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Bipolar Disorder and Eating Disorders
December 8, 2010
Bipolar disorder and eating disorders both pose very serious health risks in different ways. The detrimental effects of the different types of disorders, although completely separate, are not mutually exclusive. In fact, many symptoms of bipolar disorder, especially depression, are quite often diagnosed alongside symptoms of anorexia nervosa and bulimia nervosa. Although the medical and psychological fields of study currently lack sufficient information about the comorbidity of eating disorders and bipolar disorder, there is plenty of evidence to conclude that major depression, a main symptom of bipolar disorder, is in fact comorbid with both anorexia nervosa and bulimia nervosa, suggesting a possible comorbidity of these eating disorders and bipolar disorder.
Bipolar Disorder and Depression
Bipolar disorder, otherwise known as manic depression, causes noticeable swings in mood from the “lows of depression to the highs of mania” within a relatively short time period (“Bipolar disorder,” 2010). There are three main types of bipolar disorder: bipolar I, bipolar II, and cyclothymia. While all three are serious medical concerns, Bipolar I and Bipolar II disorders are more severe than cyclothymia, which is considered only a mild condition. The swings in mood associated with Bipolar I and Bipolar II disorders include a deep depressive state, which alone may be termed clinical depression. Clinical depression may be an initial sign of bipolar behavior, although it more often exists as a separate condition. Clinical depression is caused by an imbalance of neurotransmitters in the brain, specifically serotonin, norepinephrine and dopamine in the hypothalamus (Purse, 2010).
Major Depression and Eating Disorders
Depression has been found to be a common comorbidity with eating disorders, specifically anorexia nervosa and bulimia nervosa (Keel, Klump, Miller, McGue, & Iacono, 2005) An experiment performed on rats revealed that healthy stimulation of the both sides of the hypothalamus at specific times leads to a very consistent eating cycle and therefore a fairly consistent body weight (Hirst, 1998). When either side of the hypothalamus is over-stimulated, disordered eating patterns occur. This over-stimulation comes from an imbalance in the neurotransmitters serotonin, norepinephrine and dopamine, the same neurotransmitters that are responsible for causing depression. It seems logical then that since the same part of the brain and the same neurotransmitters in that part of the brain are responsible for both depression and disordered eating, these two conditions would be comorbid. The results of a cross-sectional study of 1,030 pairs of Caucasian female twins, although limited, “substantially contribute to the observed comorbidity between anorexia nervosa and major depression” (Wade, Bulik, Neale, & Kendler, 2000). Similarly, a study of 229 female patients seeking treatment for bulimia nervosa revealed that the most commonly diagnosed comorbidity disorder was major depression (Herzog, et. al., 1992).
Bipolar Disorder and Eating Disorders
There have been many studies about the correlation between eating disorders and major depression, however, little research has been done about the comorbidity of bipolar disorder and eating disorders. The few sources available on the web concerning this comorbidity claim that bipolar disorder is often associated with anorexia nervosa and bulimia nervosa, and vice versa (Long, 2005; “Associated mental health,” 2007).
In conclusion, not enough is known about bipolar disorder, but it is likely that the high correlation between depression and the eating disorders anorexia nervosa and bulimia nervosa is similar to the correlation between bipolar disorder and eating disorders due to the fact that the biological causes of all of these disorders concern the same parts of the brain. More studies need to be done with twins and perhaps cross sectional studies or trans-generational studies tracing the heterogeneity of the conditions and their comorbidity rates.
Associated mental health conditions and addictions. (2007). Retrieved from http://www.something-fishy.org/isf/mentalhealth.php
Bipolar disorder. (2010, January 5). Retrieved from http://www.mayoclinic.com/health/bipolar-disorder/DS00356
Herzog, David B, Keller, Martin B, & et al. (1992). Psychiatric Comorbidity in Treatment-Seeking Anorexics and Bulimics. Journal of the American Academy of Child and Adolescent Psychiatry, 31(5), 810. Retrieved December 8, 2010, from Health Module. (Document ID: 5800694).
Hirst, J. (1998). Biological causes of anorexia nervosa and bulimia nervosa. Retrieved from http://serendip.brynmawr.edu/bb/neuro/neuro98/202s98-paper3/Hirst3.html
Keel, P.K., Klump, K.L., Miller, K.B., McGue, M., & Iacono, W.G. (2005). Shared transmission of eating disorders and anxiety disorders. International Journal of Eating Disorders, 38(2), doi: 895016861
Long, P. W. (2005). Internet mental health. Retrieved from http://www.mentalhealth.com/dis/p20-md02.html
Purse, M. (2010, January 21). What causes depression? physical reasons, mood triggers. About.com: Nutrition, Retrieved from http://bipolar.about.com/od/depression/a/what_causes_depression.htm
Wade, T.D., Bulik, C.M., Neale, M., & Kendler, K.S. (2000). Anorexia nervosa and major depression: shared genetic and environmental risk factors. The American Journal of Psychiatry, Retrieved from http://ajp.psychiatryonline.org/cgi/content/full/157/3/469
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