Although it isn’t clear exactly how eating disorders, like anorexia nervosa or bulimia, and depression are related, they often seem to go hand in hand. While there is some scientific evidence that depression may increase the risk of developing an eating disorder, there is also evidence that the reverse can be true, that have an eating disorder can increase the risk of developing depression.
This link with depression seems to be apparent with the three primary eating disorders to varying degrees. With anorexia, in some circumstances the physiological changes resulting from the disorder can lead to depression. In others, the underlying cause of the eating disorder may be depression and anxiety. In those with binge eating disorder, the disorder itself can cause feelings of guilt and shame that impact self-esteem and can contribute to or worsen existing depression.
The signs of depression in people with eating disorders are the same as the signs for anyone with this condition including:
- All encompassing feelings of sadness, hopelessness, and/or unhappiness
- Losing interest in activities
- Quick temper
- Difficulties sleeping
- Changes to sleeping patterns or habit
- Loss of appetite
- Changes in eating habits
- Suicidal thoughts or tendencies
Mental health providers use the same diagnostic tools for determining if someone with an eating disorder has depression as they would for any patient. But when it comes to treating the two co-existing conditions, some challenges present themselves.
In order to be effective, a treatment approach for people that have an eating disorder and depression must address both disorders in order to be successful. This is one of the reasons it is so important for people who are suffering from both to get both disorders diagnosed. If treatment focuses solely on the eating disorder or solely on the depression, progress and remission are unlikely in most cases.
Depression and eating disorders are generally treated with anti-depressant medications, cognitive behavioral therapy(CBT), and/or education on healthy eating habits. Those with binge eating disorder may also be treated with an anticonvulsant medication that has proved to be effective at reducing binge episodes. CBT is a common treatment option for depression but it is also proving to be very beneficial for those with anorexia, bulimia, and binge eating disorder.
The fastest results come when medication is used but a medication only approach carries a higher risk for relapse. Those who are treated only with CBT are less likely to relapse but it takes time to see results. However, when used together, these treatment options can help those with these conditions overcome both disorders.
Treating eating disorders with underlying depression is possible but for the greatest chance of success, all mental health conditions including depression, anxiety, etc. must be diagnosed and the treatment plan implemented must be tailored to the individual’s needs.