Depression occurs in approximately half of women who meet the criteria for anorexia nervosa. Eating disorders can result in a severely malnourished state, which can lead to physiological consequences such as poor mood states or feelings of worthlessness, which can lead to depression. Alternatively depression itself can result in eating disorders such as anorexia nervosa, binge eating disorder and bulimia nervosa.
Eating disorders are triggered by severe underlying stress and many individuals use disordered eating behaviors such as binging and self-induced purging as ways to self-treat their depression however these poor coping behaviors are known to worsen the depression while causing extreme harm to the body. For example, life stressors, like the demands of puberty, the death of a loved one, a divorce and physical or sexual abuse, can lead to depression. For many individuals, eating disorders are a way to exercise control over a life that’s become unmanageable. Ritualistic eating patterns and extreme weight loss can become a poor coping mechanism to suppress overwhelming emotional pain associated with depression.
Anorexia nervosa and depression are known to certain neurological factors, which include the following:
· High levels of cortisol, a hormone that the body produces in stressful situations
· Low levels of serotonin, a hormone that’s responsible for mood regulation
· Low levels of norepinephrine, a neurotransmitter that plays a role in emotions and moods
· High levels of vasopressin, which has also been linked with obsessive-compulsive disorder
Because of the complex nature of depression and eating disorders and the overlapping factors of both, it is critical to treat both conditions simultaneously. In addressing underlying factors that are contributing to the progression of eating disorders and depression, it may be discovered that both stem from similar causes; thus the importance in caring for both. Cognitive behavioral therapy, developing positive coping skills and anti-depressant medications are well-known treatment approaches for individuals with depression and eating disorders.
Treatment for this disorder consists of a combination of medications and psychotherapy. Although studies have shown that these medications and psychotherapy approaches can be used alone for mild depression, when used in combination, individuals receive the best outcomes in terms of symptoms relief for moderate depression. The most common pharmacological treatments include antidepressant classes such as selective serotonin reuptake inhibitors (SSRIs), serotonin/norepinephrine reuptake inhibitors (SNRIs), atypical antipsychotics, and tricyclic antidepressants (TCAs). Medication generally takes approximately 6-8 weeks for results to take effect. Psychotherapy includes cognitive behavioral therapy, interpersonal therapy, problem solving therapy and mindfulness-based cognitive therapy.
An antidepressant medication is usually the first-step in the treatment plan for an individual with mild to moderate depression. There is a vast array of medications available and the initial selection often depends on the known medication side effects, safety and tolerability of these side effects, duration of timing it takes for the drug to work, an individual’s response to prior antidepressant medications, cost of the medication, interactions with other medication and the individual’s preference. Antidepressants take two-six weeks, at the correct dosage, for a clinical response to occur and therefore it is imperative individuals stay motivated and compliant during this time period. Additionally, psychotherapy can be initiated at the start while these medications take their time to produce clinical effects. The following are classes of antidepressants widely used in the general population to treat it:
Our Center For Discovery Outpatient Centers' Recovery Treatment include Cognitive behavioral therapy and interpersonal psychotherapy are the two most common therapy approaches to treating depressive disorder. Cognitive behavioral therapy focuses on reducing depressive symptoms by recognizing the thought the irrational thought patterns, emotions, beliefs and distorted attitudes toward oneself and their environment that results in symptoms of it. Once the recognition of maladaptive thoughts occurs, an individual can then work on their behavioral patterns to turn these negative symptoms around into positive outlooks, and gain insight and self-appreciation in order to develop behavioral techniques such as self-control therapy, problem solving, and social skill training. Interpersonal psychotherapy focuses on acknowledging the triggers associated with depression such as the loss of a loved one, a stressful social situation, the loss of a job, financial burdens, social isolations or the loss of a romantic relationship. In this form of therapy, depression is viewed as a medical illness and the illness is the cause of the depression. Techniques that involve building relationships, learning coping mechanisms and developing conflict resolution skills can help diminish these triggers and form positive insight in future conflicts. Other forms of psychotherapy that have been implanted to treat it include the following:
Our Center For Discovery Outpatient Centers specialize in treating Depression and Co-Occurring Eating Disorders with customized treatment for the individual to get well on the way to his/her eating disorder recovery.
For more information, resources, or to consult with an eating disorder treatment specialist, call 866.482.3876