Young Adults’ Experiences of Depression in the U.S.

Depression and eating disorders

Depression, other mental health issues such as anxiety, and eating disorders may all occur together*,*1. Eating more or less, a common symptom of depression, is also is a sign of eating disorders. Several young adults we interviewed described disordered eating as part of their depression experience. For some, managing what they ate provided a sense of control when other aspects of their life felt out of control. Julia says she “couldn’t control whether my mom was going to be home or not and I couldn’t control…feeling like I had someone to go home to… but I could control things like what I put in my mouth”. Elizabeth similarly says that her eating disorder allowed her to control the emotions that resulted from her anxiety. However, she also felt that eating less made her feel more depressed.
The beginnings of eating disorders

Many people we talked with described their eating disorder as beginning with a concern about their body image. Often, this happened when there was a change in their weight during puberty or in college. For Sara, she became anxious about judgment from her friends and boys.
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Several people said their family members’ behaviors contributed to their eating disorder. Julia notes her mother also had an eating disorder. Her own behavior was both caused and normalized by her mother’s behavior. She says her mother would make comments such as, “Oh, you look so good.” or “You’re so thin.” and “compare herself to me, like “I’m a size 00.”” Similarly, Frankie said her mother has “always been a dieter” and she herself would often be subject to the diets as well. As a self-described “perfectionist”, Frankie liked the positive attention she received when she lost weight on restrictive diets. Gaining weight when she returned to a normal diet re-activated her eating disorder.
Men also suffer from eating disorders. In the United States, it is estimated that 10 million men will have a clinically significant eating disorder at some point in their life*2. Devin, in our study, attributes his eating disorder to feeling guilty about having his father pay for his food when he could not financially support himself.
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Signs of eating disorders: counting calories, excessive exercising, overeating

People we talked to described not eating, counting calories, or exercising excessively as a sign of their eating disorder. Often, these behaviors were a way to cope with certain emotions, but Julia describes how her counting calories led to her feeling more anxious, and that she would work out to try to burn any calories she ate. Leanna overate sugary foods to cope with her feelings.

A few people said their symptoms were a sign that they were being unhealthy and they were aware that these behaviors could have future consequences. Leanna in fact developed high blood pressure from overeating. Frankie realized her calorie restriction was unhealthy, but felt judged by others when she stopped and regained weight.
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People also discussed their ongoing struggles with body image. Devin discussed how he still struggles with his body image and says that he “still [has] those times where I still don’t like myself, the way I look”. Frankie says her behavior was more “sporadic” and “would go months without any symptoms” or “would go three days in a row… eating a ton of food and then like throwing it up… or just deciding for the day that I wasn’t going to eat any food.”

Treatment for eating disorders

Getting help for depression or eating disorders helped some of the people we interviewed identify and address both issues. One participant said the symptoms of her eating disorder in combination with her depression symptoms resulted in her doctor offering her medication for depression. 

For more information on treatment for depression, see ‘Therapy and counseling’, ‘Depression, medication, and treatment choices’, ‘Holistic and integrative approaches to depression’, and ‘Depression and healing’.

References
*Salbach-Andrae, Harriet, et al. "Psychiatric comorbidities among female adolescents with anorexia nervosa." Child psychiatry and human development 39.3 (2008): 261-272. 
*1 Wade, Tracey D., Anna Keski‐Rahkonen, and James I. Hudson. "Epidemiology of eating disorders." Textbook of Psychiatric Epidemiology, Third Edition (2011): 343-360.

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