Connecting the Dots: Find Relief From Eating Disorders and Co-occurring Conditions
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What is a co-occurring condition?
A co-occurring condition happens when someone experiences two or more mental health challenges at the same time – and it’s more common than you may think.
Managing multiple diagnoses can feel like a never-ending game of whack-a-mole. Just when you think you’ve handled one thing, another one pops up. But here’s some good news: Understanding how these conditions overlap can help you manage them. And finding the right care team to help you connect the dots can make all the difference.
What causes co-occurring conditions?
Co-occurring conditions happen for several reasons, a major one being that many conditions have overlapping symptoms. For example, post-traumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD) can be hard to differentiate.
“Feeling nervous or on edge, experiencing racing thoughts, having difficulty concentrating and being unable to relax are symptoms of both PTSD and GAD,” explains Lucas Bagnara, LPC-S, a primary therapist at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight). “Someone with PTSD may start feeling anxious about going out in public or engaging in social interactions. This can create worry around attending social events and lead to the onset of GAD.”
Another reason is that having one mental health condition can impact our ability to function and cope, increasing the risk of developing another condition.
Bagnara shares a common example, “When someone struggles with depression, low motivation and a lack of energy can make it hard to find healthy ways to cope.”
Turning to drugs or alcohol can seem like a way to numb or escape the sadness. But over time, this can lead to a substance use disorder.
The same is true when people use food behaviors to cope with anxiety or depression. This is why looking at the full picture and addressing these conditions together is the most effective way to ensure lasting wellness.
Untangling eating disorders and co-occurring conditions
Eating disorders rarely occur in isolation. Like other mental health challenges, they often develop alongside conditions such as:
These disorders can all lead to certain behaviors that result in disordered eating.
OCD
For instance, people with OCD often have specific fears or thought patterns about food, sometimes leading to avoidant/restrictive food intake disorder (ARFID).
ADHD
Similarly, individuals with ADHD may struggle to recognize hunger cues, increasing their risk of binge eating disorder (BED).
“Having a multidisciplinary team with a psychiatrist, primary care physician, therapist and dietitian can best provide an effective way to treat any co-occurring conditions,” advises Bagnara.
How to identify co-occurring conditions
When people experience something intensely, different feelings get mixed together, and it can be hard to notice or separate symptoms. The best way to get clarity is to work with a provider who understands common co-occurring conditions and how they might show up.
“At ERC Pathlight, patients complete at least five different assessments so we can see if there’s more than one diagnosis present,” says Bagnara. Even with one diagnosis, it’s tough to fully see someone’s internal struggles. “A thorough look at everything helps connect the dots, rather than just focusing on the most obvious signs,” Bagnara adds.
Six proven therapies for treating co-occurring conditions
Mental health challenges often feed off each other. For example, depression can cause anxiety to be more severe, creating a difficult cycle to manage.
“Treating both diagnoses at once often leads to faster relief for the individual,” explains Bagnara.
Here are six therapies proven to help with multiple mental health conditions.
- Cognitive behavioral therapy (CBT) helps people spot negative thoughts — about themselves, others or the world — that cause emotional distress, often leading to eating disorders and mood and anxiety disorders.
Understanding how these thoughts affect emotions and behaviors and using techniques like cognitive reframing can help shift them and break the cycle. For example, a patient might learn to reframe “I always fail” into “I can learn from my mistakes.”
- Dialectical behavior therapy (DBT) is particularly effective for people who often struggle with overwhelming thoughts and emotions. To cope, they might try to escape, avoid or numb these feelings, which can lead to greater distress over time.
DBT skills help people navigate these challenging emotions as they learn how to develop mindfulness, distress tolerance, emotional regulation and relationship building to make meaningful behavioral changes.
- Eye movement desensitization and reprocessing (EMDR) involves the use of guided eye movements during therapy sessions to help the brain reprocess traumatic memories and reduce their emotional impact.
“EMDR was originally discovered and used to treat trauma, but now it’s used for anxiety, depression, addiction and many other diagnoses and symptoms,” explains Bagnara. “In addition to being a highly effective form of therapy to address childhood trauma, it’s amazing for co-occurring diagnoses.”
- Radically open dialectical behavior therapy (RO DBT) is an innovative new treatment designed for emotionally overcontrolled individuals. People with this temperament tend to avoid risks, people they don’t know and new situations — factors that can lead to several mood and anxiety disorders, as well as eating disorders.
RO DBT encourages patients to question their beliefs and behaviors by focusing on their openness to feedback, flexibility and connectedness to others.
Emotion-focused family therapy (EFFT) helps individuals navigate co-occurring diagnoses by including family and caregivers in the care process. Weekly family therapy sessions, educational resources and support groups strengthen connections between loved ones and empower caregivers to support them in all aspects of their mental health.
Key principles include:
- Emotion coaching to help caregivers support their loved ones while managing their own emotions
- Behavior coaching to guide them through obstacles and fears that may surface
- Relationship repair to facilitate healing, processing and recovery from past pain
- Milieu therapy, often referred to as group therapy, gives people a safe and supportive place to prevent self-destructive behaviors. In this comfortable community setting, individuals can develop new skills and habits they can carry into their daily lives.
Milieu therapy is especially helpful for those with co-occurring conditions because it offers real-time feedback and support. The structured group environment encourages them to navigate difficult emotions together, form meaningful relationships and build confidence in a healing space.
Long-lasting mental wellness is possible
Mental health challenges can complicate life at any age, making it difficult to untangle what’s going on. Whether you’re navigating one mental health diagnosis or co-occurring challenges, reaching out to a mental health professional can help you understand what’s happening and help you heal.
“By talking about the issues and symptoms in a safe and comfortable therapeutic environment, you’ll have much greater success of resolving your concerns and experiencing relief than by trying to take care of it on your own,” Bagnara adds.
At ERC Pathlight, 70% of patients enter treatment with more than one mental health diagnosis [1]. Each person is unique, so we look at mental health holistically to see the full picture, connect the dots between co-occurring conditions and make sure you get the exact support you need.
Our patients report clinically significant improvements in their overall quality of life and the ability to manage their symptoms effectively. If you’re interested in learning more about the impact of our care, explore our treatment outcomes to see how we’ve helped thousands of individuals identify and address co-occurring conditions to start feeling like themselves again.
Find help today
For more on how we can support you or your loved one, call us at 866-622-5914 or send us a short message. We’ll listen to what you’re going through and help you find your unique path to lasting mental wellness.
Read more on eating disorders and co-occurring conditions:
Sources
- ERC Pathlight 2023 annual outcomes report.
