Eating Disorders and Depression
Blog Post By Ashley Davis
May is Mental Health Month, and an important time to talk about the connection between eating disorders and other mental health issues like depression. Depression is one of the most prevalent mental disorders. In 2021 alone, 8.3% of all US adults had at least one major depressive episode. This prevalence was highest among ages 18-25 and was more common in women than men. However, depression touches all demographics.
While depression and eating disorders do not always overlap, the likelihood that someone with an eating disorder will also suffer from depression is extremely high. In fact, 42% of those with anorexia nervosa, 70.7% of those with bulimia nervosa, and 46.4% of those with binge-eating disorder have been diagnosed with a mood disorder. In fact, high impairment of depression has been associated with more severe eating disorder symptoms for females aged 12-25 years old.
What is depression?
Major depressive disorder, most commonly referred to generally as “depression,” is characterized by the following symptoms during the same two-week period:
Depressed mood
Loss of interest and/or pleasure
Weight loss or gain and/or decrease or increase in appetite
Insomnia or hypersomnia
Psychomotor agitation or retardation
Fatigue or loss of energy
Feeling worthless or excessive/inappropriate guilt
Decreased concentration
Thoughts of death and/or suicide
In addition, depression is associated with a high mortality rate from suicide. One study placed the suicide risk rate for people with major depressive disorder as high as 15%. With suicide as a leading cause of death in the United States, it is imperative that those with depression receive the help they need.
How does depression manifest?
Depression may look different from person to person, so it’s important to be aware of the different ways it can present itself.
Feelings of sadness, hopelessness, worthlessness
Tearfulness
Irritability
Moodiness
Obsessive rumination
Anxiety
Phobias
Physical pain, such as headaches, joint pain, abdominal pain
Low self-esteem
What does depression have to do with eating disorders?
You may have noticed that many of the symptoms of depression overlap heavily with side effects of eating disorders. While one may not necessarily cause the other, it is helpful to understand how they can relate to one another.
Undernourishment, as seen in anorexia nervosa, can significantly impact the brain. When the brain is undernourished, it cannot function properly, often resulting in moodiness, irritability, and faulty thinking. Many people with eating disorders also experience negative body image. This poor relationship with one’s body can often result in low self-esteem, a very common symptom of depression. Furthermore, in a depressive episode, one’s body and appearance may bear the brunt of low self-esteem caused by the disorder.
In addition, people may turn to food to cope with the symptoms of depression. Food can self-soothe and provide comfort in times of distress. However, in our culture that promotes diets and lauds “clean eating,” engaging in these activities may create further shame and depression. Shame adds fuel to depression’s fire, leading to isolation and feelings of hopelessness. Shame, guilt, and depression are also all potential symptoms following binge episodes in bulimia nervosa and binge-eating disorder.
Finally, suicidality is a major risk for those with eating disorders. Anorexia nervosa, bulimia nervosa, and binge-eating disorder are all associated with higher than average rates of suicide. When an eating disorder and depression exist simultaneously, the risk for suicide becomes even greater.
How can you prioritize your health with an eating disorder and depression?
Take care of your physical health by making sure you are prioritizing your meals and snacks. Depression can make taking care of your nutrition feel like an insurmountable task, and your eating disorder may take advantage of this. Getting in all of your meals and snacks every day challenges the eating disorder and fuels your body and mind.
Foster hope by hearing from others in recovery. There is often nothing more powerful than hearing how others in the depths of an eating disorder have found freedom from food and body struggles. Hearing these testimonies can inspire and provide hope when it feels impossible to be found. If there is no one in your life who has recovered from an eating disorder, find people on Instagram or other social media sites.
Reduce isolation by reaching out to your support system. Rally the troops and gather your community; you are not in this alone. Whether you invite others into your pain or just need someone to take your mind off of things for a moment, don’t hesitate to tap into your support system.
Utilize relaxation and stress management techniques. Chronic stress has one of the biggest impacts on physical and mental health. Show yourself kindness by engaging in deep breathing exercises, reducing your workload, and prioritizing sleep.
Step outside into the light and engage in some gentle movement. Light therapy has been shown to have great improvement on depression symptoms. Even just sitting on your patio or standing outside for a few moments offers a breath of fresh air that has wondrous benefits. If you are able, try engaging in some gentle, joyful movement to increase your mood
Resources:
American Psychiatric Association Publishing. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR. American Psychiatric Publishing.
Orsolini, L., Latini, R., Pompili, M., Serafini, G., Volpe, U., Vellante, F., Fornaro, M., Valchera, A., Tomasetti, C., Fraticelli, S., Alessandrini, M., La Rovere, R., Trotta, S., Martinotti, G., Di Giannantonio, M., & De Berardis, D. (2020). Understanding the complex of suicide in depression: From research to clinics. Psychiatry investigation, 17(3), 207–221.
Reichenberg, L. W., & Seligman, L. (2016). Selecting effective treatments: A comprehensive, systematic guide to treating mental disorders (5th ed.). John Wiley & Sons, Inc.
Sander, J., Moessner, M., & Bauer, S. (2021). Depression, anxiety and eating disorder-related impairment: Moderators in female adolescents and young adults. International journal of environmental research and public health, 18(5), 2779.
U.S. Department of Health and Human Services. (n.d.). Eating disorders. National Institute of Mental Health. https://www.nimh.nih.gov/health/statistics/eating-disorders
U.S. Department of Health and Human Services. (n.d.). Depression. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/depression
About Ashley Davis: Ashley joined Rock Recovery as a Counseling Intern in August 2023. She earned her BA in Psychology from Vanderbilt and is currently pursuing her MA in Clinical Mental Health Counseling through Wake Forest University. Ashley is passionate about helping clients form positive relationships with food and their bodies and uses holistic, person-centered, and mindfulness approaches in her work.