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Eating Disorders and Depression
There is often a correlation between eating disorders and depression. This article contains information on how depression is associated with three eating disorders; binge eating and depression, anorexia and depression, and bulimia and depression.
Depression is a pervading sense of sadness of loss of emotional flexibility. It may be characterized by changes in eating habits, insomnia or oversleeping, loss of interest in usual activities, indecisiveness, and other behavioral manifestations. Depression may be preceded by a stressor event, potentially one that is very difficult to bear or sad. When it lasts only a few weeks, it may be a normal response to the normal stresses of life. When it lasts longer, it signals a mental disorder.
Eating disorders are mental disorders in which the normal behaviors of eating - including what, how much, and when to eat - are disturbed. The term eating disorders comprises a variety of different disorders including anorexia nervosa, bulimia, and binge eating. Although eating disorders frequently co-exist with depression, since these are different disorders, their relationship to co-existing depression and treatment of depression is different. This article examines each one in turn.
Binge Eating and Depression
Binge eaters are subject to occurrences of compulsive overeating, often undertaken alone and at great speed. Currently, binge eating as separate eating disorder (without purging, as in bulimia nervosa) is classified by the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) as an “Eating Disorder Not Otherwise Specified” (EDNOS), but it has received widespread attention, not least because it is the eating disorder that has the highest prevalence of male sufferers. Unlike the other eating disorders, it tends to be characterized by weight gain and obesity. It may be triggered by attempting a very strict diet.
Guilt and shame about binge eating can lead both to more binge-eating and co-existing depression - whether as cause or effect - is often present. For some patients, antidepressants may both reduce the incidence of binge eating as well as help with the depressive symptoms.
Anorexia Nervosa and Depression
Anorexia nervosa is a mental disorder in which the person has a distorted body image and fears gaining weight. Weight gain is so feared that the person will over-exercise or even starve him- or herself to avoid weight gain. Teens and young adult women are most at risk for this disorder. Like depression, the onset of anorexia nervosa may be triggered by a traumatic event. It is also often accompanied by depression. The exact relationship between the trigger event, the anorexia, and the depression is not yet clear.
Antidepressants - often used to treat depression in patients with anorexia nervosa - have only been moderately effective. And, according to the National Institute of Mental Health (NIMH), recent research has shown that the use of antidepressants is not effective during the period in which a patient’s normal weight is being restored and may not be effective in preventing a relapse.
In addition, research has shown that antidepressants may cause suicidal thoughts in children and teens, and for that reason if antidepressants are used, careful monitoring of the person with anorexia nervosa is particularly important.
Bulimia Nervosa and Depression
Bulimia is binge eating followed by purging. During the binge, the person often eats large amounts of food that is very high in calories. Following this, the person undoes the caloric intake one way or another, which may be through vomiting, use of laxatives or diuretics, fasting, or over-exercising. The typical binge eater is a teenage girl or young adult, who may be within the normal weight range.
There is often a co-existing depression found with bulimia nervosa. In a 2007 publication, NIMH indicates that Prozac (fluoxetine) is the only antidepressant approved by the United States Food and Drug Administration (FDA) for the treatment of bulimia. Besides addressing the depressive symptoms, the antidepressant actually seems to help reduce the problematic behaviors (binging and purging), reduce the risk of relapse, and improve attitudes about eating.
Related Article: Warning Signs of Eating Disorders >>