I'm so sick of psychiatrists failing to distinguish between legitimate ugliness and imagined ugliness. By failing to make this distinction, they incorrectly diagnose thousands of people with BDD and end up making their lives worse.
The fact of the matter is that beauty is overwhelmingly objective: It comes down to the symmetry of your facial halves and the proportions of your facial landmarks. That's it -- there's hardly any subjectivity involved in interpreting beauty.
I should also add that attractiveness plays an enormous role in determining the quality of one's life (duh!). Therefore, people who are legitimately ugly have every reason to be distraught over their appearance. They have every reason to be depressed and -- depending on the severity of their ugliness -- suicidal. I firmly believe that in some cases of incorrigible ugliness, death is a realistic option.
What legitimately ugly people need is not counseling but surgery. Cosmetic surgery doesn't perform miracles, but it can provide significant and objective improvements to one's facial appearance. Someone with a wide, humped, crooked nose would probably benefit much more from a quality rhinoplasty than therapy. Unlike therapy, surgery treats the problem (unattractive facial features), not the symptoms (depression and anxiety over appearance).
So if you are readings this, I implore you: Be skeptical of BDD. If you are legitimately ugly, then your best option is to correct what is making you unattractive. If after correcting these problems you still believe you are ugly, then perhaps you should seek a counselor. But do NOT be lured by the comforting diagnosis of BDD, which seems to suggest that no one is ugly. That's a fairy tale.