My new friend Adam Lamparello posted the following on his Facebook page One thing that many people discuss when it comes to eating disorders is the issue of co-morbidity, that is, many people with anorexia, bulimia or any other eating disorder also struggle with depression, anxiety, obsessive compulsive disorder, etc. I agree with this, in part because I had the same problem and the research supports this fact. But now, research is showing that eating disorders, and factors such as low-self esteem and extreme sensitivity, may have biological roots. In other words, we may be pre-disposed to developing an eating disorder and be predisposed to having the factors that are common to causing the development of an eating disorder (although there are many other factors unique to the individual). There's one thing that I do disagree with, though, and that seems to be that ED experts separate the issues of eating disorders and depression, anxiety, OCD, etc. Hence the term co-morbidity. I would hypothesize that anorexia and bulimia can actually cause depression and anxiety disorders in an individual who would not necessarily be pre-disposed to these conditions. At the very least, eating disorders can make these conditions considerably worse in those individuals that are predisposed to mental health issues or would not necessarily develop such issues based on pre-disposition alone. In fact, I think they are intertwined, especially when we eventually know the extent of their biological roots.
Basically, right on.
A lot of the personality and eating disorders research seems to indicate that many sufferers have a cluster of different personality traits that seem to predispose them to EDs. The two general clusters tend to be over-controlled, anxious, and perfectionistic, and the other is impulsive, anxious, and novelty-seeking. Not surprisingly, these personality clusters also predispose people to co-occurring conditions like depression, OCD, and personality disorders.
I do think that some people truly have co-occurring conditions. I've had episodes of severe depression, anxiety, and OCD that were totally separate from my eating disorder. But the eating disorder also amplified my obsessive, anxious, perfectionistic temperament, and not in a good way. You can't tackle co-occurring conditions if you're not also tackling the eating disorder. As well, regular nutrition generally tends to improve co-occurring conditions. For some people, what looks like depression and anxiety and whatever else are actually side effects of starvation.
The truth is that no one really knows whether things like OCD and depression are part and parcel of an eating disorder or they exist alongside of it but totally separate. Another example would be red hair and green eyes--I am proud owner of both these traits. Although they do frequently appear together, plenty of people with red hair have blue or brown eyes, and my mom has green eyes and blonde hair.
As well, no one knows at exactly what level these temperament traits become pathological. At what point do they cease to become odd quirks and start to be something that needs treatment. So no one really knows.
It's a question I wish more psychologists and researchers took time to ask.