This section includes people describing their experiences of depression, self-harming and suicidal thoughts which some people might find upsetting or distressing to read. All the material on this website is intended to support a better understanding of why these unhelpful behaviours in eating disorders happen, how to get help for them and to support genuine recovery from eating disorders.
Eating disorders and emotional well-being are closely linked. Difficulty in coping with negative emotions is thought to be a cause of eating disorders by. In order to cope with these emotions, people may start restricting food (limiting what they eat) or bingeing (eating a lot in a short space of time) and purging (getting rid of food from the body). Depression and feeling low are negative emotions particularly linked with eating disorder. It can be difficult for people to know which came first' the eating disorder or low moods.
Emotional well-being and eating disorders
People described a range of emotions over the course of an eating disorder. They had often felt anxious, upset, angry, emotional, moody and irritable. They described feeling sad and “crying all the time” for no obvious reason.
Katie is 21 and works as a research assistant. She is single and lives in a shared house. White British.
Quite angry. Well, no, angry but at the same time also very fragile. So I would cry very easily, and cry practically every day. Yeah, or if somebody said something I would cry and like over noises, like every noise seemed to be louder to me.
So I would think people were being really noisy all the time, I just liked to be quiet which doesn’t help because my cousin has Asperger’s syndrome so he’s not aware of like social you know, how to modulate your voice. I mean he just shouts all the time so, you know, I’d get quite annoyed because they came to stay with us sometimes. And anxious about that. And, yeah, I was a complete clean freak. Just, everywhere had to be really tidy and I would get quite cross you know, if I’d just tidied and then somebody came and made a mess and yeah, so I was angry and irritable but at the same time I could easily take the other way and be like really upset and, you know delicate.
Do you remember what the anger was about or directed at?
Just everybody else [laughs]. People wanting me to try and put on weight, people were challenging what I was doing and not just letting me get on with it. People for being noisy and messy. And just basically everything [laughs].
Some had mood swings or had been aggressive and argumentative at times. People felt that their mood was often directly linked to their weight. They weighed themselves regularly and any weight gain could be upsetting. However, being underweight could contribute to depression. When Sara was at a low weight she couldn’t “think straight” and didn’t “view" herself "right”. Some had “no emotions” at all. They felt “numb” particularly while they were underweight and as they started gaining weight, the emotions would surface or ‘bubble over’.
David is 22 and works as personnel coordinator. He is single and lives with his parents.
When I wasn’t feeling good about myself it was a real big issue. I was very; I could be very argumentative, very aggressive. Then there are days sort of that come where I just, it’s not anger it’s, I just feel very well without saying depression, ‘cos I’ve not got a history of depression, just very depressed and very introverted and in general I’m a very outgoing, easy going guy, and there just became days where you know even my Mum would question why I was so quiet or why I was locked away in my room. And they were just at times when I guess I was very unhappy with myself.
But at the same time when I lost the weight or felt very good about myself I was at a complete high. And I was you know buzzing about it, and I felt great and I loved it and all of that. And so the mood just kind of, it just went with that. But there were days when, and there still are days I guess where I’m not happy with myself and I just like to lock myself away, and I don’t want much company. That’s when I feel bad about myself. But if I’m feeling good, it’s oh well, I’m in a perfectly good mood and fine.
So the moods, you know, that’s the same thing. I never went further because I didn’t wanna feel like that. But there definitely are mood swings and it’s just linked to how good I feel about myself. Which is then in turn linked to my weight.
So that’s just a very, as you can probably tell it just affects your whole life, because obviously if you’re, you know not going out or not wanting to go out because you’re not in that sort of mood, whereas the weeks you feel good, you’ll go out and you’ll be part of your friends, your group of friends and stuff. So it just has a real big impact on everything else.
Age at interview:
Craig is 25, currently unemployed and doing an Open University course in Psychology. He is single and lives on his own. White British.
I think the more weight you put on the more emotion you gain back, which then bubbles over. ‘Cos I mean when you’ve been underweight for as long as I have there’s so much, so many issues that that all then bubbles back up which then makes it worse I guess, to a degree.
That’s really interesting that, what do you mean that the more weight you put on, the more issues come to the surface?
I think because when, when you’re underweight you’re kind of, you’re numb so any emotions that you could have, like if someone annoyed me I wouldn’t feel anger, I would just feel nothing. I wouldn’t be able to cry or anything like that. And as soon as you start putting back on weight you, you start to feel angry and you start to cry. And to a large degree I didn’t actually know how to deal with these emotions, so that kind of then, I don’t know, it makes things worse to a certain extent because you don’t know what’s going on, if you see what I mean.
Depression and eating disorders
Many people had experienced depression. A few had been diagnosed and treated for clinical depression and said they had “always” felt that way. It could be hard to separate the eating disorder and depression as they sometimes developed together, and as the eating disorder got worse, the more depressed they felt. Sometimes depression and eating disorders could be traced back to the same cause, such as bullying, an unsettled home life or low self-esteem. Sometimes people only became aware of depression after the eating disorder had been treated, and they were in recovery.
Zoe is a 23-year-old PhD student. She is single and lives in a shared house. White British.
I think it’s also important to sort of just highlight the fact that you know, even when people, you know, myself and other people talk have spoken to you who’ve had eating disorders, friends of mine. Since coming to university I’ve met several people, that even when the anorexia’s gone there are other things you have to look out for like depression, self-harm, all this kind of thing.
So other ways to deal with the same problem and that’s something that’s a slight problem for me, not too bad. But, you know, I did have periods of low, very low mood and I know other people who’ve had, who’ve used self-harm to kind of help manage. And I think it’s, yeah, just important just to be, you know, even if you think, “Good. Eating’s gone.” Just keep an eye ‘cos it’s all, you know the same similar sort of underlying things that’ll cause you to do all these different things. So yeah, be aware. Yeah, and for other people to be aware, relatives that just, you know, just because you’re eating well again it doesn’t mean that everything’s okay.
It often took people a long time to realise that the long term low moods could actually be caused by depression; something that could be diagnosed and often treated. Many said it had never occurred to them it could be depression but “just what life is like”, or “what I deserved”.
“I got increasingly depressed and I lived with it for a while and thought this was kind of how I deserved to be and how I should be. And this is what life is like. This is how people live, which I just wish I’d realised at that point that it’s not, you know that life doesn’t have to be like that and that I could have actually had some fun.” -Elizabeth
Emily is 21 and a University student. She is single and lives in halls of residence.
So they talked about depression and diagnosed, diagnosed you with clinical depression. Did that come as a surprise or…?
Yeah like the first time he mentioned that, the doctor that diagnosed me was such an expert in his field and so he’s kind of you know across the country he’s renowned and know about eating orders and depression.
So talking to him about it, and like the first time he said it to me, he said it as, “Oh,” well, no I got referred to him and my doctor that I had at the time was like, “Oh maybe it would be a good idea, like talking to you your mood seems a bit low at, like I don’t want to say anything but maybe it would be a good idea if we refer you to this certain doctor who deals with depression. And he could try and see if you are depressed, or if we’d say that you’re clinically depressed, or he’ll maybe diagnose you.
And I remember coming out that appointment and just thinking, “Oh she, she’s being ridiculous, I’m not depressed like, me having depression, I’m far too like, even though I struggle with this eating disorder and do have kind of a lot of unhappy things in my life, I still try and be optimistic about things and try, you know try and be friendly to people and things like that. I just thought no, depressed, depressed people, I’d just be like sat in a room all day and like, and that, that, it’s just not me. It’s just not my personality to be, to be depressed. So like I just thought, “No like but that’s ridiculous.”
And then I went to talk to him, and he kind of explained some of the symptoms of depression. And the more he talked about it, the more it fitted with my life and the more I kind of thought, “Oh yeah maybe. Oh, that’s,” and then like, so we had one appointment and it was like a couple of weeks until the next one. And over that couple of weeks I kind of thought about things and like some of the things where it is like you just struggle to get up in the morning, and just sad, inexplicably sad a lot of the time.
Some of those things are like really related to me, and I’d kind of thought maybe that’s just because I’m struggling with life at uni, or, that’s because that’s just the way I am. That’s just the way I feel like, like life had become really difficult for me to get, like make myself get up and I’d kind of lost interest in a lot of friendships and people, like I’d just kind of, if I was, I’ve always been quite like sociable and enjoyed people’s company, but it got to the stage where quite a lot of the time if I was in people’s company I’d just want to leave and come and sit in my room, even if it was like, even if that wasn’t particularly enjoyable, I’d just want to kind of block the world out, and not have to leave and kind of did become really isolated and sad and then when he said depression it kind of all started clicking into place and I thought oh that would explain a lot of things.
And he said there is often a big link between depression and eating disorders. I’d never heard that before or knew it but he said if we, if you want to do this research trial to help your eating disorder, it’s not going to work unless we tackle the depression first.
Age at interview:
Age at diagnosis:
Hannah Z is 18 and a first-year university student. She is single and lives in a shared house. White British.
I felt just really isolated from everyone, like everyone just wanted me to get help and I didn’t and I just felt like no-one understood me at all. And yeah, I got depressed and stuff like that and at fourteen, that was really hard but they didn’t even pick that up until I was about sixteen so yeah.
And do you think you were already depressed maybe at that time but they just didn’t notice?
Were you given any help with that later on?
Yeah, I was put on medication for that when I was around sixteen. and you know, I definitely think there’s a link between the eating disorder and the depression yeah and I think they thought that, you know, I would feel better in myself, like when my eating disorder was kind of gone, but, you know, I wasn’t and yeah and then it was just one doctor who like picked it up and was just like, “You need to be on this medication,” and I think that makes all the difference when like one doctor who’s really good understands, yeah.
What do you think the link for you is between depression and eating disorder?
I have no idea. I don’t know, I just… I don’t know. I don’t know whether like the depression would have been caused by the eating disorder or the eating disorder would be caused by the depression, it’s kind of hard to think that way.
Feeling low, upset and anxious often had a big impact on many aspects of life' people became more isolated, avoided meeting friends, going out or attending school. Emily used to love going out clubbing, shopping and doing sport but when depressed she was constantly “making up excuses” not to go. Elizabeth, who struggled to eat in public or with other people, described how food “alienated” her from others. Feeling low and isolated could also drive people to become more secretive about their eating problems or go on pro-eating disorder forums. David said his moods affected his “whole life” and everything he did. Katherine described the impact of separation anxiety;
“(I was) like a little broken kid, I was just absolutely devastated. I wouldn’t leave the house, I wouldn’t go to school. Going into friends’ houses even just for kind of a couple of hours to go for a tea was a big thing, like it took me ages to recover from it.” -Katherine
Often people had been prescribed antidepressant medicine to treat their depression. Their experiences of both the benefits and side effects of the medication varied widely. Rob said antidepressants “changed my life” and Georgia said they were “the most helpful thing” in recovery. Antidepressants helped people feel more “stable”, and enabled them to “tackle” their problems. Rob said they “alleviated some of the darkness”. For Emily, antidepressants helped her cope better with depression and bulimia nervosa. Laura found that medication did not make a difference and Craig found “no help” from medication and stopped because of side effects such as extreme nightmares. Some had had counselling for depression, whereas others hadn’t had any treatment.
People also talked about the link between self-harm, depression and eating disorders. This relationship could be difficult to understand, and people had different reasons for self-harming. It could be a form of punishment, driven by feeling low about or “disliking” oneself. Rob described self-harm as a way of “attacking myself”.
Rachel is 24 and an ad check monitor. She is single and lives at home with parents. White British.
I began self-harming when I was 15 as a way of punishment too and a way out from the person I was. Self-harming is still a problem for me – I have been battling it for nine years and I am not sure I will ever be able to stop. Self-harming is a release to me and because I hate myself so much it is a way of hurting and justifying the hatred I have for myself. I have never received specific help for my self-harm; my therapist at the adult unit knew about it and tried to get me to use different things to cope with these feelings – like wearing an elastic band on my wrist or distracting myself until the feelings of wanting to self-harm had gone away. I have tried all of these and more. Nothing works for me. It is also the one thing I have left to cope with my feelings and I told my therapist I did not want to stop it. I have been to hospital for self-harm before as well but they did not understand at all – they just looked at me like I was stupid.
Some people described the eating disorder, particularly restricting and purging, as a form of self-harm. Looking back, Rachel described restricting food as her first form of self-harm. Self-harm and purging were both methods for coping; they became outlets to release negative emotions like guilt, anger or upset. Rob tried to tackle a cycle of emotions through self-harm but said it only offered “a temporary relief”. Felicity felt that the eating disorder and self-harm were just different ways of dealing with the same underlying problem. For Charlotte, the eating disorder and self-harm developed together, both getting more serious and regular. She said after time, self-harm became almost like “a habit”.
Rob is 17 and a student at a music college. He is single and lives at home. White British.
The reason that’s relevant is because self-harm was treated as a joke. People cutting themselves, it because, it was treated, even among like that, it was, oh, you know, “emos” cut themselves, you know, “emos” are depressed and stuff. This idea of, you know, whatever it is that doesn’t, nobody’s really seemed to but... and so it was almost like, yeah, it was very as well as being secretive, it was also considered ridiculous. But I just I think there was there was a point where I was I felt so crap generally, that I was coming home and crying, you know, every day and I just felt that, and I felt that it was my fault. That it was because I was wrong and, you know, broken or whatever. And so it was just kind of a fairly spontaneous way of exercising those feelings in some ways. It didn’t help but it allowed me to cope in a in a in a negative way. It didn’t ‘cos it’d always come back worse as a result but it was like a temporary, because it does, you know, give you adrenalin or whatever and so, therefore, it would kind of have a very temporary effect of allowing you to cope. And also I guess in in some way, in some, it was almost like, for myself, it was almost proving that I don’t know, not it’s really complicated. It’s difficult to define why you’d actually do something like that.
Some people first encountered self-harm while being treated in hospital for an eating disorder. It had never occurred to Felicity to self-harm but in hospital she became aware of it and tried to self-harm.
Immediate help is available for anyone with suicidal thoughts. If you need to speak to someone please visit our resources page 'Mental Health and Wellbeing Resources' for a list of free, confidential helplines.
When people had been very ill with an eating disorder and severely depressed, sometimes they could experience self-destructive or suicidal thoughts. People said they “stopped caring” about anything and felt they had “no reason to live”. Some people had been told by health professionals that if they carried on restricting their food intake they would be risking their lives. For some, not living had felt like a "preferable” option at the time.
Experiencing suicidal thoughts could be highly distressing but people often said they wouldn’t act on them but tried to cope with them instead. It was a very different experience to actually trying to harm themselves.
We also spoke to a few people who had attempted suicide once or more. For some, realising that they had put their life in danger had encouraged them to accept help. In turn, it could influence family or professionals to take them seriously and offer appropriate treatment. Looking back, people were able to see that their feelings of worthlessness were part of being ill. These feelings reduced as they started to recover.
Andrew is 19 and at college. He is in a relationship and lives in a shared house. White Scottish.
‘Cos there was another two weeks after that where my life went, well it didn’t go downhill but it just dropped off the edge. I wasn’t talking to anyone, I was just angry all the time, exercising more, cut myself off, and then the suicidal thoughts started coming in. And I hurt myself quite a, in quite a few different ways, and I eventually tried to kill myself. Whereas quite possibly if he’d referred me to even a psychiatric nurse I’m pretty certain they could have gone like that [clicks fingers], and this is what’s wrong.
And what about the diagnosis of the bi-polar and the depression? Do you remember did they kind of felt relevant to you or?
Yeah. I think I was actually pleased at getting diagnosed with them because then it was like, thank God, you know this isn’t just how it is to be alive; this is something that’s wrong. It can potentially be fixed kind of thing. ‘Cos I just, I just hated life ‘cos I didn’t feel anything. It was just emptiness, not wanting to ever do anything, not caring about anything.
For more information and support with depression, self-harm and suicidal feelings see our resources section.