Depression and Eating Disorders
Eating disorders are some of the most dangerous mental health conditions. An untreated eating disorder can lead to severe malnutrition, decreased immunity, and can even cause organ damage and subsequent failure. People with eating disorders are also at increased risk of developing comorbid conditions, such as depression and substance use disorder. It is imperative that persons with suspected eating disorders are treated quickly before their physical and mental health deteriorates. Unfortunately, when comorbid conditions like depression and eating disorders occur in tandem, it can be challenging for clinicians to diagnose these conditions accurately, and create treatment plans that address the symptoms of both. But it is crucial that these comorbid conditions are treated simultaneously to lessen the severity of each.
What is an eating disorder?
Eating disorders refer to a grouping of adverse mental health conditions wherein patients have a distorted relationship with food and eating. The most common types of eating disorders in the U.S. are anorexia nervosa, bulimia, and binge eating disorder.
People with anorexia are terrified of gaining weight. They often suffer from a dysmorphic relationship with their body and experience distortions in appearance. A person with anorexia who is severely underweight will still believe that they are too heavy and will continue to diet to dangerous extremes. In anorexia, patients will obsessively count calories and restrict their food intake. They may turn to drugs or alcohol to further curb their appetite. Complications from anorexia are severe and include diseased related to malnutrition, infertility, bone density loss, organ damage, and organ failure.
People with bulimia have similar distortions in weight perceptions as those with anorexia. However, people with bulimia are less likely to restrict food and calorie intake. Instead, patients will eat to excess, and then force themselves to vomit or otherwise expel their food. People with bulimia will sometimes take laxatives to shed excess calories. They also risk becoming dependent on OTC laxatives. Bulimia can lead to tooth decay and tooth loss, complications from acid reflux, and heart damage.
Patients with binge eating disorder will compulsively eat food until they feel sick. They can’t stop on their own, and will often be ashamed of their inability to curb their appetite. Binge eating disorder patients often feel an extreme sense of shame, and can socially isolate themselves when they have the disorder. Patients are overweight and often obese and can experience the health complications associated with obesity, such as diabetes, heart disease, and arthritis.
Who is most likely to develop an eating disorder?
Teen girls and young women are the most at risk of becoming either anorexic or bulimic, while young men have the highest rates of binge eating disorder. In studies on children, teens, and adults with eating disorders, the following risk factors, correlations, and statistics were found:
- Anxiety disorders precipitated the start of an eating disorder in two-thirds of anorexia patients.
- Being a perfectionist and having obsessive-compulsive traits predicted higher rates of eating disorders in women.
- One in four people hospitalized for an eating disorder displayed symptoms of PTSD.
In addition, studies on people hospitalized for eating disorders found that:
- 94% of patients had comorbid depression
- 56% had anxiety disorders
- 20% had OCD
- 22% had PTSD
- 22% had substance use disorder
Further studies on hospitalized eating-disorder patients found that a staggering 97% met the diagnostic criteria for comorbid mental health conditions, most notably mood disorders.
What is the link between eating disorders and depression?
Depression is incredibly dangerous when it is untreated. The results of untreated depression and eating disorders are especially tragic, with half of all patients with anorexia committing suicide. While it is possible that depression can lead to an eating disorder, what mostly happens is that people get an eating disorder and then become depressed. Both of these mental health conditions fuel and worsen the symptoms of the other. Therefore, it is imperative that therapists and doctors develop holistic and integrated treatment plans for patients that address both conditions at the same time.
Being severely underweight and malnourished can cause changes in hormone levels and even brain chemistry, which can trigger an episode of depression. People with eating disorders often exhibit depression symptoms that are unique to their comorbidity. For example, eating disorder patients are often anxious and obsessive-compulsive. They carry a lot of personal shame and self-loathing because they do not live up to the high standards they set for themselves. These self-loathing feelings are common in depression. In eating disordered patients, these types of guilty and shameful feelings are amplified once a person brain chemistry is hindered from malnutrition. In binge eating disordered patients especially, the symptoms of socially isolation and withdrawal that are common in depression can be particularly pronounced.
How are these comorbid disorders treated?
In cases of severe malnutrition that often happen with anorexia, patients will sometimes need to be hospitalized. Eating disordered patients with comorbid depression will need to work closely with a team of medical doctors, therapists, and nutritionists to alleviate their symptoms and improve their physical and mental health. Any patients that also suffer from comorbid substance use disorder will need further integration into a detox and rehab center.
Depression and eating disorders can be effectively treated with a combination of talk therapy, group therapy, nutritional counseling, and transcranial magnetic stimulation. These two mental health conditions cannot be “cured” in the strict sense; in that, they are chronic and lifelong. However, integrated, holistic treatment with a team of experienced clinicians and medication regimens can alleviate the symptoms of both disorders. Patients can go on to make a full recovery and live free from debilitating and distressing symptoms. Family therapy and family education meetings are also incredibly beneficial for helping the family heal and learn how to support and communicate with struggling loved ones.
If you or a family member are struggling with depression that may be affecting eating habits, it’s crucial that you reach out for help. Please contact Pulse TMS today for the treatment of eating disorders and comorbid depression.