One reason stress gets a bad rap is because it can trigger physical and mental health problems, including eating disorders and depression. Knowing how stress can “cause” eating disorders and depression may help prevent you or someone you love from suffering.
To be clear, stress is not always a bad thing. Especially in the short term, when it may help you feel energized to meet challenges.
In and of itself, then, stress doesn’t mean you’re destined to develop an eating disorder or depression.
But, when demands in life are greater than your coping skills, mind and body are impacted. And usually in a negative way. As in possibly leading to eating disorders and/or depression.
Stress can trigger psychological or physical problems, or both. Makes sense. After all, the mind and body are connected.
Many factors are involved in how stress impacts mind and body. Some of these factors are family history, genetics, emotional support, race, peer relations, education, social constructs, trauma history, temperament, coping skills, finances, among others.
Some factors are a buffer, and others worsen stress’ impact.
Can stress cause eating disorders ?
National surveys estimate that 20 million women and 10 million men in America will have an eating disorder at some point in their lives. That’s a lot of people. We don’t need a national survey to tell us that 100% of people experience stress in their life.
If stress caused eating disorders, the rate of eating disorders would be 100%, or somewhere close to it.
So the next time you hear people wonder if stress causes eating disorders (and depression), you’ll know what to say: “Not exactly.”
But stress can be and often is the straw that breaks the camel’s back.
Stress does not CAUSE eating disorders (or depression) but is a variable in the equation.
There’s a handful of ways stress and eating disorders are linked.
1. Stress can trigger — and seem to cause — eating disorders (and depression).
Worrying about food and weight is central to all eating disorders, regardless of the type of eating disorder. The clear message from social media, peers, and diet culture is that thinner is better, and that what you eat defines your worth as a human. Being a part of diet culture and adopting its belief system create stress (and a $70 billion/year industry).
So, in people with other risk factors, stress can easily lead to problematic coping. Coping by dieting is socially suggested, approved, and even sanctioned.
Staying on a calorically restricted diet is stressful. Even, or especially, when the diet is camouflaged as wellness, clean eating, or a lifestyle change.
Weight loss compliments and admiration from others is a source of stress as well. In 95% of cases, weight loss will be replaced by weight gain. And no more compliments or admiration.
Dieting is one of the main risk factors for eating disorders.
Stated in another way, eating disorders begin with an “innocent” diet.
Stress is part of the perfect storm.
2. Eating disorders create (more) stress.
Having a poor relationship with your body and an unhealthy relationship with food is stressful. (Thank you, diet culture, said no one ever.) Worrying constantly about food and weight causes anxiety. It’s like a 24/7 internal battle that affects everything – your relationships, mental health, physical well being, and self worth. Your fundamental sense of who are you is at stake.
Another way eating disorders create more stress is physically. Put simply: Having an eating disorder is exhausting.
Eating disorders involve harmful behaviors in the name of achieving a cultural aesthetic. Restriction, poor nutrition, purging methods, and other eating disorder behaviors place stress on your body, including your organs. (That includes your heart.)
Eating disorders create a stress fest. But festive it is not.
3. People who develop eating disorders are often prone to stress.
The impact of stress on eating disorders is likely mediated by temperament (e.g. overly controlled; perfectionistic in the case of anorexia; impulsive, outgoing in the case of bulimia).
And certainly mediated by diet culture. Social media has intensified diet culture’s harmful impact. Even Instagram acknowledges the harmful effects of filtered selfies on body image. (“Compare and despair”)
For an eating disorder and depression to develop takes more than stress alone. When other risk factors are in place, and a stressful event occurs, an eating disorder can become activated. Without the stressful event, the eating disorder may not be triggered.
The ‘why now’ question of the timing of an eating disorder usually involves a triggering event. Examples of the kinds of triggering events include a loss of a pet or other loved one, a divorce, an injury or other medical event, or teasing. In other words, some form of stress.
4. The relationship between stress and eating disorders is a vicious cycle.
Stress does not cause eating disorders, but the two combine to create a vicious cycle.
Here is how that happens.
In general, two main eating disorder symptoms are negative body image and a problematic relationship with food.
Having a poor body image and relationship with food is stressful! And that stress in and of itself worsens body image and triggers eating disorder thinking and behaviors.
Hello, vicious cycle.
Stress occurs, and you feel overwhelmed. To cope, you turn to eating disorder behaviors. Then, ongoing negative body image and self talk associated with eating disorders increase stress.
It is a hard trap to get out of. Once you see it, though, you are in a position to make some changes to stop the cycle from continuing.
Stress and Binge Eating Disorder
The most common eating disorder is called Binge Eating Disorder (BED).
BED is characterized by eating large quantities of food (binges) and feeling a loss of control during the binge episodes. Eating is often rapid, and to the point of discomfort. Often the person feels a sense of shame or guilt afterwards. The person does not have compensatory behavior, such as purging, to offset the binge eating. The person will often deliberately restrict intake between binges.
In their lifetime, 3.5% of women and 2.0% of men will have BED.
To put this in perspective: BED is more than three times more common than anorexia and bulimia combined. BED is also more common than breast cancer or HIV.
The good news is that BED is treatable. (And preventable.)
The stress of following diets or other rules contributes to the stress that fuels BED. (Hello again, diet culture.) People with BED in larger bodies face additional stress from weight stigma and discrimination.
To cope with stress, binge eating becomes the relied upon method to manage feelings that would otherwise be overwhelming. Bingeing can provide immediate comfort. The bingeing itself, though, then causes more stress and overwhelm and causes you to feel bad about yourself.
Then, there is the stress associated with fearing weight gain. And of actual weight gain. There is also the stress associated with replacing the food you’ve binged on so no one knows about the binge.
Even physicians are guilty of shaming people with diagnosed or undiagnosed BED. Especially when people are in larger bodies. If that isn’t stressful, what is?
Stress and Bulimia nervosa
Bulimia nervosa is a serious, potentially life-threatening eating disorder. It is characterized by cycles of bingeing, and self-induced purging to undo the effects of bingeing.
Three in 100 American women suffers from bulimia.
It’s common for people with bulimia nervosa to use food and purging to manage feelings they’d rather not feel — including sadness, shame, anger, stress and boredom.
So the person with bulimia feels stressed, binges (for comfort) and purges (for relief) to alleviate the stress. What then replaces the original stress is the stress of being secretive, of cleaning up the ‘evidence’ of the binge or the purge, and of shame.
The physical impact of bingeing and of purging is another form of stress caused by the eating disorder. The list of short term and long term physical effects of bulimia is extensive.
Stress and Anorexia nervosa
Anorexia nervosa is an eating disorder characterized by weight loss, refusal to maintain a medically appropriate body weight, and distorted body image.
People with anorexia tend to restrict calories and good tasting food. Some people with anorexia also exercise compulsively, purge via vomiting and laxatives, and/or binge eat.
Anorexia can affect people of all ages, genders, sexual orientations, races, and ethnicities. One in 200 American women suffers from anorexia.
Although anorexia nervosa most often begins during adolescence, an increasing number of children and older adults are being diagnosed.
You cannot tell if a person is struggling with anorexia by looking at her. A person does not need to be emaciated or underweight to be struggling. Studies have found that larger-bodied individuals can also have anorexia, although they may be less likely to be diagnosed due to cultural prejudice against fat and obesity (yep, diet culture’s effects again).
Anorexia nervosa numbs emotion and creates preoccupation with food, weight, calories, and exercise. The preoccupation is the body’s response to restriction and starvation (both of which are stressful to mind and body).
Simply put, the preoccupation is stressful. It is all the person with anorexia can think of. It is the last thing she thinks of before bed, and the first thing that comes to mind upon awakening. Even dreams are often about food and body size.
Sleep is usually poor, which creates stress in and of itself.
Anorexia is an attempt to feel more of a sense of control in life, and therefore less stress.
However, a ton of stress is created by the symptoms of anorexia. The stress anorexia creates affects both the mind and body. In fact, anorexia has a higher mortality rate of any psych illness. That is stressful.
Can stress cause depression?
Does stress cause depression? Yes and no.
Depression is a mood disorder. Its symptoms include sadness, and/or a lack of interest or motivation in things you used to enjoy. Additional symptoms include lethargy, fatigue, low motivation, poor concentration, sleep problems, or changes in appetite. Depression may include physical symptoms that don’t respond to treatment, such as headaches or gastrointestinal problems. Having any of these symptoms is stressful.
Depression affects about one in 15 adults (6.7%) per year. One in six adults (16.6%) experience depression at some time in their life. Depression can occur at any time. Typically it first appears during the late teens to mid-20s.
Stress affects 100% of adults, yet 100% of adults do not develop depression.
1. Stress can trigger depression
Stress can (seem to) cause depression in a few different ways.
When people don’t cope effectively with stress, they may become depressed. They may feel defeated, ill-equipped, or overwhelmed by the stress. A “why bother” attitude could develop, which is a depression response to stress called learned helplessness.
What happens in learned helplessness is people eventually stop trying to manage the stress because nothing has worked in the past. Not trying leads apathy. All-or-nothing thinking comes next. The person’s self talk is based in distorted thinking. It may be something like, “Nothing I do matters. I suck”.
Chronic stress is especially problematic. It can derail your natural physiological stress response, which means you are not able to manage stress as well. Depression sets in.
Generally, when people feel stressed, their problem solving skills aren’t optimal. Without the stress, the person’s coping and problem solving skills may be effective enough.
Stress can also lead to people neglecting self-care. Or to engaging in behaviors that harm their health, such as smoking or drinking alcohol.
2. Depression creates more stress
The effects of depression can create or intensify stress.
Being depressed is stressful for a bunch of reasons..
Depression disrupts life. It’s often associated with withdrawing from people and instead isolating yourself. And not doing things you usually enjoy doing.
Depression and stress can lead to a vicious cycle
The relationship between depression and stress is bidirectional. Depression can cause stress, and stress can cause depression. Stress makes depression worse, and depression makes stress worse.
3. So how does stress cause eating disorders and depression?
Stress in and of itself does not CAUSE eating disorders or depression.
Rather, stress triggers or intensifies eating disorders or depression. Stress is bidirectional in the case of eating disorders and depression.
At their core, eating disorders and depression are disorders of disconnection.
Feeling disconnected from others or from yourself is stressful.
One way to address disconnection and social isolation is to connect with someone you trust. Let that person (or those people) support you.
Often it’s better for a supportive person to ask an open ended question rather than to tell you what to do or not to do.
The disconnection at the core of eating disorders and depression can be from yourself. And that stress has the biggest potential impact of all.
If talking to friends or family is not helpful or comfortable, please speak with a trained professional.
Learning effective methods to cope with stress decreases risk for eating disorders and depression. And makes for a more meaningful life.
There will always be stress. But it need not be harmful to your well being or quality of life.
Dr Elayne Daniels is a Massachusetts based clinical psychologist specializing in the treatment of eating disorders, body image and associated concerns. She also works with people who identify as Highly Sensitive.. Contact her here to get in touch.