Anorexia Statistics Reveal That Other Mental Disorders Play A Part. How?

According to statistics, when someone has an eating disorder, they are usually also experiencing another mental illness (if not more than one). It's called psychiatric comorbidity, and it's quite common for people with eating disorders, not to mention that an eating disorder is in itself a mental illness. Psychiatric comorbidity means that along with the eating disorder, there is another mental illness at play. What are these mental illnesses, and how do they impact the quality of life for someone with anorexia nervosa?

If you or someone you know is living with an eating disorder, consider reaching out to the National Eating Disorder Association Helpline at 1-800-931-2237.

According to the National Institute of Mental Health, eating disorders often occur in conjunction with other mental illnesses, such as depression, anxiety disorders, and other conditions. 

In one study, researchers examined patients with anorexia nervosa, bulimia nervosa, and binge eating disorder. Their research revealed that of all the eating disorder patients, over 70% of them had at least one other type of psychological disorder.

Anxiety was the most frequently occurring mental illness, and it showed up in 53% of the individuals who were studied. Anxiety appeared to be the highest in those with binge eating disorder and bulimia nervosa, but the anorexia group still showed anxiety. When it came to other comorbid disorders, 30 to 50% of people with anorexia nervosa also had depression.

What is the relationship between anorexia nervosa and a comorbid disorder like depression or anxiety? For example, which comes first—anorexia or comorbid mental illness? And to what extent do these comorbid mental illnesses strengthen anorexia nervosa in individuals?

The relationship between depression and anorexia nervosa

The symptoms of one comorbid condition can exacerbate those of the other. Someone who experiences depression may turn to disordered eating to cope with their negative feelings, which can lead to worsening symptoms of depression. It creates a cycle that can reinforce itself and may be hard to break.

One of the most common treatments for depression and anorexia is therapy, during which a mental health professional will work with the individual to address both the disordered eating and their thought patterns and mood. 

Depression and anorexia nervosa similar symptoms

It goes without saying that an individual with anorexia nervosa may have symptoms indicating extreme weight loss, malnourishment, amenorrhea, and other physical symptoms. These symptoms are not always indicative of depression, though they can be.

Depression and anorexia have many key symptoms in common. For example, both of these mental disorders exhibit the following signs:

• Fatigue
• Difficulty concentrating
• Difficulty making decisions
• Skipping meals
• Lack of emotion
• Loss of interest in activities once enjoyed

As you can see, one mental illness can worsen the other and make it difficult to know where one ends and the other begins.

Anxiety and anorexia

Like depression, anxiety can lead to or follow, anorexia. However, anxiety is the most common disorder to accompany eating disorders. Some researchers would even argue that anorexia should be considered an anxiety disorder. A 2004 study published in The American Journal of Psychiatry found that most of the study participants had OCD, social phobia, or generalized anxiety disorder as early as childhood, before the eating disorder even developed. Even individuals who did not have a history of anxiety disorders still "tended to be anxious, perfectionistic, and harm avoidant."

Therefore, researchers came away with the hypothesis that some individuals are more vulnerable to developing anorexia nervosa than others if they exhibit either an anxiety disorder or anxious, perfectionistic traits in general. (Note: Mental health research is constantly evolving, so older sources may contain information or theories that have been reevaluated since their original publication date). 

Why is anxiety so prevalent in cases of anorexia?

It makes sense that anxiety and anorexia go hand in hand. They both center around worry and anxiety; these same emotions often surround food, body weight, body image, calorie counting, and restriction.

While some researchers would hold that anorexia is a form of anxiety, it's still up for debate in the academic community.

What is the role of substance use in eating disorders?

There is strong evidence showing that eating disorders and substance use disorders co-exist. The National Eating Disorder Association states that nearly 50% of individuals with an eating disorder also use drugs and alcohol at "a rate five times greater than the general population."

However, substance use appears less common for individuals with anorexia nervosa than other eating disorders. Research has found that there are more instances of substance use disorders among those with bulimia nervosa than in both restrictive and purging types of anorexia nervosa.

Nonetheless, the co-occurrence of both substance use and anorexia nervosa is logical when one considers that people often develop these two mental illnesses as a way to gain control of some areas of their lives. What's more, a high amount of impulsivity is a trait between the two mental health disorders.

Even though individuals with anorexia nervosa have lower rates of substance use, both illnesses can result in additional hardships. Therefore, seeking early intervention from a mental health professional is recommended. Their valuable training and knowledge can offer timely counseling and assistance to someone experiencing comorbid mental illnesses.

Since the motive or reason behind the eating disorder and the substance use may stem from the same issue, a mental health professional can help address the root problem and treat both disorders simultaneously.

How can you help someone who has anorexia nervosa?

It's important to seek professional help to address an eating disorder like anorexia. Since most people living with anorexia have some form of comorbid mental illness, the best way for you—the friend or family—to help may not be immediately clear.

Each situation is unique and can be very complicated, and your relationship with the person experiencing comorbid conditions can add even more layers that are difficult to navigate objectively. These disorders can be very hard to manage for the individuals living with them, but also challenging for family and friends. Sometimes, loved ones can unknowingly make matters worse. 

• Remember that the eating disorder isn't always just about food. Sometimes, it's about something much deeper.
• Remember that the individual must want to recover for you to be able to help.
• Remember that you are not their mental health professional. It's important to have personal boundaries and take care of yourself, too.
• Remind the person that it's okay to get help and that you can help them find a licensed, experienced professional if they're open to that.
• It's okay to tell them you're concerned, but don't make their situation about you. It's about them.
• Be an open space for them. Stay firm, loving, patient, and supportive of them, but never of the eating disorder.
• Avoid shaming them.
• Don't deny, avoid, or pretend the eating disorder isn't happening.
• Don't try to force them to eat.
• Don't set any ultimatums or reward systems, like, "If you don't eat more, we're not doing x, y, or z," or "If you eat this dessert, I'll give you x, y, or z."
• Avoid conversations about weight or body appearance. Instead, focus on emotions and feelings.
• Don't provide them with simple solutions. Remember that this is a complicated experience for them, and if the solution were that easy, they probably would have figured it out on their own.
• Do listen.

Finding help

Cognitive behavior therapy is a common treatment for eating disorders. Speaking with a licensed therapist can help you understand your eating disorder and what other mental health conditions may be playing a role in your overall well-being. They can also offer solutions to help you reduce symptoms and manage your anorexia. If someone you love is living with an eating disorder, speaking with a therapist can help you uncover the best way to handle the situation and ensure your well-being stays intact. 

If speaking with a traditional therapist isn't available, consider online therapy through a platform like BetterHelp. With online therapy, you can participate in sessions from the comfort of your home, making it easier to start the recovery process. It can also make it easier to find therapists with the right specialties, which might not be available in your local area. 

Research has shown that online therapy is as effective as in-person therapy for treating common mental health conditions like anxiety and depression. It's also been shown to be an effective alternative to in-person treatment for eating disorders.