Certainly not all, but many people with dysregulated eating suffer with underlying Depressive and Anxiety Disorders. Even if they don’t have full-blown disorders, they experience sub-clinical distress that is enough to contribute to eating problems. It’s not uncommon for me to hear about panic attacks, excessive worrying, isolation due to social angst, low energy, apathy toward beneficial activities, low self-esteem, a shame-based mindset, and over-focusing on controlling life. 

What is of interest here is how clients are much more likely to be aware of and wish to talk about their eating problems than the emotional distress which drives them. I am not saying that depressive or anxiety disorders (or any other mental health problems) cause dysregulated eating. All three are biopsychosocial conditions concurrent with eating disorders. But focusing solely on eating better, without attending to underlying issues of anxiety and depression, will derail even the best therapeutic efforts.

Here’s why this distancing occurs. Some clients are surprised when we review depression or anxiety criteria. They thought “that’s just how I am” because they often were raised by parents with the same mood disorder and it felt natural. Others feel great shame in recognizing that they have depression rather than “merely” an eating disorder. This was true as well for clients I worked with at a methadone clinic: they were more comfortable thinking of themselves as addicts than as people with “mental”  problems. 

Another reason for focusing on food rather than mental health is that eating problems seem simpler and quicker to solve. Clients think that if they do this and not that, they’ll soon be “normal” eaters, whereas overcoming depression or anxiety seems like overwhelming tasks. Yet another reason is that people believe they can recover from eating problems on their own but would need to ask for help if they had mental health issues. Sadly, dysregulated eaters usually are not great at asking for help (which is one of the reasons they turn to food when they have the blues or the blahs).  

If you think that you have a depressive or anxiety disorder, including panic attacks or social phobia, go online and see if your symptoms match up with DSM-5 criteria. Both depression and anxiety are treatable with better nutrition, exercise, support from others, cognitive-behavioral and other therapies, and resolving trauma (which is highly related to eating dysfunction)—and often medication. If you’ve been struggling with eating problems for a long time without treating underlying mental health conditions, no wonder you feel stuck or do well for a while, then relapse. It’s time to get help!

Best,

Karen

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