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        • AnxietyAnxiety disorders are one of the most common mental health problems identified in children. Estimates of the rates of prevalence vary greatly from 8% to 27% lifetime prevalence by age 18. Chronic anxiety disorders are associated with increased risk of other serious mental health problems in later life. Therefore, early identification and treatment is key. Watch our information and real life experience films below or view and download our fact sheet and supporting presentation.
        • Depression
        • OCD
        • PTSD
        • Eating Disorders
        • Why is my child self-harming?
        • TraumaTrauma in children may be: A one-off experience, such as a car crash Living in an atmosphere that feels unsafe, or where they are witness to violence Experiencing, or witnessing, harm Experiences of war, or of becoming a refugee Stressful and challenging experiences are a part of life, and most children will experience these at some point. This becomes traumatic if the event is more than a child can make sense of, or cope with. To learn more about Trauma in Children, please refer to our informational and real-life experiences videos.
        • Body dysmorphic disorder

        • Neurodivergent Conditions

        • ADHD
        • Autism
        • Conduct Disorders/ODD
        • DyslexiaDyslexia in children is a common neurodevelopmental disorder affecting language processing, particularly in reading, spelling, and writing. It emerges early in childhood and persists into adulthood. Encourage your child’s strengths and provide a patient, nurturing environment. Remember, dyslexia doesn’t define intelligence. With the right resources like ours below, your child can flourish and excel in their own unique way.

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        • UK Trauma Council ResourcesNip in the Bud is very grateful to the UK Trauma Council for permitting us to show on our website their series of four excellent animation films about Trauma and PTSD. The UK Trauma Council’s work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. These animations have been produced with the involvement of young people themselves, and are designed to help young people and the adults around them recognise the signs of post-traumatic stress disorder. They also suggest ways of coping with scary memories, explain the science around the best treatments, and answer any worries you might have about getting support.

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        • Mental Health Conditions

        • AnxietyIt is becoming increasingly common that children and young people in your school or classroom may be diagnosed with anxiety. Symptoms of anxiety in children vary, but it’s important that you are able to understand and recognise how this might affect learning in a classroom environment. It’s normal for everyone to feel anxious from time to time – it’s a normal response to stress. However, some young people may experience uncontrollable levels of anxiety that are excessive in relation to what’s happening around them –can therefore struggle with their day-to-day tasks and schoolwork. Common worries can become overwhelming for children and young people with anxiety leading to them becoming quite distressed. If this does happen there are a few ways in which you can respond to try and calm the situation. Some signs and symptoms to look out for include tears when entering school, being withdrawn from their peers, concentration difficulties, fidgeting, changes in appetite, and irritability. Download our factsheet for more information on what to look for if you suspect a child or young person in your class is suffering from anxiety. Getting the conversation going can be a good starting point – for example, planning lessons themed around…
        • DepressionDepression is a common yet serious mood disorder that involves a persistence of deep sadness, hopelessness, and numbness. Someone experiencing depressing may feel a constant melancholy that prevents them from enjoying their everyday life. Children and young people especially can feel alone and misunderstood which often stops them from expressing how they feel to people close to them. This isolation can lead to suicidal feelings, self-harm and, in a worst-case scenario, suicide. Parents and teachers are often the first to identify the symptoms of depression in children and young people. Some key symptoms of depression include excessive and persistent worry, moodiness, over or undereating, and self-harm. Some symptoms manifest in physical ways that are a little easier to spot as a teacher during school time such as frequent aches and pains, not wanting to play, either complete isolation or clinginess, and uncharacteristic irritability and anger. There are many risk factors at school that can lead a child to develop depression. As a teacher, you should be on the lookout for children experiencing bullying, social isolation, a lack of self-confidence, and an inability to keep up with schoolwork, among other factors. Children particularly vulnerable to depression are ones who experience abuse,…
        • OCDObsessive compulsive disorder (OCD) is a mental health condition that involves repetitive, intrusive, and impulsive thoughts and images entering the mind, causing intense anxiety. As a result of this anxiety, the child or young person engages in compulsive or repetitive behaviours designed to ease their anxiety. They then obsessively repeat these behaviours to rid themselves of the anxiety, causing detriment to their daily life. Early signs of OCD can include excessive worrying and feeling a strong sense of responsibility over yourself and others. A child or young person will ask for constant reassurance about whether their homework is correct or whether they are doing something right or being a good student as they no longer trust their own judgement. As a teacher, these are early signs you can look out for which can inform how you approach the child going forward. Stress at school and bullying are key factors which exacerbate the development of OCD – the more overwhelmed a child feels, the more they give into their compulsive, repetitive behaviours to ease their anxiety. As a teacher, it is your duty to make sure the classroom is a safe space for all, keeping an eye on students who seem…
        • PTSDPTSD or post-traumatic stress disorder can be triggered in children and young people when they experience a particularly horrifying or scarring event. The cause can be as varied as a car crash or sexual assault. A child can develop PTSD if they are involved in this event, witnessed it, or even heard about it second-hand. It can be difficult to identify PTSD in children and young people, as they are reluctant to talk about the trauma they experienced as a way to protect themselves. However, there are some tell-tale signs of PTSD that you can look out for in your students. Children with PTSD will often have trouble concentrating and may even fall asleep during school time due to the lack of sleep they’re having at home, making learning much harder. A sudden plummet in grades is also a red flag – in such cases, it is important to check up on the student rather than reprimand them, which can cause further harm. PTSD also causes many children or young people to become highly irritable and angry due to the intense emotions they’re experiencing, often making them see other people as a threat. In this case, it is important to…
        • Eating DisordersAn eating disorder develops when a child’s and young person’s emotional well-being gets tangled up with their eating habits – for example, if their self-esteem is dependent on how much they eat or don’t eat. Eating disorders are most common in teenagers between the ages of 13 to 17 and they can manifest in a multitude of ways. Anorexia nervosa is a serious mental illness where a person has an intense fear of gaining weight, often accompanied by body dysmorphia – a distorted view of one’s body. This fear leads them to eat very little or nothing at all, leading to severe and potentially life-threatening weight loss. Bulimia nervosa is a serious mental illness that stems from being shamed about consuming large amounts of food, and your weight. A person will binge eat as much food as they can in a short space of time – this is often out of their control. They will then purge – making themselves throw up all the food they have eaten to avoid putting on weight from the binge. This leads to severe and potentially life-threatening weight loss. Binge eating is a serious mental illness which, similarly to Bulimia, involves consuming large amounts…
        • Self-harm in the ClassroomSelf-harm in children and young people happens when a person experiences an overwhelming flood of emotions such as guilt, shame, anger, hate, and a lack of control. This leads them to inflict deliberate harm upon themselves as a way to relieve the flood of emotions they are experiencing and punish themselves for feeling them in the first place. This can take the form of cutting themselves with sharp objects, over-eating or under-eating, pulling their hair out, burning themselves, and misusing intoxicants such as alcohol and drugs. Distress and overwhelming emotions often manifest during school time, and as a teacher it is important to have an awareness that school can be a trigger for students struggling with self-harming tendencies. Create a safe and open space for all students by letting your students know you are always here to support and hear them out whenever they need it. Common signs of self-harm include cuts, burns, and hair-pulling – these are easier to spot as they are often visible on the student’s body. However, young people can be very good at hiding their scars under long jumpers and trousers. If a student is adamant about keeping their jumper on even during hot temperatures,…
        • TraumaIf a child in your care is suffering with Trauma, they will be very distressed. This may be obvious, or it may show up in the form of physical ailments such as headaches or vomiting. They may show signs of regression in toileting or feeding, struggle with their schoolwork or find it difficult to concentrate. Watch our Informational film on Trauma and Children with Dr Sian Williams and Dr David Trickey to understand how children react to Trauma and how they can be helped.
        • Body dysmorphic disorder

        • Neurodivergent Conditions

        • ADHDADHD, or Attention Deficit and Hyperactivity Disorder, presents itself in many ways which can sometimes make it difficult for teachers to spot the signs. It is characterised by difficulties in the areas of attention, level of activity and impulse control. ADHD is a recognised developmental disorder which can affect many areas of a child’s life – including in a learning environment. It is common for ADHD to be misdiagnosed in girls, as the symptoms of ADHD present differently to that of boys, and aren’t as commonly shared. One of the most important things you can do as a teacher for a student with ADHD is to learn and understand how they are feeling, and how they see the world around them. Sometimes for students with ADHD it may feel like nobody understands them. In this video, we go through our tips for teachers who have a child in their class who has Attention Deficit Hyperactivity Disorder (ADHD). Also, view our Practical Tips for Teachers in the Classroom below .
        • Autism
        • Conduct Disorders/ODDODD, or oppositional defiant disorder, is diagnosed in children and young people that are persistently and repetitively antisocial, disobedient, have frequent tantrums, can not listen to authority, and purposely harm others. Conduct disorders are the most common disorders in children and are more frequent in boys, with 7% of boys and 3% of girls meeting the criteria for conduct disorders. It is normal for children and young people to be defiant towards authority to some degree, but if a particular student stands out from the others in your class and is perpetually defiant, violent and resentful towards others, this can develop into ODD. A child or young person with ODD will often engage in a range of violent and destructive behaviours such as fighting, temper tantrums, arguing with adults and peers, and lying and blaming others for their behaviour. In some extreme cases, the child or young person may engage in being cruel to animals and starting fires. As a teacher, it can be difficult to know how to handle a student with ODD in a way that ensures they make the most of their learning and helps their behaviours and social relationships. However, there are things you can do…
        • DyslexiaChildren with Dyslexia have a different intelligence, way of thinking and way of seeing the world.  Many innovators, inventors and successful entrepreneurs have been Dyslexic.  Dyslexic thinking skills include imagination, inspiration, creativity and the ability to solve things. They sometimes find it difficult to fit into rigorous, inflexible education methods. Our resources for teachers and professionals on Dyslexia explain that if the condition is spotted early, there are strategies that can be used to work on the strengths of Dyslexic children which will allow them to develop different talents and thrive in life.

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        • UK Trauma Council ResourcesNip in the Bud has been given permission by the UK Trauma Council to share this series of four short animations which they have produced on the topic of Trauma and PTSD. The UK Trauma Council’s work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 License. These animations have been produced with the involvement of young people themselves, and are designed to help young people and the adults around them recognise the signs of post-traumatic stress disorder. They also suggest ways of coping with scary memories, explain the science around the best treatments, and answer any worries you might have about getting support.

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Fact Sheets / What is Body Dysmorphic Disorder (BDD)

What is Body Dysmorphic Disorder (BDD)

This article was reviewed and enriched with expert insights from Dr Sean Cavanagh – Academic Clinical Fellow, National and Specialist CAMHS OCD, BDD and Related Disorders Service. We are grateful for his time and expertise in ensuring the accuracy and clarity of this piece.

What is BDD?  A simple definition

Body dysmorphic disorder (BDD) is an anxiety-related mental health condition in which a child or adult becomes preoccupied with one or more perceived flaws in their appearance. These perceived flaws are either not visible or appear only slight to others. The preoccupation causes significant distress or interferes with daily life (school, play, friendships, family routines). It often leads the person to perform time-consuming repetitive behaviours such as checking their appearance or comparing the perceived flaw with other people. The person can go to significant efforts to hide the perceived appearance flaw (e.g. with clothing, or make-up), and it can lead them to avoid social contact with others. BDD commonly co-occurs with depression and carries a raised risk of self-harm and suicidal thoughts. For more detailed information you can see nhs.uk,

It’s important as much as possible to view problems in functioning (not just symptoms) and to consider interactions between your child or pupil and their environment:

  • Body functions & structures (impairment): persistent distressing preoccupations about appearance, repetitive checking or comparing.
  • Activities & participation (activity limitations / participation restrictions): difficulty concentrating in class, avoidance of PE, refusing school photographs, reluctance to join social activities or play with peers.
  • Environmental factors: family responses (criticism or over-reassurance), peer teasing, and social media/advertising that emphasise appearance can increase distress. Find more about this here BDDF, or co.uk
  • Personal factors: low self-esteem, anxiety, perfectionism and possible neurobiological vulnerability (a person’s increased risk, due to their brain’s biology); co-existing depression or OCD features change how a child functions at home and school. Thinking in this way helps plan practical supports (home, school, clinical) that reduce disability and improve everyday functioning. You can also learn more about OCD in children here.

To learn more about experiences of living with Body Dysmorphic Disorder (BDD), you can listen to this podcast with Dr Bruce Clark or watch the video version. We also share films designed to support people who are caring for or working with a child experiencing Obsessive Compulsive Disorder (OCD), as well as films that explore what it can feel like to live with OCD.

Things to watch for in primary-school aged children at school

Children with emerging BDD may show subtle or changing behaviours.

Look for patterns (persistent, lasting weeks to months):

  • Repeated worries about a feature (face, skin, hair, teeth, body size) that seem disproportionate to the actual appearance.
  • Excessive time spent checking mirrors, asking for reassurance (“Do I look weird?”) or covering/avoiding the part of the body.
  • Avoiding PE, swimming, school photos, parties or other activities because of appearance worries.
  • Wearing excessive amounts of make-up or covering up with clothes or glasses in an attempt to hide a perceived appearance flaw. This may lead to difficulty following a school uniform policy.
  • Frequently comparing themselves to classmates, siblings or images (TV/apps) and becoming very upset.
  • Difficulty with concentrating in class may occur due to pre-occupation with intrusive thoughts about their appearance.
  • Difficulty with school attendance due to appearance-related worries. Children may arrive late as they are performing time-consuming repetitive behaviours or may avoid school altogether. Avoiding being around groups of other children.
  • Strong negative reactions if teased about appearance – or continual attempts to hide perceived flaws (hats, scarves, hair over face).
  • Signs of anxiety, low mood, talk about worthlessness or any mention of self-harm or “not wanting to be here” – take any talk of self-harm seriously, KidsHealth

If you notice several of these, it’s reasonable to seek a professional assessment – ideally via your child’s GP or local child & adolescent mental health services (CAMHS).

NICE recommends assessment from age 8 upwards when BDD is suspected.

Practical ideas & strategies for parents and carers at home

(Quick, actionable strategies grounded in clinical guidance and family resources.)

  1. Stay calm and curious. Ask open, non-judgmental questions about how they feel (“That sounds very upsetting – tell me more.”) rather than minimising or arguing about appearance. Avoid statements like “there’s nothing wrong with you”
  2. Limit reassurance and appearance-focused discussion. Reassurance often provides short relief but maintains the cycle. Instead of talking about the content of the appearance concern, acknowledge the emotion (“I can see you’re really worried”) and redirect to coping steps.
  3. Reduce checking and avoidance gently. Work with the child on small, manageable steps (e.g., shorten mirror time, join a short activity they enjoy) and praise effort. Use problem-solving: plan what to do when worries come up.
  4. Avoid supporting behaviours to hide perceived appearance defect. It is understandable that parents and carers often try to support their child’s attempts to hide their appearance concern. This can include giving them large amounts of cosmetic products. Hiding their appearance often provides short relief but maintains the cycle.
  5. Focus on function, not appearance. Encourage activities that build skills and confidence (clubs, skills-based play, creative projects) to increase participation and peer connections.
  6. Model healthy talk about bodies. Avoid negative body talk about yourself or others; emphasise strengths, kindness and what the body can do. co.uk
  7. Keep routines and sleep consistent. Anxiety and low mood are worse with poor sleep and chaotic routines; structure helps. Learn more in our film with Dr Sian Williams on how to support children with their sleep.
  8. If there are safety concerns (self-harm or suicidal talk): do not leave the child alone, seek urgent help (GP, emergency services/CAMHS crisis) and use crisis lines if needed. See the ‘Where to go’ section below for helplines. uk and watch our films to help support a child at risk of self-injury/self-harm.
  9. Seek specialist help early. BDD is a common condition which is very treatable with expert support. NICE recommends cognitive behavioural therapy (CBT) adapted for BDD (and medication in some cases). Early access to assessment and treatment improves outcomes. NICE, ACAMH
  10. Look after yourself. A child experiencing BDD can be distressing for the whole family. It is important to take time to look after yourself and make sure you have a support network in place. Some parents or carers can find support groups helpful.

Practical ideas & strategies for teachers and schools

(Tried and tested classroom adjustments and supportive responses – for more information about how to tackle Body Image conversations or make adjustments watch our film with educationalist Alis Rocca.)

  1. Listen, validate, and record concerns. If a pupil reports distress about appearance, respond calmly (“I’m glad you told me. I’m worried about how upset you are.”) and note what they said; pass to the designated safeguarding lead or SENCo.
  2. Avoid public attention to appearance. Don’t single out the child for PE or photos; offer a private conversation to find reasonable accommodations (e.g., alternative PE clothes for privacy). Keep adjustments discreet.
  3. Focus on participation goals. Set small, measurable activity targets (e.g., attend playtime twice a week) and celebrate functional gains rather than appearance; reduce participation limits.
  4. Supportive classroom adjustments. These may include providing extra time to complete homework or exams, and providing short breaks when the child is distressed. Take an understanding and supportive approach if a child’s school attendance is impacted by appearance concerns.
  5. Work with parents and professionals. Arrange sensitive, collaborative conversations with parents/carers and, with consent, involve school nurses, educational psychologists or CAMHS as needed.
  6. Reduce appearance triggers in class. Be aware of media content (ads, filtered images) used in lessons; include media-literacy and kindness/anti-bullying work that addresses appearance pressure.
  7. Provide emotional supports and safe spaces. Ensure the child knows a trusted adult they can go to, and offer short check-ins; consider social skills groups to rebuild peer confidence.
  8. Know and respond to risk. If a child mentions self-harm or suicide, escalate immediately to safeguarding arrangements and urgent services – don’t promise confidentiality over safety. uk

What treatments and supports are effective?

  • Cognitive Behavioural Therapy (CBT) tailored for BDD is the recommended first-line psychological treatment for children and young people. CBT is a form of talking therapy where you are supported to see the connections between thoughts, behaviours, and feelings. For BDD, NICE recommends specialist CBT approaches that address checking, avoidance and distorted beliefs about appearance. See more at NICE or ACAMH
  • Medication (SSRIs / sometimes other agents) can be effective in moderate-to-severe cases, usually in combination with CBT; medication decisions for children should be made by specialists.
  • Family involvement, psychoeducation and school liaison improve outcomes by reducing environmental factors that maintain distress. See more at BDDF

Safety and suicidal thoughts – how to respond

Take any talk of self-harm or “wanting to die” seriously.

Stay with the child if they are in immediate danger and call emergency services (UK: 999). Contact the child’s GP, CAMHS urgent access or local crisis team: nhs.uk

  • Use 24/7 helplines if you need immediate emotional support (Samaritans in the UK: 116 123). If you are outside the UK, use local emergency numbers or national suicide prevention services. Samaritans and uk
  • Document concerns and escalate through your school’s safeguarding procedures and with parents/carers, unless there are clear reasons not to (in which case seek immediate professional advice). NICE
  • To learn more about self-injury or self-harm you can also watch our expert-led, evidence based film “Understanding Self-harm”

Where to go for further information and support

(Trusted, evidence-based organisations and pathways.)

  • NHS (UK)
  • Information on BDD, crisis help and how to access local services; start with your GP for assessment and referral to CAMHS
  • NICE guideline CG31 : Clinical guidance for assessment and treatment of OCD and BDD (covers young people aged 8+). Useful for clinicians and schools: NICE
  • Body Dysmorphic Disorder Foundation (BDDF): Access to parent guides, practical resources and peer support materials: BDDF
  • YoungMinds: Practical, age-appropriate advice for parents about body image and getting help for children/young people: YoungMinds and the appco.uk
  • Samaritans – 24/7 emotional support in the UK (116 123). If you feel there is immediate danger, call emergency services (999 in the UK): Samaritans

Local CAMHS  For assessment and treatment of children and adolescents (access via GP or school health service).

Remember

  • You are not alone – parents, teachers and clinicians working together give the best chance of early identification and helpful intervention.
  • The charity BDDF is focused only on BDD so can be a vital resource.
  • If you are worried about safety now (self-harm or suicidal thoughts) act immediately: keep the child safe, call emergency services (999 in the UK), contact the GP/CAMHS urgent team and use 24/7 helplines such as Samaritans (116 123).

How to Begin: Supportive Questions for Primary-Age Children

If you are looking for help in how you have a conversation when talking to a primary-school-aged child who might be experiencing body dysmorphic disorder / BDD-type worries you can adapt these ideas.

These questions use age-appropriate, non-judgmental language and aims to validate your child or pupils feelings, avoid reinforcing appearance concerns, and open a door to ongoing support.

First Steps

Setting:
Choose a quiet, calm place where the child feels safe (at home or in a low-stimulation area at school). Sit at the child’s level. Keep your voice warm and unhurried.

  1. Opening gently

“I’ve noticed you’ve been looking a bit worried lately, especially about how you look. I wanted to check in because you’re important to me, and I care about how you’re feeling.”

Why this works: It’s observation-based, not judgmental, and it focuses on the child’s feelings, not their body.

  1. Inviting them to share

“Can you tell me a bit about what’s been on your mind? There’s no right or wrong answer.”

If the child finds it hard to start, you can offer prompts:

  • “When do these worries come up most?”
  • “What happens in your body when you start to feel worried about how you look?”
  1. Validating feelings

“It sounds like those thoughts are really upsetting for you. I’m sorry it feels that way, that must be hard.”

Avoid: “Don’t be silly” or “There’s nothing wrong with you.” This can make the child feel unheard.

  1. Naming the experience in simple terms

“Sometimes our brains get stuck on one thing – like a little glitch – and keep telling us there’s a problem, even when other people don’t see it. It’s not your fault, and it doesn’t mean you’re making it up. It just means your brain needs some help to feel calmer about it.”

  1. Reassuring about help and support

“We can work together to find ways to help you feel better about this. You don’t have to manage these thoughts on your own – there are grown-ups who know how to help with these kinds of worries.”

  1. Next steps

“Let’s make a little plan together about what to do when these thoughts pop up. And I’m going to speak to [another trusted adult/teacher/doctor] so we can get the right help for you.”

Tips for using these prompts:

  • Check in with yourself and how you’re feeling- Keep your tone calm and steady – children often take emotional cues from adults.
  • Pause after each question or statement; give the child time to think and speak, you don’t need to fill the gaps.
  • Avoid too much reassurance about appearance – focus on the feelings and the plan.
  • Follow up soon after with clear next steps (e.g., contacting a GP, school nurse, or CAMHS) so the child sees that talking leads to action.

For more ideas on talking with children about their mental health or neurodivergent experiences, watch our YouTube Q&A series with clinical psychologist Dr Bettina Hohnen, where she answers real parents’ questions.

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