Vijai P. Sharma, Ph.D
Changes in appetite and eating behavior are generally associated with depression, but lesser known is the fact that anxiety can also cause an eating disorder.
Anxiety and depression affect the appetite and eating behavior quite differently. Depression tends to suppress most biological functions and drives related to hunger: thirst, sex, movement or exploration of the environment. Anxiety seems to over stimulate and overcharge the same systems. Therefore, when anxious, we become "hyper," "fidgety," over focused or super vigilant.
For sake of simplicity, let's say that in depression a person becomes "under reactive" and in anxiety, "over reactive." Pursuing this line of thinking, we can see that, by and large, in depression the appetite and eating should be reduced, while in anxiety, the same should be increased. Sounds simple. Right?
But, real life is far more complicated. We know that depression can both increase or decrease the appetite. Some depressed individuals develop a hyper appetite and crave for food all the time. Likewise, anxiety can either kill appetite or turn a person into a voracious eater. How is that possible? How come the anxiety and depression both can take us to the opposite extreme?
To answer these questions, we have to look at anxiety and depression a little more closely. Many times, depression is mixed with anxiety. Studies show that depression and anxiety go hand in hand in about sixty percent of cases. Some depressed individuals feel restless and agitated. Restlessness and agitation, which are really signs of heightened activity and excitement, might in fact be caused by anxiety accompanying the depression.
It's possible that the increase in appetite and craving for food seen in depression is really caused by anxiety. I am not offering this as just "food for thought," but it can be important for the treatment of eating disorders associated with anxiety and depression.
Therefore, a depressed individual who also exhibits hyper appetite and craving for food should be evaluated for presence of anxiety. If there is a significant level of anxiety, then therapy should obviously include techniques for anxiety reduction.
As mentioned earlier, life throws a few curves now and then, here and there. Here is one such curve: some anxious individuals report severe loss of appetite. They can become emaciated. They should, of course, be evaluated for depression, but, keep in mind that anxiety can also cause the same symptoms.
Here is one explanation regarding how anxiety can kill the appetite and suppress eating behavior: anxiety causes excessive secretion of acids in the stomach causing low-grade nausea and giving the feeling of fullness in the stomach. Furthermore, a feeling of fullness in the throat and difficulty in swallowing experienced in anxiety can also suppress the desire to eat.
Other associations between anxiety and eating disturbance are not yet clearly understood. For instance, social fears and the thoughts of being negatively judged or evaluated by others are sometimes associated with loss of appetite or food refusal.
Relationship conflicts, or "tangles," are also associated with both under eating and over eating. Perhaps, anger and anxiety are responsible for this. The reverse is also true. Anxiety and eating problems improve as relationships improve.
Interestingly, in some cases during pregnancy and breastfeeding, anxiety and eating problems are spontaneously modified. However, personal and family conditions do play an important role. If conflict and tension already exists in a family, pregnancy or childbirth is likely to increase anxiety or depression and, consequently, disturbed eating and appetite.
If anxiety alone is causing overeating or under eating, calming the over reactivity of the nervous system can be helpful. And, you should calm the mind as well. Obviously, if there is a situation that is keeping you tensed up, it needs to be modified.
Learn relaxation techniques to calm the body and the mind. Gentle music can enhance the effect. Use breathing techniques to relax the whole torso.
After a round or two of relaxing the whole body, lightly stretch the abdominal and pelvic area. Relax the abdomen externally and internally. Breathe softly and gently in and out from the diaphragm.
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