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And so, as somebody is inputting information about 'I'm trying to lose weight,' and the chatbot is saying, 'Good job, you're losing weight.' And so, they start to adapt to what is happening and they start to almost encourage the behavior,\" Slaven explained.",{"type":65,"attrs":2297,"content":2298},{"textAlign":67},[2299],{"text":2300,"type":71},"Slaven advises parents to pay attention to clues.",[2302],"86c19221-c58b-4139-9138-a4cde149c18f","ERC's Dr. Kaitlin Slaven was a featured guest recently on WBAL to share insight about how AI chatbots are impacting eating disorders in kids. In this segment, Dr. Slaven discusses how these problematic chatbots work; what signs caregivers should watch for; and understanding how to access help.",[],"https:\u002F\u002Fwww.wbaltv.com\u002Farticle\u002Fai-chatbots-disordered-eating-baltimore\u002F73172472",{"id":2307,"alt":2308,"name":14,"focus":2309,"title":14,"source":14,"filename":2310,"copyright":14,"fieldtype":175,"meta_data":2311,"is_external_url":177},215397905808365,"Dr. Kaitlin Slaven was a featured guest recently on WBAL to share insight about how AI chatbots on eating disorders","659x220:660x221","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F900x556\u002Faff736e1fd\u002Fkaitlins-slaven-wbaltv-11-nbc.png",{"alt":2308,"size":2312,"title":14,"source":14,"copyright":14},"900x556",{"id":2307,"alt":2308,"name":14,"focus":2314,"title":14,"source":14,"filename":2310,"copyright":14,"fieldtype":175,"meta_data":2315,"is_external_url":177},"672x206:673x207",{"alt":2308,"size":2312,"title":14,"source":14,"copyright":14},"ai-chatbots-disordered-eating-baltimore","news\u002Fai-chatbots-disordered-eating-baltimore",-4890,[],"732a7f18-be5e-46bc-a614-40b1b1581381",[],{"name":2323,"created_at":2324,"published_at":2325,"updated_at":2326,"id":2327,"uuid":2328,"content":2329,"slug":2362,"full_slug":2363,"sort_by_date":67,"position":2364,"tag_list":2365,"is_startpage":177,"parent_id":1896,"meta_data":67,"group_id":2366,"first_published_at":2367,"release_id":67,"lang":201,"path":67,"alternates":2368,"default_full_slug":67,"translated_slugs":67},"How Colorado's fitness culture (and the rise of GLP-1s) are fueling eating disorders","2026-07-21T15:48:16.535Z","2026-07-21T17:03:19.688Z","2026-07-21T17:03:19.702Z",200537278646480,"5706d1c2-e959-483d-a367-4cd9303ea539",{"_uid":2330,"body":2331,"authors":2348,"excerpt":14,"summary":2350,"component":1878,"categories":2351,"article_type":1880,"external_link":2352,"featured_image":2353,"external_link_text":1888,"listing_thumbnail_image":2359},"ee1c11df-b5af-40c5-91c2-8155e14bacbe",{"type":62,"content":2332},[2333,2338,2343],{"type":65,"attrs":2334,"content":2335},{"textAlign":67},[2336],{"text":2337,"type":71},"Ads for weight loss medication are everywhere. For the people experiencing or treating eating disorders, it’s “a catastrophic situation.” So says Dr. Elizabeth Wassenaar, a board-certified psychiatrist specializing in obesity medicine and eating disorders.",{"type":65,"attrs":2339,"content":2340},{"textAlign":67},[2341],{"text":2342,"type":71},"Dr. Wassenaar has seen kids younger than 12 prescribed GLP-1s for weight loss. She’s also seen a rapid rise in patients relapsing, and believes the widespread use of such medication is further contributing to deadly diet culture, a world in which the only acceptable body is a dangerously thin one, and millions of people suffer the long-term side effects.",{"type":65,"attrs":2344,"content":2345},{"textAlign":67},[2346],{"text":2347,"type":71},"Dr. Wassenaar is joined by Olivia, a recent CU grad who is in recovery for an eating disorder. Both women dissect Boulder’s health + fitness culture and the way it contributes to unhealthy behavior.",[2349],"bf9591da-e2df-4843-8fae-035693f7e02e","ERC alum Olivia and ERC Regional Medical Director Dr. Elizabeth Wassenaar are featured in this episode of Boulder Valley Frequency as the host examines how Colorado's fitness culture (and the rise of GLP-1s) are fueling eating disorders.",[],"https:\u002F\u002Fwww.boulderfrequency.com\u002F2600535\u002Fepisodes\u002F19461249-how-boulder-s-fitness-culture-and-the-rise-of-glp-1s-are-fueling-eating-disorders",{"id":2354,"alt":2355,"name":14,"focus":2356,"title":14,"source":14,"filename":2357,"copyright":14,"fieldtype":175,"meta_data":2358,"is_external_url":177},200540914053616,"Teen girls mountain runners","1038x1867:1039x1868","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F2000x3000\u002F52e1d7aff8\u002Fteen-girls-mountain-runners.png",{"alt":2355,"title":14,"source":14,"copyright":14},{"id":2354,"alt":2355,"name":14,"focus":2360,"title":14,"source":14,"filename":2357,"copyright":14,"fieldtype":175,"meta_data":2361,"is_external_url":177},"1017x1667:1018x1668",{"alt":2355,"title":14,"source":14,"copyright":14},"how-colorado-s-fitness-culture-and-the-rise-of-glp-1s-are-fueling-eating-disorders","news\u002Fhow-colorado-s-fitness-culture-and-the-rise-of-glp-1s-are-fueling-eating-disorders",-4880,[],"c56648a3-02b4-4af3-893d-826c6082b441","2026-07-21T16:36:33.605Z",[],{"name":2370,"created_at":2371,"published_at":2372,"updated_at":2373,"id":2374,"uuid":2375,"content":2376,"slug":2422,"full_slug":2423,"sort_by_date":67,"position":2424,"tag_list":2425,"is_startpage":177,"parent_id":1896,"meta_data":67,"group_id":2426,"first_published_at":2427,"release_id":67,"lang":201,"path":67,"alternates":2428,"default_full_slug":67,"translated_slugs":67},"Letters of Light: MI teen creates eating disorder recovery nonprofit","2026-07-06T21:15:25.437Z","2026-07-06T21:26:34.824Z","2026-07-06T21:26:34.837Z",195309262625814,"32f5b9aa-8ba5-40d8-bd6d-ae52e3562113",{"_uid":2377,"body":2378,"authors":2410,"excerpt":14,"summary":2411,"component":1878,"categories":2412,"article_type":1880,"external_link":2413,"featured_image":2414,"external_link_text":1888,"listing_thumbnail_image":2420},"dea35668-f197-4363-9026-205531a84d83",{"type":62,"content":2379},[2380,2385,2390,2395,2400,2405],{"type":65,"attrs":2381,"content":2382},{"textAlign":67},[2383],{"text":2384,"type":71},"Sophie Perrenoud first needed to get help for herself — and now she’s forging a path to lending others a vital hand in the realm of eating disorder recovery.",{"type":65,"attrs":2386,"content":2387},{"textAlign":67},[2388],{"text":2389,"type":71},"After having a shaky relationship with food beginning in fifth grade, things took a bad turn during the summer between her freshman and sophomore years at Mercer Island High School (MIHS), she said.",{"type":65,"attrs":2391,"content":2392},{"textAlign":67},[2393],{"text":2394,"type":71},"Returning home after soccer conditioning, she barely ate, adding that she wasn’t even eating a meal a day.",{"type":65,"attrs":2396,"content":2397},{"textAlign":67},[2398],{"text":2399,"type":71},"“It really got to the point where I was afraid to take medicine at some point because I was scared of the calories it might contain. I was scared having an extra blueberry because, again, like, calories,” Perrenoud, now 17 and a MIHS rising senior, said on a recent afternoon.",{"type":65,"attrs":2401,"content":2402},{"textAlign":67},[2403],{"text":2404,"type":71},"She added that the food culture in high school becomes worse with other girls also struggling with their body images.",{"type":65,"attrs":2406,"content":2407},{"textAlign":67},[2408],{"text":2409,"type":71},"“I think a really big part of that was my whole life (I’ve) been labeled as skinny. When you go through puberty, your body’s going to go through changes naturally. But for me, I was almost scared that I was going to be losing that part of my identity,” said Perrenoud, noting that her brother first noticed there was something wrong and then she eventually went to the doctor with her concerned mother.",[],"Eating Recovery Center alumna Sophie Perrenoud is featured in this Mercer Island Reporter article as she shares how she turned her recovery journey into an opportunity to give back and educate others about eating disorders through the creation of her non-profit Letters of Light and podcast \"Dear Body, Dear Mind.\"\n",[],"https:\u002F\u002Fwww.mi-reporter.com\u002F2026\u002F07\u002F02\u002Fletters-of-light-mi-teen-creates-eating-disorder-recovery-nonprofit\u002F",{"id":2415,"alt":2416,"name":14,"focus":14,"title":14,"source":2413,"filename":2417,"copyright":2418,"fieldtype":175,"meta_data":2419,"is_external_url":177},195311399484593,"Mercer Island High School student Sophie Perrenoud hosts her “Dear Body, Dear Mind” podcast. Courtesy photo","https:\u002F\u002Fa.storyblok.com\u002Ff\u002F286555691919486\u002F768x1024\u002F006e285e92\u002Feating-disorders-mir-sophie-perrenoud.png","Courtesy photo",{"alt":2416,"title":14,"source":2413,"copyright":2418},{"id":2415,"alt":2416,"name":14,"focus":14,"title":14,"source":2413,"filename":2417,"copyright":2418,"fieldtype":175,"meta_data":2421,"is_external_url":177},{"alt":2416,"title":14,"source":2413,"copyright":2418},"letters-of-light-mi-teen-creates-eating-disorder-recovery-nonprofit","news\u002Fletters-of-light-mi-teen-creates-eating-disorder-recovery-nonprofit",-4870,[],"979f0001-4251-4ac2-9744-93823655e52f","2026-07-02T07:30:00.000Z",[],[],[],{"age":2432,"cache-control":2433,"connection":2434,"content-encoding":2435,"content-type":2436,"date":2437,"etag":2438,"per-page":2439,"referrer-policy":2440,"sb-be-version":2441,"server":2442,"strict-transport-security":2443,"total":2444,"transfer-encoding":2445,"vary":2446,"via":2447,"x-amz-cf-id":2448,"x-amz-cf-pop":2449,"x-cache":2450,"x-content-type-options":2451,"x-frame-options":2452,"x-permitted-cross-domain-policies":2453,"x-request-id":2454,"x-runtime":2455,"x-xss-protection":1974},"174","max-age=0, public, s-maxage=604800, stale-if-error=3600","keep-alive","gzip","application\u002Fjson; charset=utf-8","Mon, 26 Oct 2026 16:56:11 GMT","W\u002F\"bb230f4f04de1c168cadda7fea3c7456\"","4","strict-origin-when-cross-origin","5.996.4","nginx","max-age=31536000","476","chunked","Origin,Accept-Encoding","1.1 4fc8673a211db56277b05b91a8f98872.cloudfront.net (CloudFront)","DBQMjPE4-GqFR269j3EDKUn-HY2eacCxtXZdtEXj7yneD_PFxrKw9A==","IAD55-P6","Hit from cloudfront","nosniff","SAMEORIGIN","none","dee2686d-b0f0-4823-bdf7-d0b6a8882a41","0.025612",4,476,{"data":2459,"headers":2585},{"story":2460,"cv":203,"rels":2583,"links":2584},{"name":2461,"created_at":2462,"published_at":2463,"updated_at":2464,"id":2465,"uuid":2466,"content":2467,"slug":2574,"full_slug":2575,"sort_by_date":67,"position":2576,"tag_list":2577,"is_startpage":177,"parent_id":2579,"meta_data":67,"group_id":2580,"first_published_at":2581,"release_id":67,"lang":201,"path":67,"alternates":2582,"default_full_slug":67,"translated_slugs":67},"Body Dysmorphia and Eating Disorders in Gay Men","2026-02-02T11:57:30.844Z","2026-03-10T16:32:25.727Z","2026-03-10T16:32:26.945Z",140672413109359,"3cb09d1f-ae5c-4882-9bbb-5eff49b05047",{"_uid":2468,"body":2469,"type":2470,"topic":2471,"author":2472,"authors":2473,"summary":14,"audience":2518,"component":1563,"conditions":2520,"meta_title":2521,"reviewed_by":2522,"featured_image":2568,"meta_description":2571,"special_populations":2572},"2060e461-e31c-4129-b56c-ce9804558a07","\u003Cp>A notable and pervasive issue with a more physical focus has started to plague the gay male community.&nbsp;\u003Ca href=\"\u002Fnode\u002F3666\" data-entity-type=\"node\" data-entity-uuid=\"42fb5d53-b255-4225-9208-61a581242f00\" data-entity-substitution=\"canonical\">Body dysmorphic disorder (BDD)\u003C\u002Fa>&nbsp;is a psychological diagnosis that refers to one’s preoccupation with a perceived defect or flaw with his or her physical appearance. This can lead to repetitive behaviors like mirror-checking,&nbsp;excessive exercise&nbsp;and reassurance seeking.\u003C\u002Fp>\u003Ch2>Gay men and body image\u003C\u002Fh2>\u003Cp>It’s no secret that many gay men tend to be obsessed with their bodies. What other reason could explain the obsession with working out and the endless shirtless selfies on Instagram? Gay men even categorize each other based on physical appearance by using words like twink, otter or bear. And despite this diverse classification based on physical characteristics, there is an ideal that most gay men try to achieve.\u003C\u002Fp>\u003Cp>There are many theories that attempt to explain gay men’s complicated relationship with their bodies, but perhaps the most viable is that of Alan Downs. In his book,&nbsp;The Velvet Rage,&nbsp;he discusses the role that shame-based&nbsp;trauma&nbsp;plays in how gay men construct their sense of self.\u003C\u002Fp>\u003Ch3>A quest for the ideal body\u003C\u002Fh3>\u003Cp>Being raised in a milieu where you’re told you don’t measure up to the masculine ideal sets most young gay boys up to feel they need to overcompensate to hold onto other people’s affections. Many gay men have attempted to hold onto those affections through efforts to perfect their bodies.\u003C\u002Fp>\u003Cp>When someone has a history of rejection (name-calling on the playground, getting crammed into lockers, ridicule for feminine interests, etc.) he might work tirelessly to achieve acceptance throughout his life—after all, rejection creates a thirst for acceptance.\u003C\u002Fp>\u003Cp>While attempting to change or suppress one’s mannerisms, personality and interests are difficult—if not impossible—to do, changing one’s body is more achievable. In the quest to attain acceptance, the gay man’s best strategy is attaining the masculine body ideal.\u003C\u002Fp>\u003Cp>By working out tirelessly and reaping the sexual attention that comes from such intense workouts, the gay man can temporarily assuage the root \u003Ca href=\"\u002Fnode\u002F7561\" data-entity-type=\"node\" data-entity-uuid=\"7ccb848f-af1c-4be6-a1bb-32a0031532ce\" data-entity-substitution=\"canonical\">anxiety\u003C\u002Fa> and fear he carries about being rejected. Working out is something he&nbsp;can&nbsp;control—heavier sets, more protein shakes, more crunches. In turn, he can have his choice of sexual partners and glean (temporary) male acceptance.\u003C\u002Fp>\u003Cp>Although a creative coping mechanism, excessive focus on achieving the ideal body does nothing to address the root problems driving the maladaptive behaviors and negative body image: self-hatred, shame and unresolved \u003Ca href=\"\u002Fnode\u002F7571\" data-entity-type=\"node\" data-entity-uuid=\"c7ef7a77-c12c-443c-bf85-7b70982bf802\" data-entity-substitution=\"canonical\">trauma\u003C\u002Fa>.\u003C\u002Fp>\u003Cp>\u003Cstrong>But, when you feel that badly about yourself, gym time and caloric restriction will not heal that wound.\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>In an environment wherein physical attractiveness has become the primary value, there is fierce competition to attract partners and physical attractiveness becomes the main comparison point. The same perfectionistic, high achieving temperament that helps a gay man achieve weight loss and physique goals also drives&nbsp;\u003Ca href=\"\u002Fnode\u002F8516\" data-entity-type=\"node\" data-entity-uuid=\"7520e086-841b-4496-9631-0cd80e6ca534\" data-entity-substitution=\"canonical\">eating disorders\u003C\u002Fa> and BDD.\u003C\u002Fp>\u003Cp>Struggles abound for gay men that don’t fit the masculine ideal, including higher weight men and those that suffer from&nbsp;\u003Ca href=\"\u002Fnode\u002F5236\" data-entity-type=\"node\" data-entity-uuid=\"46e41f30-3d45-457c-9173-e3cd26863e64\" data-entity-substitution=\"canonical\">binge eating disorder\u003C\u002Fa>&nbsp;and\u002For&nbsp;\u003Ca href=\"\u002Fnode\u002F5246\" data-entity-type=\"node\" data-entity-uuid=\"212694d8-c29c-4529-8629-09fddefa078b\" data-entity-substitution=\"canonical\">compulsive overeating\u003C\u002Fa>. In his article&nbsp;“It Gets Better, Unless You’re Fat,”&nbsp;Buzzfeed&nbsp;writer Louis Peitzman talks openly about the pain of being an overweight gay man who struggles to measure up to the gay physical ideal:\u003C\u002Fp>\u003Cblockquote>\u003Cp>“The truth is, the gay community isn’t interested in embracing overweight people because we’re a blemish on the image of perfection. And much in the same way progressives as a whole can get away with ignoring anti-fat bigotry, gay men never bother examining the way they treat their overweight brothers. Ignore us or relegate us to the butt of hackneyed jokes: We just don’t matter. It doesn’t get better for us.”\u003C\u002Fp>\u003C\u002Fblockquote>\u003Cp>Gay men who buy into this drive for the perfect body to hide their insecurities are actually hurting themselves and others who don’t measure up.\u003C\u002Fp>\u003Cp>\u003Cstrong>Chiseling the perfect body is a great distraction from the underlying feeling of not being good enough.\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>For many gay men, it short-circuits the ability to address the root problem and to process emotion deeply and authentically. For a subset of others, specifically those genetically predisposed to eating disorders, the tireless pursuit of the ideal gay physique may evolve into a life-disrupting (and at times life-threatening) eating disorder.\u003C\u002Fp>\u003Ch2>For providers working with gay men\u003C\u002Fh2>\u003Cp>For clinicians working with gay patients, it’s important to consider this meaningful psychosexual context when exploring eating, exercise and body image concerns. Coming from a sexual minority, these patients have unique, often painful developmental histories marked by&nbsp;trauma, fear of being ostracized or rejected, and\u002For trauma associated with these fears having been realized. They internalize these feelings and take it out on their bodies, attempting to wield control through weight loss and\u002For building up muscle mass (hence the pervasiveness of BDD in the gay community).\u003C\u002Fp>\u003Cp>How providers can support gay men with BDD\u003C\u002Fp>\u003Cp>Consider the following clinical best practices:\u003C\u002Fp>\u003Cp>\u003Cstrong>1. Conduct a thorough assessment\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>In addition to a comprehensive&nbsp;eating disorder assessment, include an age-appropriate assessment of psychosexual development. Consider exploration of the following topics related to sexuality:\u003C\u002Fp>\u003Cul>\u003Cli>Family non-acceptance\u003C\u002Fli>\u003Cli>Peer harassment and bullying\u003C\u002Fli>\u003Cli>Community bias and hostility\u003C\u002Fli>\u003Cli>Unequal social status\u003C\u002Fli>\u003Cli>Trauma\u003C\u002Fli>\u003Cli>Internalized negative attitudes (ie. observations related to social status, identification with stigmatized group or self-loathing, conflict between wishes for authentic identity and belonging)\u003C\u002Fli>\u003Cli>The developmentally significant struggle of “coming out” versus “staying in the closet” (denial or hiding may be adaptive, family reactions are diverse ranging from hatred for gender variance to grief over lost expectations)\u003C\u002Fli>\u003Cli>Substance abuse (elevated use, earlier onset and faster progression among certain LGBT subgroups; bisexual males and lesbians may be at higher risk for substance abuse; drugs\u002Falcohol often used to achieve feeling of belonging or relieve painful effects of trauma, rejection, self-hatred, etc.)\u003C\u002Fli>\u003C\u002Ful>\u003Cp>\u003Cstrong>2. Be wary of attempts to justify BDD and\u002For explain away the body dysmorphia in the gay community\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>Body obsession isn’t about being physically healthy; it’s about overcompensating for an internalized fear of rejection and self-hatred due to a childhood and adolescence filled with shaming.\u003C\u002Fp>\u003Cp>Make no mistake about what the true purpose is—\u003Ca href=\"https:\u002F\u002Fpubmed.ncbi.nlm.nih.gov\u002F18089146\u002F\">gay men pay for gym memberships and personal trainers in droves\u003C\u002Fa>&nbsp;to offset the nagging shame gremlins that lurk in their psyches. Physical health has very little—if anything—to do with it. Rationalizing exemplifies the hedged emotional processing that most gay men partake in.\u003C\u002Fp>\u003Cp>\u003Cstrong>3.&nbsp;Emphasize emotional processing.\u003C\u002Fstrong>\u003C\u002Fp>\u003Cp>Carrying internalized shame squelches emotional processing because it tells us that we can’t handle what is actually behind the curtain covering the darkest corners of our minds. Shame tells us that a perfect body to plaster all over Instagram is the only thing that can keep people interested in us. Shame tells us that with excessive workouts, calorie counting and emotional avoidance, we can achieve happiness and contentment. But shame is what keeps the high rates of eating disorders, body dysmorphia and&nbsp;\u003Ca href=\"\u002Fnode\u002F17621\" data-entity-type=\"node\" data-entity-uuid=\"b86a86fc-441f-471d-95d4-602a31b805c5\" data-entity-substitution=\"canonical\">depression\u003C\u002Fa>&nbsp;alive and well in the gay community, and this shame is telling us lies.\u003C\u002Fp>\u003Cp>Clinicians can thoughtfully and compassionately explore these lies gay patients have accepted in order to avoid looking at their real vulnerabilities.\u003C\u002Fp>\u003Cp>\u003Cstrong>4.&nbsp;Be prepared to consult and act as a liaison —&nbsp;\u003C\u002Fstrong>with other health care providers, schools and relevant community in an effort to advocate for the unique needs of sexual and gender minority patients and their families. Targeted resources are increasingly abundant; however shame, fear and hurt can keep even the most well-meaning and motivated people from getting the help they need.\u003C\u002Fp>","Blog","Signs and Symptoms","Zach Rawlings",{"name":2472,"created_at":2474,"published_at":2475,"updated_at":2476,"id":2477,"uuid":2478,"content":2479,"slug":2510,"full_slug":2511,"sort_by_date":67,"position":2512,"tag_list":2513,"is_startpage":177,"parent_id":2514,"meta_data":67,"group_id":2515,"first_published_at":2516,"release_id":67,"lang":201,"path":67,"alternates":2517,"default_full_slug":67,"translated_slugs":67,"_stopResolving":35},"2026-03-02T08:37:09.649Z","2026-04-24T16:21:33.626Z","2026-04-24T16:21:33.639Z",150532217474768,"a2f4acd7-94f8-4019-bf70-1a224eb7b29b",{"bio":2480,"_uid":2481,"body":2482,"layout":2483,"status":2484,"facebook":2485,"linkedin":2486,"pronouns":14,"component":2487,"instagram":2488,"locations":2489,"twitter_x":2490,"categories":2491,"meta_title":14,"bio_heading":14,"credentials":14,"designation":14,"specialties":2492,"what_we_treat":2493,"featured_image":2494,"portrait_image":2498,"specialization":14,"languages_spoken":2500,"meta_description":14,"advanced_training":2501,"areas_of_interest":2502,"education_history":2503,"listing_sort_order":14,"board_certifications":2504,"schema_person_address":14,"schema_person_same_as":14,"show_in_all_locations":177,"schema_person_works_for":14,"clinical_information_text":2505,"primary_clinical_location":2508,"professional_associations":2509},"\u003Cp>Zach holds a doctoral degree in clinical psychology. He is a Licensed Mental Health Counselor who primarily works with those suffering from eating disorders and the effects of trauma and abuse. He has worked for several nonprofits and in a variety of hospital settings over the past several years and currently works with a research group through Yale University that aims to create evidence-based treatments for LGBTQ+ individuals suffering from depression and anxiety. 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