When an eating disorder has "friends"

These friends, of course, are other mental illnesses. Eating disorders, of course, don't need any accompanying disorders to be miserable and deadly- they're quite capable of that on their own. And many sufferers can develop depression and anxiety while ill with their eating disorder, in part due to the malnutrition (yes, even if your weight is "normal" or you have a binge and/or purge pattern) and in part due to the sheer misery of the illness itself.

Sometimes, though, these disorders precede the eating disorder. Mine did. I've had OCD over half my life, as well as depression, both a full 4+ years before I started overexercising and restricting. I didn't think they were disorders, I just thought this was how life was going to be.

The OCD and depression play greatly into the eating disorder. Anxiety kills my appetite, flips off the switch between brain and stomach. Depression does as well, though it also makes me less motivated to fight off the ED thoughts when they arise.

Despite these other diagnoses, my first treatment priority was refeeding. Treatments for these disorders don't work when you're at a low weight and not eating properly. So I had to eat, and that did help with some of the symptoms. Not all of them, however, and so here I am, still in therapy (though admittedly, I'm also still in therapy for the eating disorder). I take meds for both OCD and depression, which helps, but not 100%. I couldn't function without them, however.

A recent essay from the Atlanta Journal-Constitution spoke to this need to treat the "underlying disorders" as well as the one that's the most obvious:

"My brain plays dominoes with these disorders. A bout of mania knocks over the depression domino, which knocks over the anorexia domino, which knocks over the exercise-drug-alcohol addiction domino, which goes on and on.

It took decades for me to figure this out. It took even longer to realize that the chain-reaction that effortlessly topples the dominoes does not work in reverse. They won’t automatically pop up if I manage to right just one.

Each disorder has its own treatment. Successfully treating one will not necessarily cure the other. A bipolar drug addict who gets clean is still going to have eye-popping mood swings, bursts of energy and paralyzing depression if the bipolar is not treated, too.

A food addict who smokes and gets treatment for her eating disorder but keeps smoking is still addicted to nicotine. Same with the alcoholic who cuts herself. She is not necessarily going to stop cutting just because she gets sober.

Like I said, it’s not fair. It is even worse because many doctors don’t understand this. They treat one illness but fail to diagnose the companion disorder(s). Then we blame the antidepressants or therapy for not working and we quit. Life becomes hell, all over again.

My solution: Surrender. Recognize the other disorders and treat them, too. I don’t think of it as being a loser. I just joined the winning side."


MelissaS said...

great points. i suffer from anxiety and depression. i was also a drug addict and have on and off problems with alcohol. i treat all of this, but it is exhausting! eating's under control, but i want wine. i'm not drinking, but i start thinking about food too much. drinking makes me depressed and anxious. not drinking makes me anxious. i take an anti-depressant, and it helps. i don't do drugs. other than that -- i really struggle. great post!

Anonymous said...

The truth. Anxiety and fear kill the appetite. I eat and then I feel depressed. I get depressed and then I don't want to eat. If I don't purge then I cut...to get rid of the anxiety...and to prove that I am real...that I am alive. Sometimes I do it just to feel. There's that line in the song..."Yeah you bleed just to know you're alive." Everything is wrapped up - and thinking about it all...it's exhausting.

marcella said...

Very good points. Now to actually get someone professional to get them. Ironically the drive towards "evidence based treatments" has made it more difficult around here for people to be seen as individuals and get treatment for more than one illness at a time. "Treatment for eating disorder is CBT" was the judgement of my least favourite psychiatrist in the world (so far, I expect there'll be more along the line) and it's TRUE. Specialised CBT IS the treatment of choice for eating disorders, but it isn't going to be much good if anxiety disorder makes it impossible to get out of the door to attend the therapy, or ADHD makes the patient lose her food diary in the first day.

Gaining Back My Life said...

Wow I guess I have an excellent PCP. He began treating me for depression and anxiety (although it was prior to the refeedng, so it didn't help much). Although he's not an expert on anoerexia, my D informed me that my meds would work better if I started eating again.

Truth be told, things are getting a *bit* better as I continue to nourish my body. But if I wasn't taking the meds, I would most certainly be deep in depression and anxious ashell, spiraling me into the restricting cycle again.

Bravo for people who recognize how complex our mental health can be (sounds obvious, but you never know...)

thethirddegree said...

"I didn't think they were disorders, I just thought this was how life was going to be." Those two sentences connected so close to my heart today.

I know that feeling. I deal with "connective" disorders like this and they feed off one another. It's frustrating at times, but other times I'm able to just embrace it and know that this is who I am.

Carrie Arnold said...

Part of the reason I picked that particular quote to share was the image of the dominoes falling- it's so like that with mental health. One little push, and the whole thing goes toppling over.

I guess like Mad Eye Moody said, you just have to be vigilant.

John P. Murtha said...

Depression is just one of the mental illnesses that people can actually suffer from but it is in fact the most common. It is caused by a chemical imbalance in the brain and can lead to mood swings, low self-esteem and self-harm. http://www.buy-xanax-online-now.com/

Sarah said...

wonderful post, Carrie.

my favorite line about surrender --
when you surrender, they stop shooting at you.


weight loss said...

I have eating disorder when using phentermine.

Post a Comment

Newer Post Older Post Home

ED Bites on Facebook!

ED Bites is on Twitter!

Search ED Bites

About Me

My photo
I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

Drop me a line!

Have any questions or comments about this blog? Feel free to email me at carrie@edbites.com

nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


Popular Posts


Recent Comments