What does this mean? First, it may help us to understand why people who suffer with ED have periods of depression or sadness/stress. Depression is common in ED, although it might not even be clinically diagnosed. For example, I did not have CLINICAL depression in the sense that it was not bad enough to be diagnosed as such. However, there were many days when I was ill when I felt sad. angry, and truly thought that I would be better off dead. Although there are many reasons for this (serotonin, dopamine, norepinephrine, BDNF, the environment, etc), this new finding helps us to further understand why ED is so difficult. Not only is the patient physically ill, but their brains are undergoing so many changes that leave them vulnerable to low moods, feelings of sadness, tiredness, frustration, and hopelessness.
From a clinical perspective, this lets us understand what we need to include when treating patients with ED. Although food is important, I am a firm believer that the patient's mental and emotional well-being must be addressed as well. To me, this means that we need to help the patient feel better. This can be done using medicine (if appropriate), but I think it also needs a bit more than that. BDNF, for example, can decrease in response to stress, sadness, despair, and weakness. On the other hand, studies show that in ED, this is temporary and can be reversed if addressed quickly enough and with evidence-based measures. What does this mean? It can mean putting the patient in therapy, supporting them with family/loved ones, playing games with them, taking them out, etc. (The image to the right shows various aspects of health - it is much more than just physical. All of these domains are equally vital to living a healthy, happy life).
For me, one of the worst parts about ED was that many people who tried to help me recover did not understand how my mental and emotional health were functioning during this time. Yes, I completely agree that food is important. and I am NOT saying that you can recover without normalizing meal patterns. But what bothered me is that not many people (including health professionals) tried to help my emotional/mental state. If you find a trained, therapist, I say GOOD! Go for it, and continue. Make sure your team helps not only the physical, but also the MENTAL and EMOTIONAL aspects of ED as well. To those of you helping someone with ED, try to understand that this poor victim is suffering from multiple things - they are scared, tired, feel alone, and their brain 'chemicals' (neurotransmitters like BDNF) are all over the place! Patients with ED need you to understand that they are more than just their illness, and they need more than food and weight. They need ways to find happiness again, to bring joy into their lives, and hopefully, to fix the mess of neurotransmitters in their brains.
Nearly thee years later after recovery, I can say that I am doing A LOT better. Granted, there are times when I feel 'icky'. Other times I just want to cry because of stress or frustration - but who doesn't have these days? I have also been successful with helping others around me understand what is occurring with my emotions and thoughts. Now, my family understands that they need to care for ALL of me - not just my weight, food intake, etc - but also my feelings, listening to my stories and thoughts, etc. I can now freely talk about my emotions and help myself feel better. I can identify negative thoughts and work to resolve them. I do not know how my BDNF levels are doing, but I DO know that I am much, much happier than I ever was for the last five or seven years. See? Recovery really does happen! It did not come without a long fight, and it isn't always easy. But it is these moments that give me the hope, strength, courage, faith, motivation, and will to keep going.
Recovery is a marathon, not a sprint. It is a journey, not a destination. Keep going!