Comorbidity

Many people who have eating disorders often have other mental health disorders.  I have seen statistics stating that 50-75% of people with EDs will struggle with depression at some point, and 2/3 of individuals with EDs struggle with anxiety of some type.  This contributes to the fact that eating disorders are complicated and truly unique.

It is important to gain a full understanding of each disorder, as well as the relationship between the various disorders specific to each person.  In some cases, the eating disorder is actually a symptom that is underlying a different primary psychological disorder.  In other instances, the eating disorder may be primary, with other mental health diagnoses secondary.  It is important to explore the relationship between the disorders, as this can help guide treatment and lead to more effective outcomes.



Depression:

"Severe sadness, along with feeling worthless, hopeless, and helpless over a prolonged period of time are some of the hallmark symptoms of major depression. These symptoms interfere with a person's ability to work, sleep, study, eat, and enjoy once-pleasurable activities. Major depression is disabling and prevents a person from functioning normally. The Merck Manual notes that In some patients, "depressed mood is so deep that tears dry up; they report that they are unable to experience usual emotions and feel that the world has become colorless and lifeless." Nutrition may be severely impaired, requiring immediate intervention. Some depressed patients neglect personal hygiene or even their children, other loved ones, or pets. Many with major depression consider suicide as a serious option."

Symptoms may include pervasive feelings of sadness, worthlessness, hopelessness, changes in sleep patterns, loss of interest, fatigue, inability to focus, suicidal ideation, and physical symptoms such as headaches.

Hyperbole and a Half has one of the best descriptions of what it feels like to live with depression I have ever seen.  Check out part 1 and part 2.

Anxiety:

“Generalized Anxiety Disorder isn't about day-to-day worries. GAD is about chronic, excessive worry over events that are unlikely to occur. They may worry about finances just because a bill arrives in the mail, or health because they saw a news story on heart attacks. Then there's family problems, relationships, work. People with GAD can't turn off the worry. They dwell on what could go wrong.

Generalized Anxiety Disorder occurs when normal levels of anxiety become severe, prevent everyday activities, and persist over more than a few months. Normal life becomes difficult for people with GAD because they experience high levels of worry, dreading the immediate future and concentrating on all the bad possibilities that could come their way, but feel unable to take action or control events."

Symptoms may include excessive worrying or fears, changes in sleep, shakiness/trembling, sweating and cold/clammy hands, dizziness, tension, fatigue, racing heart or pulse, and upset stomach.

Obsessive-Compulsive Disorder (OCD):

"OCD is characterized by recurrent intense unwanted and obtrusive obsessions and/or compulsions that cause severe discomfort and interfere with day-to-day functioning. Obsessions are recurrent and persistent thoughts, impulses, or images (concerns about contamination, doubts that something that needs to be done hasn't been done, fear of loss, fear of hurting someone) that are unwanted and cause marked anxiety or distress. Frequently, they are unrealistic or irrational and may even seem silly, weird, nasty, or horrible to the person experiencing them. They are not simply excessive worries about real-life problems or preoccupations. Compulsions are repetitive behaviors or rituals (like hand washing, hoarding, keeping things in order, checking something over and over) or mental acts (like counting, repeating words silently, avoiding). In OCD, the obsessions or compulsions cause significant anxiety or distress, or they interfere with the person's normal routine, academic functioning, social activities, or relationships.
Most people with OCD are aware that their obsessive thoughts do not reflect actual risks and that their compulsive behaviors are ineffective. Obsessive-compulsive disorder, therefore, differs from psychotic disorders, in which people lose contact with reality. Obsessive-compulsive disorder also differs from obsessive-compulsive personality disorder in which specific personality traits are defined (for example, being a perfectionist).

People with obsessive-compulsive disorder are aware that their compulsive behaviors are excessive to the point of being bizarre, and they are afraid they will be embarrassed, shamed or stigmatized. Thus, they often perform their rituals secretly, even though the rituals may occupy several hours each day."

Post-Traumatic Stress Disorder:
"Post-traumatic Stress Disorder is a severe reaction to an extremely traumatic event. The person can actually experience the event (i.e. be in a plane crash) or be a witness to the event (i.e. rescue worker at a plane crash).
Over time and with psychological help, some people learn to cope with the aftermath of the event. However, for others, symptoms such as flashbacks and depression can become worse, lasting a long period of time, and seriously disrupting the person's life.
Sometimes symptoms do not begin until many months or even years after the traumatic event took place. If post-traumatic stress disorder has been present for 3 months or longer, it is considered chronic."

Symptoms may include: flashbacks, sleep disturbances, hypervigilance, difficulty concentrating, and excessive startle response.

Information taken from Healthy Place (http://www.healthyplace.com/)