Eating disorders and depression often go hand in hand. So in order to recover, both need to be addressed.
Depression can often be caused by stress, and we call it situational depression. Loss and change create tremendous strain to our sense of equilibrium and well-being. A death in the family, an illness, a move, a financial downturn, even a “positive loss” – such as a child going away to an out of town college – all give rise to coping with food if you are an emotional eater. Bingeing, purging, or starving helps to detour sadness, anxiety, and depression. Who can think of worrying about your daughter living out of state if you have your head in a box of donuts? Emotional eating is a mood altering drug to detour, derail, and divert your tension.
Depression can often be biological as well. Over the past thirty-five years, scientists have made great strides in understanding the enormous role that hormones, neurotransmitters, thyroid, blood sugar levels, physical pain, pregnancy, and menopause play in affecting our behavior.
Our complex inner biochemistry also controls our eating patterns and our perceptions of hunger and fullness.
Research now shows that almost three-quarters of all patients with anorexia and bulimia suffer from a depressive disorder. Clinicians also report that a significant number of compulsive eaters suffer from depression. Depression is different from the occasional sadness that we all experience from time to time. And to make matters more complicated, an emotional, situational depression can often actually trigger internal biological changes. It is sometimes difficult to distinguish what is biologically related without professional help.
Types of Depression
There are several types of depression:
A major depression refers to a severe episode of depression lasting more than two weeks with five of the following symptoms:
(1) depressed mood
(2) a lack of interest or pleasure in life
(3) a significant weight loss or weight gain not related to dieting or an increase or decrease of appetite every day
(4) insomnia or oversleeping every day
(5) psychomotor agitation or retardation every day (feeling “hyper” or “dragged out”)
(6) fatigue or loss of energy every day
(7) feelings of worthlessness, or excessive or inappropriate guilt
(8) diminished ability to think, concentrate, or make decisions
(9) recurrent thoughts of death, suicidal thoughts, or reckless behavior
Persistent Depressive Disorder (Dysthymia) refers to a chronic state of depression that has lasted for at least two years. Even the person’s achievements and successes do not alleviate the depression, except temporarily.
Bipolar Disorders are disorders in which the person’s mood swings between lows and highs, ranging from deep depression to inappropriate elation (formerly called manic-depressive illness).
Depressive and Bipolar Disorders with Atypical Features ofDepression (Atypical depression) tends to be chronic and more common in bulimics. Symptoms include increased appetite, weight gain, bingeing, oversleeping, heaviness in the arms or legs, and sensitivity to rejection, particularly romantic rejection. (It is called atypical depression because it is the opposite of typical depression which usually involves loss of appetite, weight loss, and insomnia.)
Seasonal Affective Disorder (SAD) is another form of biological depression often connected with eating disorders. It occurs during autumn and winter months and diminishes with the increase of sunlight in spring and summer. Seasonal Affective Disorder responds to light therapy and various antidepressant medications.
Panic and Anxiety
Anxiety and panic often accompany depression. Patients with eating problems often suffer from panic disorders and anxiety. Many eating disorder patients also experience anxieties such as social phobia (fear of being in social situations), simple phobia (fear of a specific object like snakes or spiders), agoraphobia (fear of going outside), or obsessive-compulsive disorder. Some experience anxieties which are related to persistent dieting, such as anxiety about losing control of their eating or anxiety about being too fat. Anorexics have a significant percentage of anxiety disorders and studies of bulimic patients report that over 50 percent have at least one anxiety problem.
Premenstrual syndrome (PMS) refers to a wide range of symptoms that women suffer during the week prior to their monthly period including irritability, tearfulness, fatigue, anxiety, depression, bloating, and increased food cravings. The emotional and physical symptoms of premenstrual dysphoric disorder (PMDD) are more severe than PMS and can affect daily functioning. The symptoms usually ease off once the woman gets her period.
If you suffer from binge eating, bulimia, anorexia, chronic dieting, or obsessive thoughts about your body, this may be a symptom of depression. Go for an evaluation with a trusted medical doctor or a psychotherapist. A professional will help you decide what’s the next step to feeling better. Psychotherapy (also known as the “talking cure”) and sometimes medication can get you back on track. There is no virtue in suffering in silence, especially in this day and age when we now know so much about how to help people with depression get better.