Eating Disorders, Depression & Anxiety
An eating disorder is a mental health condition that greatly impacts a person's life, no matter their age, gender, weight or diagnosis. In all of this, an eating disorder can impact a person's mental health by exaggerating or impacting other mental health conditions. Research has shown that there is as much as an 80 % comorbidity between anorexia and depression [1], a 63.5% comorbidity with anorexia, bulimia and anxiety [2] and a 32.5% comorbidity with body dysmorphic disorder [3]. Whilst I won't share any more statistics, the list goes on and on, with my point confirmed that eating disorders frequently occur with comorbid mental health conditions. The research I have shared may not be the most recent, but what we can see is that there are a lot of people not only struggling with one mental health illness, but will more than one, and this only seems to be increasing.
You may be wondering why eating disorders can present with other comorbid diagnoses such as depression and anxiety, and for those of you who are, here are some factors that may impact the occurrence of more than 1 mental health condition:
Genetic predisposition - mental illness has genetic links, and therefore if people have the genes which make them more susceptible to mental health illness, this can lead to an increased likelihood of poor mental health.
Serotonin imbalance - serotonin is a very important neurotransmitter in our brains. It helps with many bodily processes such as appetite and emotional regulation. In those with mental health conditions, there is often an identified imbalance or dysfunction of the serotonin which can lead to low mood. Fortunately, this can be treated with medication by speaking to your GP.
Maladaptive emotional regulation strategies - when we are unable to acknowledge of manage our emotions in a positive way, we try to reduce the emotion without dealing with the underlying cause. Overtime, this suppression can lead to poor mental health and a reliance on behaviours such as excessive exercise, binge eating, restriction and self-harm, which are often observed in eating disorders. Ultimately, these behaviours lead to the worsening of emotions, but become ritualistic and difficult to stop.
Malnutrition - low-calorie intake leads to low mood due to nutrient deficiencies affecting brain neurotransmitters, hormonal imbalances, and structural brain changes. Starvation mode and psychological stress worsen anxiety and depression, while body image distortion and isolation intensify emotional distress.
Low self-esteem and perfectionism - These characteristics can increase depressive and anxious symptoms by fostering self-criticism, a negative body image, and feelings of inadequacy. Perfectionism often leads to chronic stress and anxiety as individuals with eating disorders relentlessly pursue an unattainable ideal. This combination of low self-esteem and perfectionism creates a self-destructive cycle, intensifying feelings of hopelessness and anxiety, which are central to the emotional experience of eating disorders.
Social isolation - The secretive nature of eating disorders often leads to social isolation, further intensifying feelings of loneliness and despair, contributing to depressive symptoms.
(https://withinhealth.com/learn/articles/eating-disorders-with-co-occurring-disorders)
So you see, it is like a vicious circle. One worsens the other, which worsens the first, which worsens the other and the spiral can just keep going on down until people hit complete rock bottom with everything.
Recovery from an eating disorder is hard, and when you throw in other mental health conditions it can become a complete mind field. Navigating this journey can lead to people feeling scared, vulnerable and confused. However, recovery is possible with small steps. I am not going to advise that you paint your nails, make a cup of tea, or go and sit in nature. If that makes you feel good, great. But for a lot of us, it doesn't. The important thing I found was finding what made me feel good, inspired, and aligned with my goals. This made me want to recover, and grasp the life I was missing out on.
It is possible, even if you take tiny steps each day, you are still moving forward. It's the small things that matter, so remember you can do this. You are never alone.
References
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8958208/
[2] https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.161.12.2215
[3] https://onlinelibrary.wiley.com/doi/abs/10.1002/eat.20219