Mood Disorders and Co-Occurring Eating Disorders: Why Comprehensive Treatment is Key to Recovery

You may already know that mood is linked to chemicals—the phrase “I have a chemical imbalance,” for instance, has become a common casual explanation (or excuse) for irritable or depressed mood or bad behavior. And of course, nutrition is chemical, too—there’s an entire field of study dedicated to “food chemistry.” But how are the two related?

Contrary to popular belief, the mood-food connection is not quite as simple as eating a piece of chocolate to cure depression. While what you eat can affect how you feel, such quick fixes are generally low-impact and temporary. There is no one food that can “cure” a mood disorder, nor does one meal a recovery make.

What does seem to make a difference is the quality of your overall diet over an extended period of time. Recent research suggests that regular consumption of fatty, sugary foods—especially anything deep-fried or candy-coated—tends to negatively impact overall mood and mental health, while a diet consisting mainly of fruits, veggies, low-fat dairy, lean meats, and other healthier choices appears to be much more conducive to maintaining elevated moods and managing disorders and their symptoms.

In other words, eating healthy on a consistent basis is good for your mind and your body, while eating too many unhealthy foods too often can be detrimental to your mental health.

Just as food can affect how you feel, how you feel can affect what kind of dietary choices you make. “Emotional eating” is, of course, the prime example of this. You may turn to a tub of your favorite flavor of Ben & Jerry’s for consolation on a bad day, or if you’re on a diet and feeling discouraged you may give up and indulge for a day, a week, or forfeit your diet altogether. If you’re stressed out, particularly if you’re worried about an upcoming social event and craving a little “liquid courage,” you might grab a glass—or a bottle—of your liquor of choice.

A snack or a sip here and there isn’t such a big deal, nor is skipping the occasional meal when you’re in a hurry; the problem arises when the behavior becomes habitual and begins to affect your emotional stability and physical health. In much the same way that drugs cause a release of “happy” chemicals in your brain on which it’s notoriously easily to become dependent, so too do comfort foods—and they can be surprisingly addictive. This can create a vicious cycle of low mood followed by emotional eating, which then may continue or worsen the low mood, inspiring more of the unhealthy eating behavior, and so on.

While not as obvious a road to addiction as indulgent eating, severely restricting food intake can create a similar vicious cycle. Perhaps you’ve been feeling down and not getting out much, so your appetite is low. So you start skipping meals—thus beginning a potential downward spiral without even realizing it. One of the number one signs that your caloric intake is too low is a persistent lack of energy because your body isn’t getting the fuel it needs to run properly.

While one doesn’t necessarily lead to the other, mood disorders and eating disorders often co-occur. According to the Psychiatric Times,

Data from epidemiologic research support the overlap between eating disorders (eg, anorexia nervosa, bulimia nervosa, binge eating disorder) and mood disorders. For example, approximately 5% of patients with MDD also have an eating disorder (all DSM-IV diagnoses); for female patients with MDD, this rate has been reported to be as high as 33%.

The rates of lifetime prevalence of mood disorders in patients with eating disorders are even higher. For anorexia nervosa, the rate is 42.1 percent; for binge eating disorder, 46.4%; and for bulimia nervosa, a whopping 70.7%. Eating disorders manifest in conjunction with a variety of mood disorders, including both anxiety and depressive disorders as well as bipolar, dysthymia, and more.

Furthermore, according to the Anxiety and Depression Association of America (ADAA), “two-thirds of people with eating disorders suffer from an anxiety disorder at some point in their lives and that around 42 percent had developed an anxiety disorder during childhood, well before the onset of their eating disorder.”

The most common anxiety disorder to co-occur with an eating disorder is obsessive-compulsive disorder (OCD). In addition to the major overlapping factors of food and mood discussed above, those who suffer from both OCD and an eating disorder may experience unique symptoms which create further overlap between the two, such as obsessive thinking about food or weight, compulsions like dividing food into tiny, precisely measured portions, or binge eating.