I know there are very high rates of depression and eating disorders (especially bulimia) and after going through the diagnostic criteria for depression a thought crossed my mind. Eating disorders can cause a lot of the symptoms of depression. Does that mean that in some people with eating disorders, depression isn’t its own separate problem but something that will go away once the disorder is alleviated?
To have a diagnosis of depression, a person needs to possess five of the following:
1. depressed mood most of the day, nearly every day
a. I don’t think this can really be caused solely by an eating disorder, although if someone binges and purges a lot I’m sure they would be entitled to feel bad about it.
2. Markedly diminished interest or pleasure in all or almost all activities most of the day nearly every day
a. Well, if all you can concentrate on is not eating or your own illness, then your interest in other activities could certainly be diminished. In addition, the eating disorder kind of saps pleasure out of things. Dancing, an activity I used to enjoy, became something of a chore that I convinced myself I enjoyed because it burned calories. I was too tired to take pleasure in it.
3. Significant weight loss or weight gain
a. This can obviously be caused by any eating disorder
4. Insomnia or hypersomnia
a. If someone is starving themselves to the point of malnutrition, I think it’s harder to get to sleep. Conversely, the person might feel so tired all the time that she’s sleeping extra hours. That definitely happens to me, although I try to stay awake if it’s a weekday.
5. Psychomotor agitation or retardation
a. When I starve myself, my mental clarity goes way down, and it’s obvious, because after a binge, I feel sharp and alert. Or even after eating normally. Retardation is a natural effect of decreased mental clarity, so I think this could definitely be caused by an eating disorder.
6. Fatigue or loss of energy nearly every day
a. Purging takes all the energy out of you. Starving takes all the energy out of you. Exercising until you drop takes all the energy out of you.
7. Feelings of worthlessness or excessive or inappropriate guilt
a. I think almost everyone with an eating disorder feels this way.
8. Diminished ability to think or concentrate or indecisiveness.
a. Again, starving and the fog of binge/purge cycles decreases mental clarity, which causes decreases in concentration ability.
9. Recurrent thoughts of death or suicidal ideation
a. I don’t think that eating disorders alone can cause this, although there are certainly people who have suicidal thoughts along with eating disorders or because of them, or before them.
The total is 7 symptoms that could very easily be caused be eating disorders.
What does this mean?
I have no idea. It doesn’t mean that people with eating disorder and depression aren’t facing extra challenges, it doesn’t make anyone’s diagnosis less serious, and I could very well be wrong.
Food for thought though.