How depression and eating disorders are related

Eating disorders and depression are two of the most common mental health conditions. Together, they affect millions of people nationwide. These conditions often co-occur, with research showing that most  people with an eating disorder also live with depression.

If you live with both depression and an eating disorder, it might feel like there’s an insurmountable mountain in front of you. But there’s hope, and you’re not alone. Both depression and eating disorders are highly treatable conditions, and, with therapy, you can build a meaningful and happy life.

Where depression and eating disorders overlap

People with all types of eating disorders — including anorexia nervosa, bulimia nervosa, and binge-eating disorder — are more likely to develop depression than people without an eating disorder. Some research has found that up to 93% of people with an eating disorder also have depression.

Official reports estimate that people with bulimia are the most likely to have a co-occurring mood disorder by a wide margin.

According to these reports, more than 40% of those with anorexia, 70% of those with bulimia, and 45% of those with binge-eating disorder also live with depression or bipolar disorder. In addition, younger people (adolescents and young adults) with eating disorders are at the highest risk of also having depression. 

Living with both depression and an eating disorder can feel challenging. Research shows that people with both depression and an eating disorder experience more severe eating disorder symptoms as well as worse quality of life. 

With many overlapping signs and symptoms, depression may reinforce an eating disorder, and vice versa.

Self-esteem and body image

People with depression tend to have lower self-esteem. They may be plagued with feelings of worthlessness and guilt. Self-esteem comes into play with eating disorders as well. People with eating disorders have a higher tendency to associate their worth to their body shape or size. 

Genetics 

There could also be biological links between eating disorders and depression. One study found that anorexia and depression share 38 specific genetic markers, which are like tiny instructions in your DNA. This may explain why these two conditions appear together so frequently — the same genes that increase your risk for one condition also increase your risk for the other.

Brain differences can also come into play here. For example, depression can cause executive dysfunction, which affects more complex cognitive skills like impulse control. For example, this can make it more difficult to resist a binge-eating or purging episode.

Perfectionism

Perfectionism is also a known risk factor for both depression and eating disorders. If you live with these conditions, you may tend to set sky-high standards for yourself that are impossible to meet. When you’re unable to meet these standards, it could increase feelings of worthlessness and failure, which then lead to depression. Similarly, you might expect yourself to have a “perfect” body, which may increase your vulnerability to develop an eating disorder.

How depression can worsen eating disorders, and vice versa

There’s no single answer as to why depression and eating disorders appear together so frequently. Just like there are complex factors that lead to eating disorders and depression individually, there are also complex factors that can increase your risk for developing both.

Depression and eating disorders also interact in ways that can increase symptoms. 

Can depression cause an eating disorder?

It’s inaccurate to say that depression directly causes eating disorders. But some symptoms of depression may make you more vulnerable to developing an eating disorder.

For example, depression causes feelings of worthlessness and low self-esteem. This lack of self-worth could contribute to body image issues that may develop into an eating disorder.

Eating habits are also highly influenced by depression. One of the core symptoms of depression is a change in eating habits. You might lose your appetite and find it difficult to eat regular meals. Or you might experience the opposite; you might start eating more than usual as a way to cope with stress and depression.

Either way, these drastic changes in appetite and eating patterns can contribute to the development of an eating disorder. If you gain weight, you could develop body image issues. You could be tempted to try to lose weight in unhealthy ways. You may also develop binge eating disorder, especially if you eat to cope with painful emotions.

Can an eating disorder cause depression?

The causes of depression are complex as well, but having another health condition — including an eating disorder — significantly increases your risk of developing depression. 

Part of this is because of the stress that comes along with living with an eating disorder. Eating disorders can come along with many painful emotions and negative impacts on your life, including:

• Feelings of shame
• Social isolation
• Physical fatigue
• Nutritional deficiencies

In addition, research on the gut-brain axis and nutrition can help us understand how eating disorders can increase your risk of depression. The gut is home to trillions of microorganisms (the gut microbiome) that affect brain function and mood. It’s so important to mental health that it’s often called the second brain. 

If you have an eating disorder — especially one like anorexia that can cause severe nutritional deficiencies — you could develop a disrupted gut microbiome, which could then worsen depression symptoms.

Addressing depression in treatment for eating disorders

If you live with an eating disorder and depression, it’s critical to get the right diagnosis and treatment for both conditions to heal. Because these two conditions are so highly interwoven, improvement in depression symptoms can also lead to improvement in eating disorder symptoms.

On the other hand, if you ignore depression and focus only on treating the eating disorder, you may risk resorting to disordered eating behaviors to cope with the untreated depression.

Your healthcare provider can work with you to decide if treatment for one condition needs to be prioritized first. For example, if your physical health is in jeopardy due to an eating disorder, you may need to treat this condition first.

The two most effective treatment methods for eating disorders and depression are interpersonal therapy (IPT) and cognitive behavioral therapy (CBT).

• IPT: This type of therapy helps you improve your interpersonal relationships. It can help you understand the social context for both depression and eating disorders and address social problems, like isolation, that may have contributed to both conditions.
• CBT: This approach focuses on the way your thoughts, behaviors, and emotions are interconnected. A therapist who specializes in CBT can also help you reframe or challenge the negative thought patterns that may contribute to your eating disorder and depression.

Find care with Rula

Living with depression and an eating disorder can feel challenging, especially as the symptoms of each condition reinforce the other. But rest assured that treatment is available for both conditions. With therapy, you can find your way back to happiness and health.

With Rula’s user-friendly therapist matching system, you can easily find a therapist who takes your insurance and specializes in depression and eating disorders. Don’t hesitate to reach out for help — you can begin treatment as early as this week.

Get started with Rula today