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.
How Eating Disorders Result From Depression
Are you depressed? Are you having eating issues? Eating disorders are more common than you might think. A specific week highlights this problem and focuses directly on these issues. Family members may also want to know more about the signs of an eating disorder and depression to find a better understanding.
It may not be apparent to family or friends that someone they care about has an eating disorder. In addition to depression, an eating problem can result in shame, disgust, guilt, and a feeling of being alone or isolated. All races, genders, religions, and ethnicity may be affected by these feelings. A study found that eating disorder/OCD patients showed a higher lifetime prevalence of comorbid conditions, with higher anxiety and depression scores.
Treatment for OCD, Obsessive-Compulsive Disorder and depression may help overcome an eating disorder. TMS, Transcranial Magnetic Stimulation, is an effective treatment for OCD and thus eating disorders.
What Are Some Types of Eating Disorders?
There are different types of eating disorders. In both anorexia and bulimia, ongoing thoughts revolve around body image, weight gain, and food intake. These ideas may lead to formal methods of eating, dieting, and exercising.
- Anorexia nervosa
- Bulimia nervosa
- Binge eating disorder
Women and teen girls are most at risk for bulimia and anorexia. On the other hand, studies found that men had the highest chance of a binge eating disorder. One in four people hospitalized for an eating disorder showed symptoms of PTSD.
Orthorexia is another eating disorder; it results in a compulsive need for healthy eating and rigidity that sees the possibility of dangerous foods’ consumption. Like bulimia, there is shame involved with eating.
Signs of an Eating Disorder
Some of the signs of an eating disorder include the following:
- Meticulous rigidity
- All-or-none thinking
- Behaviors that are obsessive-compulsive
Anorexia may appear as a person has an extreme fear of gaining weight. It may begin as an interest in dieting and progress to something much worse. Dramatic weight loss may be one sign of anorexia.
Bulimia may be suspected if a person leaves behind several empty wrappers and containers. Large amounts of food may be missing. The person uses the bathroom after meals, and signs of purging are evident.
Treating an Eating Disorder
There are many ways of treating an eating disorder. In severe cases of anorexia, hospitalization of the patient might be necessary. OCD, along with depression, can be treated with individual therapy, group therapy, nutritional counseling, or TMS (Transcranial Magnetic Stimulation). Holistic and integrated counseling can help the patient lead a life free of distressing symptoms.
A lifelong process of self-awareness and help from your family, which may receive therapy or education, will help a person make a full recovery from an eating disorder.
If you or a loved one have signs of an eating disorder, we can help. Contact us at 310.878.4346 to learn more or begin treatment.