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8 December 2004
Bulimia And Depression Often Linked In Teens 
Teenagers suffering from bulimia may actually be fighting two disorders, coping with the effects of a devastating eating disorder while also struggling with a chronic form of depression. Researcher Marisol Perez, of Texas A&M University, says the finding has critical implications for the way the disorder is treated. Dysthymia - a lower-level, chronic form of depression - is often present in bulimics and may even predispose them to the eating disorder, says Perez. "As pernicious as major depression can be, it tends to remit, even if untreated," she notes. "By contrast, dysthymia is unrelenting, often lasting decades, with the average episode length lasting more than 10 years." It's this long-lasting nature that makes dysthymia, rather than major depression, more likely to be associated with bulimia, which is characterized by unrelenting negative feelings about one's self. Bulimics, says Perez, tend to have chronic low self-esteem. The chronic and pervasive self-esteem problems associated with dysthymia may make dysthymic people vulnerable to bulimia, she says. Perez believes that her findings can provide additional information to create more focused and effective treatments for teens with bulimia. Knowledge of the co-existence of bulimia and dysthymia in teens can help therapists assess specifically for dysthymia in bulimic patients and choose a treatment that will combat both disorders. It is possible for adults to suffer from both disorders, but she notes that the patterns between bulimia and dysthymia may change from adolescence to adulthood, making major depression more likely to co-exist in adults than dysthymia. She reasons that as the course of bulimia progresses, the social support network and resources of a bulimic person may start to diminish, making negative life events harder to overcome. The binges and purges that serve as a type of coping mechanism in the beginning of the disorder may, over time, lose their comforting aspects while their harmful ones continue to be amplified. This, in turn, may cause the intensity of the depression to increase, making the occurrence of major depression and bulimia more common in adults, she concludes.
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