Depression is rampant in our society. It stems from a combination of social, biological, emotional, and economic factors. It depletes physical, emotional, and mental well-being. While everyone feels down sometimes, it is important to distinguish normal feelings of sadness from clinical depression. Professionals characterize the latter by extreme feelings of worthlessness, hopelessness, and helplessness. These are also commonly experienced by individuals with eating disorders. But did you know depression and eating disorders often occur simultaneously?

Research shows an alarming prevalence of depression in people who have eating disorders. 33-50% of people with anorexia, and nearly half of people with bulimia and binge eating disorders, struggle with depression. Often, the same or similar underlying causes (fear, trauma, loss, insecurity, etc.) result in someone developing both depression and concurrent disordered eating behaviors.

If you or a loved one is struggling with an eating disorder and also seem to be depressed, it can be helpful to understand the interplay between the two.

Whitney McMullan, LCSW Psychotherapist/Recovery Coach & Care Coordinator for Eating Disorder Recovery Specialists, sheds light on some of the numerous ways that eating disorders and depression feed each other: “Both isolate the person dealing with them. With an eating disorder, the more one engages in behaviors, the more one creates distance in meaningful relationships–which creates depression, which is isolating in and of itself. And often depression leads to use of eating disorder symptoms…so it becomes a vicious cycle.”

Individuals also often engage in disordered eating as a means of coping with the seemingly intolerable feelings of depression. Becca, a young woman in recovery from anorexia nervosa, struggled with major depressive disorder for years. She reflects on how she used her eating disorder to cope with her depression. “I often convinced myself that my restriction was simply a reaction to the sadness that filled up my whole body, or a necessary means to the end of numbing the combination of devastating emotions. In a way, I believe my anorexia began as a form of self-medication.”

At the root of it all, Becca sees her depression as the deepest source of her struggle: “My depression was both the catalyst and the fuel for the entirety of my struggle with both sadness and food.” She points out how when one of her mental health conditions feels steadier, the other is prone to taking over: “I’ve walked into the trap of feeling resolved as I establish my anorexia recovery, only to leave myself utterly vulnerable to an episode of severe depression.”

But this insidious cycle can be broken, with support, awareness, and patience.

Whitney encourages individuals who are working on healing from both eating disorders and depression to allow the recovery process to be slow. She explains: “We are a society of instant gratification. We don’t always do a good job tolerating the slow pace at which change happens, which can throw someone back to being entrenched in their eating disorder and depression. It’s important to remember–and to be reminded by one’s treatment team and loved ones–that learning to tolerate and sit with a difficult thought or feeling is the work of recovery…but this does not mean sitting in the difficult thought or feeling.” The key is to cultivate awareness without being self-critical–no small task, but the only way to truly overcome avoidance, minimization, and stagnation in suffering.

For Becca, it has proven imperative to remain constantly aware of her feelings and thoughts: “I cannot overstate the importance of vigilance. Mental illness likes to sneak back into thought and behavior in the most subtle, conniving ways.”

Whitney also emphasizes the importance of having realistic expectations of the often rocky recovery process: “Often, people believe that when things start to get better, everything will be better. So when there are still difficult emotions present, it can sometimes feel frustrating, like no progress has occurred, which can lead back to depression and eating disorder behaviors.” Whitney encourages people to be “clear and specific and realistic about what their hopes and goals are.” This way, they will take small steps away from their struggles, and be able to see and acknowledge their forward movement.

Try recognizing the small accomplishments. As Becca has learned, they add up to large-scale life change. One year into strong recovery from her eating disorder, she is filled with gratitude for her committed work to overcome her eating disorder: “I have a healthy body and mind, I am returning to college in the spring, I am able to make and keep relationships, and most importantly I have my spirit back.”

However, once she had regained stability on the eating disorder front last summer, she fell into the most severe depressive episode of her life. But because she had persevered in her eating disorder recovery, she was able to tend to her depression: “Because I was physically healthy for the first time in my life, I was able to address my depression in a real way. I fought to keep eating, because for the first time in my life I knew that I couldn’t address and defeat my depression any other way.” By staying on track with her eating disorder recovery, she was able to come “back to life in a way where I finally believe that I will make it out of this alive and maybe even happy.”

Whitney encourages those who are doing the hard work of recovery to remember: “It’s possible to feel better and recover. And–it’s a difficult path. It’s important to validate the struggle, but not get stuck in the struggle.”

If you or someone you know may be struggling with depression as well as eating disordered behaviors, please contact Eating Disorder Recovery Specialists. We are here to support you!