Anorexia Nervosa Treatments

Co-Existing Disorders With Anorexia Nervosa

Few medical or mental health conditions exist as "stand-alone" illnesses. For example, someone diagnosed with Major Depression is also likely to have a co-existing sleep disorder since one of the symptoms of depression is insomnia or hyposomnia (sleeping too much). Many times, it is difficult for a mental health professional to determine which the primary disorders are and which are the secondary disorders that are caused by the primary disorder. It is often a "chicken or the egg" dilemma. In any case, all conditions are usually treated simultaneously.

Mental health disorders that occur simultaneously with another primary disorder are called "co-morbid" disorders; "morbid" meaning sick, or ill. It is quite common, for example, to diagnose a patient with Alcohol Dependence (primary diagnosis) and a co-morbid disorder of Dysthymia, a milder form of chronic depression. Both conditions are treated together; improvement in one condition means improvement in the other condition.

Looking specifically at Anorexia Nervosa as a primary condition, let us look at co-morbid mental health conditions often accompany this eating disorder:

Major Depressive Disorder as manifested by depressed mood, social withdrawal, irritability, insomnia and disinterest in sex.

Obsessive-Compulsive features. An Anorexic's mind is frequently pre-occupied with food and an Anorexic will hoard foods like saltines and lettuce, or other foods with little to no nutritional value. The Anorexic will keep a strict eye on their store of foods and what they will allow themselves to eat, checking repeatedly to make sure the numbers are right and to confirm that the food is still there.

Body Dysmorphic Disorder. With this disorder, the patient has an unshakable belief that his/her body is horrifically ugly despite hearing the truth about their appearance from others. Anorexics are convinced that their abdomen, buttocks and thighs are fat and unattractive, although these body parts may actually be agonizingly skeletal in appearance. The term "flat butt" used by mental health professionals who treat eating disorders indicate a patient's completely flat buttocks, a sign of severe malnutrition. Alcohol and Drug Abuse. Anorexics tend to abuse illegal stimulant drugs to avoid feeling hungry and to maintain a false level of energy. Alcohol is abused for similar reasons; anorexics that drink excessively develop alcohol gastritis, an acute stomach pain that prevents them from eating.

Borderline Personality Disorder. A personality disorder is a mental health condition that stems from the underlying character, or personality, of the patient. They reflect the patient's view of the world and their place in it. Personality disorders are permanent conditions although their symptoms can be effectively managed. The Borderline Personality Disorder's primary characteristics are a life constantly in chaos and turmoil, history of suicide attempts, unpredictable and impulsive mood, lack of genuine personal relationships, and a constant need for "drama" in their lives. Anorexics with BPD make frequent suicide attempts, have very unstable personal relationships, and their chaotic behavior may try the patience of everyone who knows them. A combined primary disorder like Anorexia Nervosa and a co-morbid personality disorder are referred to as "double trouble" among mental health professionals.

Through the examination of the list of co-morbid disorders, it is easy to see how complicated it is to treat a patient with Anorexia Nervosa. This type of treatment is not for the novice mental health practitioner and therapy should be done by someone who has considerable expertise in the field.

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