Subjects afflicted with this disorder believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation at their appearance. They tend to be very secretive and reluctant to seek help because they are afraid others will think them vain—or they may feel too embarrassed to do so. Ironically, BDD is often misunderstood as a vanity-driven obsession, whereas it is quite the opposite; people with BDD believe themselves to be irrevocably ugly or defective. A similar disorder, gender identity disorder, where the patient is upset with their entire sexual biology, often precipitates BDD-like feelings. Gender identity disorder is directed specifically at external sexually dimorphic features, which are in constant conflict with the patient’s internal psychiatric gender.
The character needs to be around others and will not be left alone, however they also are not quite able to relate to others in a normal way and may also take risks or make impulsive decisions.