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Is there a link between eating disorders and depression?

Donna Hill Howes, RN
Family Practitioner

Women who have depression often also have eating disorders, including bulimia and anorexia. 

 

Young women are most vulnerable to development of an eating disorder, especially when they engage in activities that emphasize the importance of being thin or achieving an ideal body weight through compulsive exercise or persistent dieting. Perfectionism and negative self-perception are common stepping stones to full-blown eating disorders. Because of the need to be perfect, they may also feel sad, hopeless, guilty and worthless; lose interest in things they used to enjoy; and lack energy or the ability to concentrate their attention to do things they normally would. They may also feel nervous, tense, anxious, worried, irritable, distracted and restless, and experience sleep disturbances.

People with eating disorders commonly display mood disturbances consistent with depression and anxiety disorder. Major depressive disorder, generalized anxiety disorder and obsessive-compulsive disorder are the most common psychiatric conditions in people with eating disorders. It is commonly thought that anxiety disorders may precede the onset of an eating disorder, and depression persists after intervention and recovery. Interestingly, higher rates of eating disorders have also been linked to eating alone at an early age and having less than five family meals per week.

Many people with eating disorders also appear to suffer from depression, and is believed that there may be a link between these two disorders. For example:

  • In the central nervous system, chemical messengers known as neurotransmitters control hormone production. The neurotransmitters serotonin and norepinephrine, which function abnormally in people who have depression, have been discovered to also have decreased levels in both acutely-ill anorexia and bulimia patients, and long-term recovered anorexia patients.
  • Research has shown that some patients with anorexia may respond well to antidepressant medication that affects serotonin function in the body.
  • People with anorexia, or certain forms of depression, seem to have higher than normal levels of cortisol, a brain hormone released in response to stress. It has been shown that the excess levels of cortisol in both persons with anorexia and in persons with depression are caused by a problem that occurs in, or near, the hypothalamus of the brain.
  • Biochemical similarities have been discovered between people with eating disorders and obsessive-compulsive disorder (OCD), and patients with OCD frequently have abnormal eating behaviors.
  • The hormone vasopressin is another brain chemical found to be abnormal in people with eating disorders and OCD. Levels of this hormone are elevated in patients with OCD, anorexia, and bulimia.
Judy Caplan
Nutrition & Dietetics Specialist

Overeating can mask depression by hiding the feelings of sadness and loneliness. Often when people are depressed they use food to comfort themselves. Overeating can affect the brain to release hormones that cause well-being. Basically they are using food to self-medicate. Unfortunately this leads to overweight which can cause a new set of mental health issues that can deepen the depression.

Dr. Ramani Durvasula, PhD
Psychology Specialist

Depression sufferers can use food to mask, numb and distract them from their emotions and sad feelings. In this video, I will discuss emotional overeating, and how our food choices can impact our emotional well being.

Dr. Lara Honos-Webb, PhD
Psychology Specialist

Overeating is a quick and easy way to dull or numb painful feelings. Overeating can also give you energy that seems to hide the despair and fatigue of depression. If you overeat to mask depression, it may take on such a habitual quality that at the first sign of a feeling of hopelessness or sadness you automatically reach for sweets or high-fat foods to dull the sense of emptiness and pain. In this way, you may never really recognize the underlying depression. You may struggle with your compulsive eating, but you may be unaware of the harshness of your emotional landscape.

The reason the compulsive overeating maintains itself is that once you restrict your eating you come face to face with the depressive feelings, which feels like a punishment. Any behavior that increases pain is likely to be stopped pretty quickly. The only escape from this vicious circle is to practice increasing your tolerance of the pain that drives you to overeat.

Listening to Depression: How Understanding Your Pain Can Heal Your Life

More About this Book

Listening to Depression: How Understanding Your Pain Can Heal Your Life

A New Way of Thinking About DepressionWhat does it really mean to be depressed? You know depression as a collection of symptoms—fatigue, listlessness, feelings of worthlessness—and the source of...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.