h3>What is muscle dysmorphia?</h3>
Muscle dysmorphia is a type of body dysmorphia. The key distinction is that those who suffer from muscle dysmorphia fixate on muscle tone and size.
Many of the symptoms of muscle dysmorphia are similar to body dysmorphia. However, there may also be more of a focus on exercise and diet. Some common signs of muscle dysmorphia include:
<ul>
 <li>Excessive exercise (particularly lifting weights)</li>
 <li>Obsessive calorie counting</li>
 <li>Avoiding eating in settings where there’s less control over food content</li>
 <li>Using steroids or other drugs to enhance appearance or muscle growth3</li>
</ul>
<h3>What are the complications and risks of body dysmorphia?</h3>
Body dysmorphia can be overwhelming and extremely intense. Left untreated, the symptoms can have a significant impact on one’s quality of life.
Living with body dysmorphia without professional help can lead to:3
<ul>
 <li>Severe social anxiety</li>
 <li>Low self-esteem</li>
 <li>Negative thoughts</li>
 <li>Feelings of isolation</li>
 <li>Relationship problems (with friends, romantic relationships, family members, or colleagues)</li>
 <li>Performance problems at work or school</li>
 <li>Reckless behaviour such as excessive cosmetic surgery or dangerous dieting</li>
 <li>Suicidal thoughts</li>
</ul>
<h3>Can you have body dysmorphic disorder and other mental health conditions?</h3>
Like many mental health conditions, it is possible to suffer from BDD and other conditions at the same time. In fact, it’s common for BDD patients to also suffer from anxiety disorder, depression, or obsessive-compulsive disorder (OCD).2
BDD can often be misdiagnosed as OCD and other disorders due to the similarity in some of the symptoms in patients. It’s therefore extremely important to seek a proper diagnosis from a mental health professional. This will help make sure that you are receiving the best treatment for you.
<h2>What are the body dysmorphia treatment options?&nbsp;</h2>
Living with body dysmorphic disorder can be truly overwhelming. The good news is that there are many different ways to treat body dysmorphia. With the right support and guidance from healthcare professionals, you can learn to control repetitive behaviours and significantly improve your quality of life.
<h3>Therapy options for treating body dysmorphic disorder&nbsp;</h3>
Once you reach out to your healthcare provider for support, they may suggest that you try Cognitive Behavioral Therapy (CBT). This is a type of psychotherapy (sometimes referred to as talk therapy) that is used to treat a number of different mental health conditions. Its main focus is to help patients to identify and change their thought and behaviour patterns.3
Using a method called exposure and response prevention (ERP), cognitive behavioural therapy is designed to help decrease repetitive and compulsive behaviours like mirror checking and camouflaging by gradually exposing patients to situations that they fear.5
<h3>Medication for body dysmorphia</h3>
Selective serotonin reuptake inhibitors (SSRIs) such as Fluoxetine are the most commonly used drugs for body dysmorphia. This antidepressant medication can help to control compulsive behaviours and symptoms associated with BDD.3 .
Different drugs will work better for different people, so it’s important to seek professional medical advice from a qualified clinician before you take any medication for body dysmorphia. It’s also worth noting that some people may respond better to therapy and will therefore not require the use of medication at all.&nbsp;
<h3>How to help a loved one with body dysmorphia</h3>
It can be hard to know exactly how to help a loved one. It’s a deeply personal and overwhelming experience.&nbsp;
Some useful tips for helping a family member or loved one with body dysmorphia include:
<ul>
 <li>Listen (you don’t always need to provide a solution — just listen)</li>
 <li>Accept their feelings (even if you don’t understand them)</li>
 <li>Provide practical support so that they can prioritise their therapy sessions or self-care practices</li>
 <li>Acknowledge and celebrate the small wins</li>
 <li>Learn and understand their triggers</li>
 <li>Remember to take care of yourself too!</li>
</ul>
<h2>Babylon offers high-quality, 24/7 comprehensive health care. Let us help:</h2>
<a href="https://www.babylonhealth.com/en-gb/download-app">Download the Babylon app</a>
Learn more about<a href="https://www.babylonhealth.com/en-gb/product"> our services</a>
References:&nbsp;
<ol>
 <li>MIND, What is body dysmorphic disorder?, <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/about-bdd/">https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/about-bdd/</a>, published July 2022</li>
 <li>MIND, What causes BDD, <a href="https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/causes/">https://www.mind.org.uk/information-support/types-of-mental-health-problems/body-dysmorphic-disorder-bdd/causes/</a>, published July 2022</li>
 <li>NHS, Body dysmorphic disorder, <a href="https://www.nhs.uk/mental-health/conditions/body-dysmorphia/">https://www.nhs.uk/mental-health/conditions/body-dysmorphia/</a>, published October 2020</li>
 <li>International OCD Foundation, Muscle dysmorphia (MD),&nbsp; <a href="https://bdd.iocdf.org/about-bdd/subtypes-of-bdd/">https://bdd.iocdf.org/about-bdd/subtypes-of-bdd/</a>, reviewed January 2023</li>
 <li>NICE, Obsessive-compulsive disorder and body dysmorphic disorder: treatment, <a href="https://www.nice.org.uk/guidance/cg31/chapter/Recommendations#steps-3-to-5-treatment-options-for-people-with-ocd-or-bdd">https://www.nice.org.uk/guidance/cg31/chapter/Recommendations#steps-3-to-5-treatment-options-for-people-with-ocd-or-bdd</a>, published November 2005</li>
</ol>

Body dysmorphia symptoms, diagnosis and treatment 

Social anxiety(previously referred to as social phobia) is one of the most common anxiety disorders so if you are struggling with symptoms of it, you’re definitely not alone.1&nbsp;
The good news is that with some help from a mental health professional, you can learn to manage social anxiety and—in some cases—even overcome social anxiety. Before we look at how to manage social anxiety, let’s first clarify what it is.
<h2>What is social anxiety disorder?&nbsp;</h2>
The term social anxiety can be used incorrectly&nbsp; to describe feelings of shyness or self-consciousness in social situations. However, for those who suffer from social anxiety disorder, it is an intense fear which can get in the way of daily life and significantly impact their emotional well-being.
Those with social anxiety disorder struggle with social events and worry that they will be scrutinised, ridiculed, and even judged by others. From one-on-one social interactions such as dates to situations where they have to stand up and talk in front of others and be the centre of attention, the fear and anxiety can be crippling.
Some situations that can be difficult for those struggling with social anxiety disorder include:
<ul>
 <li>Public speaking</li>
 <li>Eating in public</li>
 <li>Meeting new people</li>
 <li>Dates</li>
 <li>Job interviews</li>
 <li>Talking to staff at shops or restaurants</li>
 <li>Answering questions in a classroom setting2</li>
</ul>
<h3>What are the symptoms of social anxiety?</h3>
There are both emotional and physical symptoms of social anxiety that can include3:
<ul>
 <li>Consistent worry about daily activities</li>
 <li>Avoidance of social situations</li>
 <li>Panic attacks</li>
 <li>Physical symptoms like feeling sick, sweating, blushing, shaking or palpitations</li>
 <li>Difficulty completing tasks in front of others&nbsp;</li>
 <li>Difficulty maintaining eye contact and other social skills&nbsp;</li>
 <li>Low self-esteem&nbsp;</li>
</ul>
It’s important to speak to a GP if you think you have social anxiety. They can talk to you about your symptoms and refer you to the best people to help.&nbsp;
<h2>Treatment options and coping strategies for social anxiety disorder&nbsp;</h2>
If you, a family member, or a friend are struggling with symptoms of social anxiety disorder, it’s important to reach out to your healthcare provider. Self-help can be great in the right circumstances, but it’s also important to seek professional help to make sure that you are getting the right treatment. Everybody is different and a mental health expert will be able to help you navigate the various treatment options, medication, and coping techniques to find the right strategy for you.
<h3>Cognitive behavioural therapy for social anxiety</h3>
The most common treatment for social anxiety disorder is a type of psychotherapy called Cognitive Behavioral Therapy (CBT). There are a few different forms of this, including one which has been specifically designed to treat social anxiety.&nbsp;
This technique teaches&nbsp; different ways of thinking, behaving, and reacting to difficult situations. This kind of therapy also helps patients to practise various social skills and can be delivered in a group setting or on a one-to-one basis.4
<h3>Medication for social anxiety disorder</h3>
As we’ve already mentioned, everybody is a little bit different. Some people who suffer from social anxiety disorder may respond well to therapy whereas others might need a combination of therapy and medication. Again, a mental health professional will be able to help you to understand the best course of action for you, so it’s important to reach out to your healthcare provider before trying any new medication for anxiety.
Antidepressants can be used for social anxiety disorder. These can include:3
<ul>
 <li>Selective serotonin reuptake inhibitors (SSRIs)</li>
 <li>Serotonin-norepinephrine reuptake inhibitors (SNRIs)</li>
</ul>
Your doctor can guide you through the latest information and advise you on the best type of medication for you.
<h3>Coping techniques for social anxiety</h3>
The best way to overcome social anxiety is by getting professional help. However, there are also a number of other things you can do by yourself to manage and minimise your social anxiety symptoms.
Some useful coping strategies and relaxation techniques for social anxiety include:3
<ul>
 <li>Breathing exercises</li>
 <li>Meditation and mindfulness</li>
 <li>Light exercise (even walking around the block or stretching for 5 minutes can help)</li>
 <li>Muscle relaxation exercises</li>
 <li>Writing your thoughts down</li>
 <li>Challenging negative thoughts (try thinking, “What advice would I give a friend if they felt this way?”)</li>
</ul>
Not everyone will find every single one of these techniques useful. Some might find deep breathing to be effective whereas others might prefer to write down their thoughts and fears. Some might find that a combination of a few things is best for them.&nbsp;
The important thing is to try different techniques and find what works for you. Don’t overwhelm yourself by doing everything all at once—take small steps and find the right solution for you.
<h3>How to make friends with social anxiety?</h3>
Whether you’re starting a new job, moving to a new city, or starting at a new school, it can be hard to make new friends when you’re struggling with social anxiety. There’s no magic fix for this, unfortunately. In order to meet new people, you will have to face your fears on some level.
However, there are some things you can do to make the journey a little bit easier. Some top tips for making new friends include:
<ul>
 <li>Start small (even if it’s just waving at a neighbour) and work up to bigger social events</li>
 <li>Practise your social skills (even if it’s in front of a mirror, or with family and friends)</li>
 <li>Memorise a handy list of small talk topics to put your mind at ease</li>
 <li>Prioritise settings where you have things in common with others (join a sports team or book club etc)</li>
 <li>Join local support groups for social anxiety</li>
</ul>
Being open about your social anxiety could also prove helpful. When people know that you struggle with certain situations, they might be a bit more understanding and try to accommodate you wherever possible.&nbsp;
<h2>Babylon offers high-quality, 24/7 comprehensive health care. Let us help:</h2>
<a href="https://www.babylonhealth.com/en-gb/download-app">Download the Babylon app</a>
Learn more about<a href="https://www.babylonhealth.com/en-gb/product"> our services</a>
References:
<ol>
 <li>NICE, Social anxiety disorder: recognition, assessment and treatment, <a href="https://www.nice.org.uk/guidance/cg159/chapter/Introduction">https://www.nice.org.uk/guidance/cg159/chapter/Introduction</a>, published May 2013</li>
 <li>Anxiety UK, Social Phobia/ Social Anxiety, <a href="https://www.anxietyuk.org.uk/anxiety-type/social-anxiety/">https://www.anxietyuk.org.uk/anxiety-type/social-anxiety/</a>, reviewed January 2023</li>
 <li>NHS, Social Anxiety, <a href="https://www.nhs.uk/mental-health/conditions/social-anxiety/">https://www.nhs.uk/mental-health/conditions/social-anxiety/</a>, published March 2020&nbsp;</li>
 <li>NICE, Initial treatment options for adults with social anxiety disorder, <a href="https://www.nice.org.uk/guidance/cg159/chapter/recommendations#delivering-psychological-interventions-for-adults">https://www.nice.org.uk/guidance/cg159/chapter/recommendations#delivering-psychological-interventions-for-adults</a>, published May 2013</li>
</ol>

How to manage social anxiety

Written by: Bianca Armitage, Health &amp; Wellbeing Coach, Babylon
 
We all know we should be eating healthy foods and drinking lots of water. So why don’t we?
Sometimes, the advice is a little overwhelming. Or maybe a bit generic and not very actionable in day-to-day busy life. Let’s change that.
It’s Nutrition &amp; Hydration week, and this is a super common topic I work on with my patients at Babylon. Nutrition and hydration play a massive role in preventing many diseases and illnesses. Eating a healthy, balanced diet has been shown to reduce inflammation, prevent heart disease and can even get Type 2 Diabetes into remission. There’s also emerging research on the links between what we eat and our mental health! All sounds great, right? But there’s a massive gap between knowing we maybe SHOULD be doing something, and actually doing it. That’s where I come in! Firstly, forget the “should”. Do you WANT to? And what’s your “why”? Only then do we add tools.
A great place to start when it comes to our nutrition is diversity. We really want to be eating 30+ different plants a week. Sound like a lot? Well, it’s not so hard to do when we realise what counts as a plant. This can be anything from your classic fruits and veggies, to beans, nuts, wholegrains and even herbs and spices! You’d be surprised how many you’re probably already eating.&nbsp;
Having lots of plant diversity not only fills us with lots of nutritious goodness but it also helps support our gut microbiome to be full of all the “good” gut bugs we want. Research has shown that having more diversity of good gut bugs is associated with better brain, heart, metabolic, immune and mental health, just to name a few! If you’re still feeling a little overwhelmed at the idea of eating 30+ different plants, start super small. Try this: stick a list on your fridge and note down how many plants you ate that week, then just add one next week. And I’m not saying eat 100% healthy all the time either. I may be a Health and Wellbeing Coach but my love of pizza is borderline ridiculous. And that’s okay. Food is about enjoyment as well as nutrition. A great split we can aim for is the 80/20 model: 80% healthy, 20% just enjoyment. Plus, if you find yourself craving, say, a pizza a little more than 20% to start with, think “Can I add a plant to this?”. Maybe a handful of spinach? It’s all about those baby steps!&nbsp;
The same goes for water. Start with one glass of water on your desk or bedside table as you start the day, every day for a week, then build up. We can all incorporate one new plant or glass of water in our lives.&nbsp;
I challenge you this week, how many plants will you have? What new one can you add? And why not have a glass of water whilst you stare at your fridge list and have a think.