Depression and Eating Disorders

Despite being considered two distinct areas of mental health, depression and eating disorders share several commonalities. Learn how they can influence one another in the following article.

Eating Disorders: Expressing One’s Pain Through Food

The American Psychological Association defines eating disorders as abnormal eating habits that can threaten one’s health, and in extreme cases, their life. The American Psychiatric Association (also known as APA) offers a somewhat wider definition, describing eating and feeding disorders as a persistent disturbance of eating and eating-related disorders to the degree where the individual’s physical health or psychosocial functioning are significantly impaired.

At present, 8 million Americans contend with some kind of eating disorder, with 90% of them being young women. The eating disorders family is considered very dangerous, with the highest mortality rate of any mental health illness.

The APA currently recognizes the following feeding and eating disorders:

• Pica. The eating of nonfood substances, inappropriate to the individual’s developmental level.
• Rumination Disorder. Regurgitating one’s food.
• Avoidant/Restrictive Food Intake Disorder. Preventing oneself from eating a sufficient amount of food, to the point where one’s health suffers. Usually appears during infancy or early childhood. Can be related to sensory sensitivity, such as sensitivity to certain smells or textures. Cannot be better explained by a diagnosis of anorexia or bulimia, and therefore does not involve excessive concern about one’s weight or body shape.
• Anorexia Nervosa. Restricting one’s food intake to the degree that they experience drastic weight loss that adversely affects their health. Said restriction is brought on by an intense fear over gaining weight or being fat. Excessive exercising, misuse of enemas, laxatives, or diuretics, self-induced vomiting can all be part of an anorexia diagnosis, as long as food intake restriction and significantly low body weight remain central to the case.
• Bulimia Nervosa. A recurring cycle of binge-eating a significantly large amount of food during a short period of time, feelings of a total lack of control due to their binging, and acts of compensatory behavior meant to counter their binge-eating. Like anorexia, such compensatory behavior can include vomiting, enemas, excessive exercising, laxatives, or diuretics. With bulimia, however, it is the cycle of binging-and-compensatory behavior that is the central feature. It is also considered a much more hidden disorder compared to anorexia, since patients struggling with bulimia often do not reach dangerously low body weight, and therefore their body shape usually does not go through as drastic a change.
• Binge-Eating Disorder. Eating an extremely large amount of food in a short period of time and feeling out of control regarding their eating habits. Unlike bulimia, binge-eating disorder does not include compensatory behavior, such as vomiting or the misuse of laxatives.

Depression: A Longing for Something that Has Been Lost

Depression is a central mood disorder recognized by the APA. It is primarily defined as a significant decrease in one’s mood, or as a persistent inability to feel joy. Individuals with depression tend to feel completely depleted of energy, struggle to maintain relationships, and find it exceedingly difficult to function in their everyday lives. They generally have a negative perception of themselves and lack hope that their current situation will improve.

Individuals battling depression often describe it as an unwavering sadness, or a sense of grief over something that remains unknown. Patients who decide to address their depression in psychotherapy may discover a key experience, or a painful loss they had previously been unable to recognize. It is through discussing what in their lives could have contributed to their depression that individuals might gain a better understanding of themselves, as they begin to accept what they have gone through and heal.

Depression is among the most common mental health disorders, with 7% of the adult population found to contend with the disorder. It is significantly more prevalent among women, whose rate of depression is 1.5-3 times higher than that of men.

How the Two Interact

Roughly half of those facing an eating disorder have been found to also have depression, with eating Disorders, anxiety and depression all found in high comorbidity with one another. More specifically, abnormal levels of symptom severity are linked to depression and eating disorders, with high impairment rates of either depression or anxiety associated with more severe cases of eating disorders. Older age, difficulty in mood regulation, low self-esteem, and perfectionism have also been linked to more severe eating disorders symptomatology.

The individual’s age seems to play a moderating effect on the connection between depression and eating disorders: specifically, eating disorders showed a stronger association with depression during early adolescence.

The comorbidity between the two types of mental health conditions has led many patients to ask, can depression cause eating disorders, and vice versa. According to studies in the field, the answer is yes.

In certain instances, depression can actually share a symptom with anorexia, as both disorders include drastic weight change among their symptomatology. But while in depression such weight fluctuations are linked to feelings of deep, unrelenting sadness, in eating disorders, the individual’s rapid weight loss stems from an intense fear of gaining weight or being considered fat.

Similarly, cases of atypical depression may share a symptom with bulimia—specifically, that of binge-eating. While the two disorders can be given together, bulimia would only apply to cases where compensatory action is regularly taken to counter the binge-eating, in addition to having a severe concern or weight gain or body image.

As with all cases of mental health disorders, finding the right form of support and treatment is a crucial part of one’s road to symptom alleviation, and greater, overall well-being. For this reason, it is imperative to consider one’s available options, and explore the different ways they can take part in their own road toward rehabilitation and recovery.