Some who struggle with an eating disorder also have one or more additional mental health disorders. This is known as a dual diagnosis, and the two disorders are called “co-occurring.”
Read on to learn more about dual diagnosis and how it’s treated.
Most common co-occurring disorders
It is actually very common for people to have co-occurring mental health and eating disorders. The National Association of Anorexia Nervosa and Associated Disorders reports that about 50% of people who struggle with an eating disorder are also challenged by a mood disorder such as anxiety or depression.
Other mental health conditions that can co-occur with an eating disorder include:
- Trauma or post-traumatic stress disorder (PTSD);
- Body dysmorphic disorder;
- Substance use disorder;
- Major depressive disorder or suicidal thoughts;
- Obsessive compulsive disorder (OCD);
- Trichotillomania;
- Non-suicidal self-injury.
Some of these conditions tend to happen more frequently with certain types of eating disorders. For example, those of us facing bulimia nervosa are more likely to struggle with drug and alcohol abuse. It is also possible to have two or more mental health conditions along with eating disorders.
How do mental health disorders impact eating disorders?
Mental health disorders worsen eating disorder symptoms, and vice versa. A dual diagnosis can also make treatment more complex, as it will need to address both the eating disorder and the co-occurring mental health disorder. If one condition is left unaddressed, recovery may be slowed or stunted.
For example, consider a woman with generalized anxiety disorder who completes a residential treatment program for bulimia. Soon after she leaves the treatment center, she experiences severe anxiety and starts to binge and purge as a coping mechanism. Without addressing the underlying anxiety disorder, the woman was unable to cope with her symptoms in a healthy manner. Treatment, therefore, should focus both on bulimia and anxiety.
It is also important to note that an eating disorder itself is a mental illness. Co-occurring mental health disorders necessarily intertwine and can thereby exacerbate one another.
Can eating disorders cause mental health disorders?
It is unclear whether eating disorders directly cause other mental health disorders. Researchers have different theories about what triggers co-occurring disorders, but there are a few potential causes of a dual diagnosis.
Similar risk factors
Eating disorders have some of the same risk factors as mental health conditions, including:
- Genetics;
- Environmental factors like abuse or bullying;
- Stressful life events such as divorce or death of a loved one;
- Trauma;
- Social environment.
Possessing these risk factors can make us more susceptible to developing two or more mental health conditions. Researchers believe there are biological links between eating and mood disorders.
Shared symptoms
Eating disorders and other mental health disorders can also have similar symptoms, including:
- Withdrawal from family and friends;
- Difficulty concentrating;
- Compulsive thoughts and behaviors;
- Mood swings;
- Perfectionism;
- Feelings of low self-esteem, guilt or depression.
The potential biological connection between eating disorders and other mental health disorders can also play a role here.
Differences in brain chemistry
Brain imaging studies reveal that those of us living with anorexia, and even those in recovery from the disorder, have key abnormalities in our brains. Researchers at University of California, San Diego have found that the brain chemistry of someone with an eating disorder demonstrates under-active limbic circuity (an area of the brain related to feeling rewarded by pleasurable experiences) and a disruption in serotonin neuronal systems that could contribute to increased anxiety. While it’s not clear whether this abnormal brain chemistry contributed to or was caused by anorexia, it points to a neurological link between eating disorders and mood disorders.
How to treat co-occurring disorders
The Substance Abuse and Mental Health Services Administration (SAMHSA) recommends an integrated approach to treating co-occurring disorders. This means that you would receive both eating disorder and mental health treatment interventions at the same time. For example, a treatment program might offer meal practice and nutrition education to address eating disorder behaviors, as well as group therapy and medication management to improve a mental health condition.
When looking for a dual diagnosis program, ask about the specific treatment methods. Look for a mixture of traditional therapies and eating disorder interventions. Be sure to ask the clinicians if they address co-occurring disorders and the underlying causes of an eating disorder.
Do you face co-occurring mental health disorders?
If you believe you are experiencing an eating disorder and a mental health disorder at the same time, it’s important to enter a qualified treatment program that addresses both conditions. At Seeds of Hope, we treat the whole person. Our clinicians help each client identify the root cause related to each disorder.
Our residential treatment center remains open during the COVID-19 outbreak and all of our outpatient services are offered through teletherapy. No matter where you live in Pennsylvania, you can participate in online treatment.
We are currently conducting all admissions assessments through BlueJeans, a HIPAA-compliant video conferencing platform. Call us at (610) 644-6464 to schedule your first appointment.
