Article Contributed By: Dr. Gregg Jantz, Founder of A Place Of Hope
Anorexia and Co-Occurring Issues
I find that most middle-aged women who come to us for anorexia treatment are taking between four and six anti-anxiety and antidepressant medications.
This tells a troubling story of the prevalence of co-occurring anxiety, depression, and prescription drug addiction.
Anorexia and Anxiety
When you are suffering from anxiety, the worst is always just around the corner. This is not a fear founded on any evidence to suggest the worst is going to happen. Rather, it is a fear based on hidden assumptions you may have about yourself and the world around you.
I am not worthy. I am not able. I am not enough. I am alone.
The only way of living under siege of these negative thoughts is to develop coping mechanisms — or belief systems — that make life tolerable.
One of these belief systems is control.
Anorexia, Anxiety, and Control
An anxiety-filled life is one that feels out of control. Therefore, the belief is that the more control you have, the safer you will feel, thus the development of anorexic behavior.
You may not be able to control anything else, but only you have the power to control what you eat. In addition, the more you are able to resist your feelings of hunger, the more in control you feel.
In this manner, the underlying fear that is really fueling the anxiety shifts focus to a fear of gaining weight. Of course, the irony is that the fear of gaining weight only fuels more anxiety.
Anorexia and Depression
When you are living with anxiety, you are operating on high alert pretty much all of the time. Chronic worry and obsession with your body is an exhausting, full-time job.
Your mind and body can only sustain this high-octane existence for so long before needing to shut down. That is when you can fall into depression.
Depression among anorexics is also linked to the body’s natural response to anorexic behavior, as malnutrition depletes the brain of neurotransmitters that affect mood.
Anorexia and Prescription Medication Addiction
Anorexics frequently seek help from the medical community — not for their disordered eating, but for their anxiety and depression. In turn, they are prescribed anti-anxiety pills and antidepressants.
While they may need these medications, the best of intentions often take a turn for the worst. Just as anorexia masks anxiety and fear, so can prescription drugs, and the same impulsive, addictive behavior that fuels anorexia, also fuels substance abuse.
Unfortunately, med-seeking is made easier for anorexics as they typically look sick and clearly need some sort of help.
The Challenge To Treatment
Both anorexia and prescription drug addiction must be treated simultaneously. However, it must be approached with the understanding that as the drug addiction is treated, the symptoms of anorexia may increase. Specific types of treatment are available to help ease this process.
Onset of Co-Occurring Issues
It is important to note that, though a common one, the progression of issues outlined above is just one possibility. Anxiety, depression, and prescription drug addiction may develop at any stage before or after the onset of anorexic behavior. Moreover, there are, of course, other co-occurring issues that may be present.
The key to treatment is a whole-person approach that assesses the needs of individuals. There is no formula for success, only close attention to the individual’s unique physical, mental, emotional, relational, and spiritual needs.
Page Last Updated & Reviewed By: Jacquelyn Ekern, MS, LPC on May 6, 2017 Published on EatingDisorderHope.com – Information & Resources for Eating Disorders