Guide to common mental health conditions

Eating Disorders

What are some identifying signs?

Anorexia, bulimia and binge eating disorders vary in symptoms — restrictive eating; binge eating; self-induced vomiting; abuse of laxatives; weight loss or weight gain; excessive exercise; spending most of the day thinking about food, weight and shape; guilt about eating; not experiencing normal hunger or fullness; avoiding eating situations with other people; and bloodshot eyes or swollen cheeks from purging. The spectrum of eating disorders affects all genders, and there are long-lasting physical and psychological consequences for everyone suffering from one.

What are the usual treatments?

An assessment of medical and psychological status is usually done first, then either an inpatient unit, an intensive outpatient program or weekly outpatient therapy is conducted. Help from a nutritionist and a psychiatrist are sometimes involved. Medication depends on the individual.

What should be done if you notice these signs in a friend?

Sound supportive without sounding accusatory. “Use ‘I’ phrases, [such as] ‘I’m concerned about you,’ or ‘I wonder if I can help you in anyway,’ or ‘I feel like eating may be something that’s hard for you,’ or ‘I worry about you spending so much time at the gym.’ Rather than, ‘you’re spending too much time at the gym,’ ‘you’re doing this,’ ‘you’re doing that.’” — Dr. Diane Klein

What can lead to a recurrence of the condition?

Stress, a new environment where things may be out of one’s control or seasonal depression. During winter one may feel down and during summer one may feel body pressure.

Depression

What are some identifying signs?

Weight gain, weight loss, oversleeping, not sleeping enough, loss of interest, inability to concentrate, consistently discouraged mood lasting more than two weeks, eating too much, not eating, agitation, low self-esteem and suicidal thoughts.

What are the usual treatments?

Antidepressants, cognitive behavioral therapy, psychodynamic therapy, group therapy, mindfulness-based treatments and many other forms of talk therapy.

What should be done if you notice these signs in a friend?

“People [with depression] are typically treatment-seeking, more so than [those with] drug abuse. Approach them out of care, out of worry. Express concern without judgment.” – Dr. Michael Walton

What can lead to a recurrence of the condition?

Although depression is not necessarily linked to anything, it can be triggered by a memory or setback, heavy stress or seasonal depression with lack of light.

Anxiety

What are some identifying signs?

Feeling nervous, being restless, sweating, worrying excessively, constantly projecting negative outcomes, discounting success, shaking and physical upsets such as an upset stomach, headache and insomnia. Stress is often prevalent during exams or tests, but when it starts to affect a person’s performance and ability to drop their worries or rationalize, one should seek help.

What are the usual treatments?

Counseling, antidepressants to regulate serotonin levels, cognitive behavioral therapy, psychodynamic therapy, group therapy, mindfulness-based treatments and many other forms of talk therapy and skills building.

“First, these people must very carefully reduce alcohol and drug use which can inflame [anxiety]. It’s hard to treat the problem when a person is using.”– Dr. Michael Walton

What should be done if you notice these signs in a friend?

Take their concerns seriously. Reach out with support, give your direct observations, listen openly without judgment and patiently remind your friend that you are willing to assist them when they are ready to talk or get help.

What can lead to a recurrence of the condition?

It peaks around times of stress — keep a regular schedule, do not cut out sleep and make sure to exercise.

COURTESY OF Charles Marmar, M.D.; Rebecca Whiting, LCSW; Luis Ramirez, LCSW; Anne McEneaney, PH.D.; Diane Klein, M.D.; Michael Walton, M.D.

A version of this article appeared in the Thursday, Sept. 25 print edition. Email Emily Bell and Hannah Treasure at [email protected].