Depression & Eating Disorders: Are They Related?

Can Depression Cause an Eating Disorder?

There is no singular cause for an eating disorder, but depression can contribute to the development of eating disorders.² Depression causes all types of disturbances in appetite. A person with depression may turn to food and overeating as a source of comfort. This can lead to a pattern of disordered eating, which could include binging as a way to numb difficult emotions or restricting food as a way to try to gain control. Depression also causes low self-esteem, which can increase the risk of an eating disorder.

Can Eating Disorders Cause Depression?

Eating disorders can cause or exacerbate symptoms of depression for many reasons. Malnutrition can have a significant impact on brain chemistry, which can cause a disruption in neurotransmitters that help regulate mood. Eating disorders can also create feelings of self-hatred, shame, and low self-esteem; all of these can be triggers for depression.³ Additionally, there is a lot of stigma surrounding eating disorders, which can lead to isolation and worsen depression.

Here is how the different types of eating disorders can cause depression:

Anorexia Nervosa & Depression

Anorexia nervosa can lead to depression for several reasons. First, anorexia can cause severe malnutrition, which can decrease serotonin and dopamine levels, causing severe dips in mood. Secondly, anorexia involves intense negative feelings towards one’s body, which can cause the person to feel depressed and hopeless. Finally, individuals with anorexia often have less energy to socialize and do the things they enjoy, which can make them feel lonely and isolated.⁴

Bulimia Nervosa & Depression

There are many reasons bulimia nervosa can lead to depression. Physically, purging can lead to malnutrition, which can reduce the amount of serotonin and dopamine a person has in their brain and cause depression. Additionally, bulimia can lead to long-term physical health complications, such as electrolyte imbalances, gastrointestinal issues, and teeth problems, which can also cause depression.

Bulimia is one of the most stigmatized eating disorders, which can create immense shame and guilt, both of which can cause the person to feel depressed. Furthermore, because it is so stigmatized, individuals with bulimia often keep their disorder as a carefully guarded secret and are less likely to reach out for support. This can make them more isolated in their struggles and likely to feel hopeless. Additionally, individuals with bulimia often have very poor body image and low self-esteem, which can lead to feeling worthless and hopeless.

Binge Eating Disorder & Depression

Binge eating disorder, which is characterized by eating large amounts of food to the point of discomfort, is often followed by feelings of guilt and shame. These feelings can escalate into depressive episodes. Depression can also result in overeating and using food as an unhealthy coping skill. Therefore, these disorders can feed into each other and create a repeating cycle of binging, being depressed, and binging more.

How to Cope with Depression & Eating Disorders

Learning to cope with depression and an eating disorder is possible, but it will take time, patience, and a lot of professional and personal support. Because of how dangerous eating disorders and depression are, making sure you are getting professional treatment is the most important first step. Aside from treatment, there are coping strategies that you can use on your own to help you get through tough moments. There is no one-size-fits-all approach – it is about finding the skills that work best for you.

Here are eight ways to cope with an eating disorder and depression:

1. Establish a Routine

Establishing a healthy daily routine can be helpful for managing depression and eating disorders. A routine provides structure, and incorporating meaningful activities into the day can help with the lack of motivation and energy caused by depression. For someone with an eating disorder, routines can be especially helpful in re-establishing a healthy eating schedule, including three meals a day and recommended snacks.

2. Practice Mindfulness Daily

Mindfulness is simply the act of noticing the present moment without judgment. This could include setting a timer, noticing one’s breath coming in and going out, or listening intently to a piece of music. Mindfulness can help with depression by reducing stress levels and teaching a person to focus on the present rather than sadness about the past or hopelessness about the future. Mindfulness can also help someone with an eating disorder focus on the present moment rather than anxiety about what they ate or how the food will impact them in the future.

3. Join a Support group

Support groups can reduce the isolation, secrecy, and shame that often come with depression and eating disorders. Attending regular meetings with others who are going through the same issues can provide emotional support and allow participants to share coping skills for eating disorders and depression.

4. Find a Creative Outlet

Creative activities like writing, painting, or playing a musical instrument provide a healthy way to explore your depression and eating disorders without it being overwhelming. An example of a therapeutic art project is creating two face masks, one representing how the outside world sees the person and the other representing how they feel on the inside because of their eating disorder and depression. Use any paints, colors, or accessories that can make the differences come to life.

5. Monitor Triggers

Keep track of people, places, and things that trigger both depression and the eating disorder. Noticing these triggers and writing them down not only builds an increased awareness it can also help you start to identify patterns that will help you avoid these things in the future.

6. Get Good Sleep

Healthy sleep habits and a consistent sleep schedule can improve mood and energy levels. This can help to manage symptoms of depression that contribute to disordered eating. This includes activities like a calm bedtime routine, limiting caffeine in the afternoon, and reducing screen time before bed.

7. Set Boundaries

Learning to set healthy boundaries with others can reduce a person’s stress level and help them manage symptoms of depression and eating disorders. This includes saying no to additional responsibilities, staying in rather than going into a triggering situation or seeing a triggering person, or limiting exposure to social media content that triggers eating disorder behaviors.

8. Manage Stress

Chronic stress can lead to an increase in symptoms of depression and make a person turn to their eating disorder as an unhealthy way to cope with feeling overwhelmed. Some healthy ways to manage stress include talking to a friend, going for a walk, engaging in a fun hobby, or limiting exposure to stressful situations.

Treatment for Eating Disorders & Depression

It is critical to find professional mental health support when struggling with an eating disorder and depression. Eating disorders get progressively worse, so the sooner a person receives treatment, the better. Because eating disorders and depression go hand-in-hand, and one disorder makes the other worse, it is important to treat both simultaneously.

The most successful type of treatment for someone who has both depression and an eating disorder is having a collaborative care model with a team of mental health professionals, such as a therapist, psychiatrist, and nutritionist, who address different aspects of their struggles. There are different levels of care, depending on the severity of the eating disorder and depression. A doctor or individual therapist who specializes in eating disorders can help to assess what level of care is most appropriate and how to move forward.

Treatment for eating disorders and depression involves:

Therapy

There are many different effective types of therapy for eating disorders and depression, and no one type is better than all the others. Instead, focus on choosing a therapist who has experience with eating disorders and whom you trust and feel safe with because these are crucial to therapy being successful. Once you have found a therapist you would like to work with, they can help you find other people for your team.

Therapy options for comorbid eating disorders and depression include:

• Cognitive behavioral therapy (CBT): CBT for eating disorders and CBT for depression both focus on a person’s negative thoughts (i.e., “I am never going to heal from this eating disorder, so there is no point in trying”) that are leading them to unhealthy behaviors that make them worse. By changing the way a person thinks, they can change their behaviors and begin to heal from their eating disorder and depression.
• Dialectical behavior therapy (DBT): DBT for eating disorders and DBT for depression are subtypes of therapy developed by Marsha Linehan, which focuses on helping people accept and cope with the distress they cannot change (i.e., hating the way they look in the mirror and getting sad), while also taking steps to change the behaviors they are in control of (i.e., doing things with your body that you love to increase self-love).
• Group therapy: Group therapy for eating disorders is an effective form of treatment because eating disorders can make a person feel very alone and, therefore, more depressed. Group therapy will surround them with people who understand their unique struggles and also provide a space to get ideas about what worked for other people.
• Psychodynamic therapy: Psychodynamic therapy focuses on creating self-awareness and understanding the core underlying factors that trigger and keep a person’s eating disorder and depression alive. Both eating disorders and depression are often triggered by trauma, so exploring a person’s past and childhood can help heal those parts of themselves and thereby reduce both disorders.
• Art therapy: Eating disorders oftentimes involve a lot of shame, which can make traditional talk therapy difficult. Art therapy offers an alternative, creative approach to exploring thoughts and feelings surrounding an eating disorder and depression that may be hard to express with words.
• Somatic therapy: Somatic therapy is a holistic approach that incorporates the person’s mind, body, spirit, and emotions to uncover deep-rooted trauma in the body. Eating disorders and depression are often triggered by or made worse by trauma, so by working through the trauma somatically, a person can see a reduction in both disorders.

Medication

Medications for depression can directly decrease depression symptoms, which can help to stop a person from using their eating disorder to cope with depression.⁵ Research is still ongoing as to whether specific types of medications can help with the eating disorder itself. It is important to note that medication alone cannot cure depression and eating disorders. Medication can help lift the mood, and that can make working with the eating disorder in therapy more manageable.

When considering medications, make sure to find a psychiatrist who specializes in eating disorders because there are some types of medication that won’t be as effective when a person is malnourished, and also some medications that cannot be taken if an individual is actively purging.

Nutritional Counseling

A dietitian or nutritionist who specializes in the treatment of eating disorders is vital for helping a person develop a healthier relationship with food. This can include guidance on balanced meal planning and adequate nutrition for stabilizing mood. Beginning to eat properly will help the brain produce more serotonin and dopamine and thereby decrease depression.

How to Find Professional Support

When looking for a therapist or counselor, it is important to find someone who is experienced with treating eating disorders and depression, as the two disorders are connected and need to be treated at the same time. You can ask your general practitioner for a referral for a therapist. If you have a friend or a family member who struggled with an eating disorder, you can ask them for a recommendation.

Alternatively, you can begin your search using a local therapist directory and sort by specialty area and types of insurance accepted. If you prefer to see a therapist remotely, an online therapy service that takes insurance can be a good option. It is important to note that online therapy is not appropriate for individuals with severe eating disorders.