Wednesday, December 4, 2013

Eating Disorders Among Bipolar People

During the holidays, we often focus on eating.  Bipolar people are more likely to suffer from eating disorders than are others, and for some, holiday feasts can trigger anorexia, bulimia, or binge eating.

While I am bipolar and have been anorectic in the past, I haven't had an eating disorder for decades. But having written the "Dieters Notebook" column for Cosmopolitan for seven years, I have researched eating disorders then and have also found new information now.

Women are more apt to have an eating disorder than are men, and both bipolar women and men are more likely than other groups to suffer from bulimia and anorexia. Bulimia is eating and then forcing one's self to throw up. Anorexia focuses on a distorted body image so that sufferers starve themselves, sometimes so severely that they die. One of its most famous victims was singer Karen Carpenter, who died of anorexia when she was thirty-two.

About one in ten bipolar people is a binge eater, which is a higher proportion than in the general population. Binge eating can be a mood regulator, taking the edge off depression and anxiety. Bipolar binge eaters tend to have a more severe form of bipolar disorder than bipolar women and men who are not binge eaters. This may be because eating can be a form of self-medicating, improving the eater's mood and decreasing tension. Turkeys are especially good at lifting our moods due to their tryptophan, which stimulates the brain to release more serotonin, a feel-good amino acid.

Having an anorectic or bulimic person at the table (bipolar or not) can, be a downer, because anorectics are fussy not only about what they eat but also about how much. And any time bulimics excuse themselves from the table during the a meal and go to the bathroom, everyone knows they are probably throwing up. In contrast, binge eaters keep down whatever they eat, so while they may help themselves to more than their share of the meal, they keep it down.

For bipolar people, an eating disorder is most likely to be severe if the bipolar disorder is severe. Unfortunately, medications for treating bipolar disorder don't mix with medications for eating disorders. In fact, meds that can help a bipolar person may stimulate binge eating in someone who has not previously had that problem and also may trigger a binge eating spree in a patient who is already a binge eater.
From a positive perspective, psychotherapy can often help control both bipolar disorder and binge eating.