Anxiety and Mood Disorders

Whilst my specialism is working with eating disorders and body image disturbance, it is very common for those difficulties to occur alongside other difficulties, including low mood or depression, various anxiety disorders (panic disorder, generalised anxiety disorder and OCD), and post traumatic stress disorder or trauma. There is a real question of chicken or egg with these difficulties. Did they predate the eating disorder, with the eating disorder being used to manage the other difficulties. Did the eating disorder feed into low mood, low self esteem or anxiety? Or is there a bit of both? Given that, I always assess for other comorbid difficulties, and will consider these difficulties within the treatment plan.

Low mood

Low mood can range from a sense of unhappiness or lack of motivation through to severe depression. Not only is low mood difficult in its own right but it can also impact motivation to recover, as low mood is often accompanied by tiredness, apathy, or a general sense of hopelessness. If the mood difficulties are secondary to the eating disorder or BDD, no additional treatment may be needed. However, if low mood is underlying the eating disorder or making it hard to engage with treatment, it might be useful to address this directly. Typically this would be with CBT, but alternative approaches could be considered if CBT does not work for you (such as compassion focussed therapy, schema therapy, or the skills from dialectical behaviour therapy).

Anxiety

As with low mood, anxiety can predate an eating disorder, or be a consequence. In some cases, people use either restriction, exercise, bingeing or purging as ways of managing stress or anxiety. Whilst this might work in the short-term, it typically reinforces the anxiety in the long-term. Treatment will typically involve finding alternative ways to manage stress or anxiety. If someone has a more formal anxiety disorder alongside their eating disorder, such as social anxiety, OCD or panic disorder, this may need specific treatment. Again, CBT is typically indicated, and will be offered alongside the eating disorder therapy.