Depression and low mood (young people)
Depression, food & eating disorders
It is quite common for eating or “not eating” to be linked with different emotional states, for example, missing a meal before an important event due to anxiety or binge eating when upset. However, for some of the young people we spoke with, this link was more marked.
Depression and food
Quite a few young people talked about their relationship with food and the link between food and their mood. Many described eating as a form of a coping strategy, particularly as a way to attempt to control what otherwise felt like uncontrollable moods and emotions. For some, this meant not eating much at all, or only eating certain foods, or binging. Young women also talked about peer pressure in school to be of certain weight, and their classmates being constantly on diets and trying to lose weight for special occasions like the prom.
Sara's eating disorder started off as a "coping strategy". (Read by an actor).
Sara's eating disorder started off as a "coping strategy". (Read by an actor).
SHOW TEXT VERSION
PRINT TRANSCRIPT
By not eating you know I, it was to me it was self harm when I started off, by not eating it was self harm and it was, and then by throwing up it was self harm, it was, that was what I was doing but then I got so sucked into the fact, that oh wow I’m losing weight, it just got, suddenly I wanted to lose weight and it was, it was just it just kind of took over so although it was self harm it was, it just became it’s own thing as well. And it became my new kind of coping strategy for everything. And so definitely I think for the last year of sixth form it was, because both of them were going pretty strong it was very intense then. I lost a lot of weight, not too much, but I lost a lot, I mean, I was very big, I did lose a lot of weight and I do still struggle with eating, but not too much.
I mean I do still struggle, but that is my main issue that I talk to counsellors about because it’s kind of, you know, my self harming coping mechanism was taken away from me, my eating disorder although my Mum found out about it it’s much easier to hide.
Some also described control over eating as a form of self-harm. For them, not eating, being “obsessive” about eating and “calorie counting” were the only way they felt they could control their moods or depression. A couple said that not eating or binging was easier to hide and keep a secret from those around them than for example cutting.
One woman had been diagnosed with “food phobia” and said at times when she felt anxious or depressed she stopped eating. She said she had to avoid the “feel good factor” that eating could bring her as she couldn’t handle the overwhelming feeling of happiness. She later found out she’d had difficulties with food and eating since she was a baby.
Cat has been diagnosed with food phobia.
Cat has been diagnosed with food phobia.
SHOW TEXT VERSION
PRINT TRANSCRIPT
With regards to my eating, it’s all become back as an issue because my eating has been a problem in the last six months, which I thought was signs of my eating disorder coming back, but it’s not and they have diagnosed me with this “Food phobic”. When I’m anxious and depressed I stop eating. Because and that I’m scared of feeling the happy factor that food gives and I can’t deal with the overwhelming feeling of being happy. So I’m food phobic avoid it. And I’m now undergoing CBT at [place name], which costs £117 per session, for the next week for the next six months.
I mean the issue now and going through psychotherapy with CBT, is that they’ve now, we’ve now come up now, that we’ve now found a link with my eating that my eating disorder was not treated when I was 14 that we thought it was. Because the issue of my eating, it was all about, when, when I was having CBT the first time, it was all about we’ve got to get your weight to a safe level, but not why I’m not eating in the first place, not why I’ve got the issue with the food in the first place. So we’ve now gone further now I’ve got food phobia, so there’s that link, and when I was little I had issues with food when I was a baby, which I’ve only just found out about from my parents. So, that was never picked up on as a child, so, it’s as, we’re now going backwards all the way through, the links are being made.
Depression and eating disorders
We also spoke to a few young people who had developed an eating disorder, such as anorexia nervosa or bulimia nervosa. Eating disorders are much more common among women, and in fact all the people we spoke with about eating problems for this website were women. (Male experiences of eating disorders can be found in our Eating disorders website.)
Many of them had been bullied about their appearance or weight in school and they’d started losing weight to try and fit in and stop the bullying. They also said their self-esteem was really low and being bullied about their weight knocked down their confidence even more. One woman said the main issue in her developing an eating disorder was serious long term bullying she had experienced in school, which was never addressed and dealt with. People around her were more focused on getting her weight up, rather than addressing the underlying problem of the bullying.
One woman said that the most significant factor in triggering her eating problem was the media and its portrayal of skinny celebrities who always seem “happy” and “successful”.
One woman said that the most significant factor in triggering her eating problem was the media and its portrayal of skinny celebrities who always seem “happy” and “successful”.
Sian started losing weight because she was bullied about her weight in school."
Sian started losing weight because she was bullied about her weight in school."
SHOW TEXT VERSION
PRINT TRANSCRIPT
Yeah it started roughly when I was about, say about 8, 9, I was in primary school and I was just generally getting teased. I wasn’t a big child but I wasn’t like quite slender and I was like, wasn’t skinny but I wasn’t fat either, I was just like in between, the average weight. And I just got bullied for it, and that’s it really. I used to like skip meals and see if I could just, and every day I went without eating it was like a bonus for me, it was like, it was like a pat on the back to myself, like, “Well done, keep it up. Keep going.” So that I just used to keep going, keep going and see how long I could last. That was it.
As a result of bullying, Ruby started to believe that she was 'ugly' and had 'a hideous deformity...
As a result of bullying, Ruby started to believe that she was 'ugly' and had 'a hideous deformity...
SHOW TEXT VERSION
PRINT TRANSCRIPT
I did quite well in primary school, like socially and stuff, like, not Miss Popular, but just got on really well with stuff and then when I started at comprehensive school, after about six months I was bullied, what’s the word, internably? [Intermittently]. Lots. And then, and they the main thing was that they said that I looked like a pig. And I’d have comments like, “How can I concentrate on the lesson when I’ve got an extra from Planet of the Apes sat next to me?” In art class they’d draw pigs and put my name on the top and stuff like that. So my rationale was that if I was thinner my nose would be thinner and they wouldn’t be able to take the piss. That was my rationale in losing weight in the first place, like , I used to walk around town or school or anywhere like that, I was terrified of being seen anywhere, so I always used to pretend I was scratching my eyebrows or something, to hide my nose, ‘cos I really, I genuinely was made to believe that I had this hideous deformity, like I would hit myself in the face with a hairbrush and stuff in the hope that I would break my nose and have it re-shapen, or something really ridiculous. I genuinely was led to believe that I was that ugly that even walking down the street people were staring at me and stuff. And it’s like utter crap like, but at the time I was, it was so incessant, that’s the word, incessant, I was, I totally believed it, hook line, hook line and sinker.
I remember when I went for my GCSE’s; I didn’t even go back to the school to pick up my results. I just waited for them to come through the post, that’s how much I hated it, I just, I was terrified of being seen.
Jennie says she was already more 'vulnerable' but it was media images of celebrities which...
Jennie says she was already more 'vulnerable' but it was media images of celebrities which...
SHOW TEXT VERSION
PRINT TRANSCRIPT
I’d say probably the media was the main thing that sort of, like all the factors probably led up to maybe me more vulnerable to depression, but the one that sort of triggered it and set it off was the media.
Due to probably like I was sort of like lacking confidence with friends, lacking confidence around my family, like I thought my family thought like I was failing, and it’s like well these celebrities, everybody thinks they’re successful, everybody likes them, they’ve got so many friends, and it’s like, well, well I should be like that. Why am I not like that? And that sort of triggered off the whole depression thing and, then obviously the trying to control it with not eating.
For many of those who’d developed an eating disorder, difficulties with food had started off as a form of self-harm. A couple of women said they had never intended it to go as far as it did but that eating had “become a monster of its own” or gradually “taken over” their lives. For one woman binging was meant to be “a secret thing on the side” but in the end, bulimia became a “fulltime job”. She says “it became my life”. For many, not eating was a way to “punish” themselves. One woman described the extent of her bulimia in the following way:
“I was hugely bulimic. I know every public toilet in the West Country off by heart, what times to use them, when it’s quiet, like whether or not they give good loo rolls so you can wipe away the sick.”
A couple of women said they exercised a lot. One became “obsessed” with sport and the gym and another said her “sportiness” masked her weight loss. They also pointed out that once they started getting better they had to be careful not to start overdoing exercise and had to be consciously aware of getting the balance right.
For a lot of these young people their school work had suffered because of severe problems with eating. Many started missing lessons because they were too consumed with eating, or to avoid being bullied about their weight. Their grades started going down and one woman took an extra year to do her A-levels. One woman said she was “a perfectionist” and the school work put a lot of extra pressure on her mood and eating.
Cat explains how problems with eating affected her school.
Cat explains how problems with eating affected her school.
SHOW TEXT VERSION
PRINT TRANSCRIPT
No one was aware of my eating. As I’m very well known now, I’m a good liar. And I at the time it was when the fashion came in of all baggy clothes, baggy trousers, so I kind of deliberately got into that fashion to hide it. And it wasn’t, I mean I left, left school, I managed to get out of there through my GCSE’s. I mean I was predicted the normal Cs and whatever, I left there with one C, and the rest Ds and Es and everything, I, all I wanted was a C in English, so I could get through on my Media. That was all I wanted. And unfortunately that wasn’t enough to get me into college because I spent more time seeing the psychiatrist, bunking off school, not wanting to go to school, bunking off in lessons to avoid the bullying. So it just affected my whole school life.
The effects of an eating disorder on young people’s physical and mental wellbeing were just as all-encompassing as the role the eating disorder had gained in their life. Physically, they said they always felt “fatigued”, tired and had difficulty concentrating. One woman described her physical symptoms:
“I felt really weak. Difficult to concentrate on work. That could be because of the mental thing and the physical thing together; sore throat, just feeling, generally dreadful because vomiting takes up quite a lot of energy. Not having sufficient minerals and vitamins and protein and all that does make you really tired.”
One woman said she was always “cold and sleepy” and had to go to bed at 8pm. Some also suffered with bloating, black outs or were more susceptible to infections and viruses. Psychologically, people described feeling anxious and the battle with eating making depression much worse; “the depression that comes with it is just horrendous”. Several also said they had suicidal feelings and urges and a couple of people had attempted suicide. In the end, a few said they had stopped caring for and about themselves. One person said for her, eating was a way to try and distract her mind from suicidal feelings and try and ignore them, even for a short time.
Ruby describes the physical and psychological effects she experienced with bulimia.
Ruby describes the physical and psychological effects she experienced with bulimia.
SHOW TEXT VERSION
PRINT TRANSCRIPT
Physically, it’s hard to know because I was so used to feeling like shite all the time, that I could look back and go, “Oh I felt fine.” But mentally I had completely screwed myself up with everything, honestly, like I did have problems like kidney infections and like really bad throats, not like today, this is a bit like, I’ve actually got a cold today. But like horrendous throats, like marks all around my face from being sick, just like no gag reflex, absolutely disgusted at the thought of any food staying down. I thought I was grossly overweight, which was ridiculous, I wasn’t at all, I wasn’t even close to being overweight, but I looked at myself and I genuinely believed that I looked pregnant and stuff like that. And it wasn’t, it was from where I’d binged and purged, and your stomach swells because of it. And then I’d stand in front of the mirror and go, “Oh my God.” And it was like; I still didn’t cotton on the link you know?
And , so physically, I mean in hindsight, I don’t remember anything being really bad apart from when I abused laxatives and stuff, I once lost control of my bowels on a train, and had to sit in them for two hours while I came home, ‘cos I had nothing else to change into. so that wasn’t pretty. But, I got off quite light with side effects. But as it went on and on it was the psychological effects, paranoid, hypersensitive, terrified of speaking to anyone in case they thought I was stupid or making an idiot of myself you know like, it’d been five or six years and yet I was still that kid in the classroom who was trying to hide her nose and I just couldn’t operate on a social level at all. ‘Cos I didn’t know who I was, all I was bulimia and drinking, that’s all I was.
And just like so it’s the psychological stuff, I just remember being suicidal loads, and I remember when I first started self harming I was just like in the same way that the bulimia was like, “We’ll do this as a one-off.” And then within a year that was my new thing, get drunk, self harm, go bed, get drunk, self harm, but look at me, I’ve beaten bulimia. You know like, yeah again it just started with a, “Oh I haven’t tried that.” So that’s how it escalated.
Support for eating disorders
Many people they knew they had a problem with their eating but felt unable or unwilling to ask for help. One woman said bulimia is “like having a best friend only you know you shouldn’t be hanging out with”. They described feeling too “shy” or “ashamed” to seek help for their eating problems. One woman said she found it particularly hard to seek help for bulimia because she found it “a dirty secret” compared to anorexia. Almost all of them said they’d become “good liars” or experts at “keeping secrets”.
For years, Ruby was desperate for "somebody to notice just how much in the shit I was". In...
For years, Ruby was desperate for "somebody to notice just how much in the shit I was". In...
SHOW TEXT VERSION
PRINT TRANSCRIPT
I had this ongoing thing of every time there was a holiday like a, a summer holiday, Easter holiday, something like that I’d be like, “Two weeks, how much weight can I lose in two weeks?” ‘Cos I was desperate for somebody to notice what was wrong. And I just thought oh if I could just get really skinny the teachers will notice and they’ll ask if I’m alright, and you know it’ll be a way of speaking without having to speak, do you know what I mean.
But, never worked. Like I never lost that much weight ‘cos I was binging so much anyway. Like, and ‘cos I was very sporty they just assumed that I was, ‘cos I was doing lots of sports so, but, yeah that was my theory, every, every holiday was like, “Well six weeks, I’m going to be like really tiny when I go back, so they’ll know something’s wrong.” ‘Cos I just couldn’t articulate it at all. ‘Cos most of the time I didn’t know what was wrong, like why am I feeling like this, why am I, why has all this gone wrong you know, like I had no idea how to even start a conversation. And now in hindsight I realise that all you have to do is just open your mouth, say one word, and the rest like will come.
I suppose you could call it attention seeking, but not in the negative way that it’s portrayed. I was desperate for somebody to notice just how much in the shit I was. That’s, that was my goal. Not so like I would be like, “Oh my God, look at you, oh yeah.” Not that kind of attention seeking, I was desperate for an adult figure in my life to almost, take me under their wing, rescue me in some way. And I thought if I could just get thin enough someone will notice and they’ll be all caring and stuff towards me.
But it’s like I was constantly doing this, and it’s like, turns out years later all I had to do was turn round and ask for help and I would’ve got it. But I was too ashamed, too shy; you know everything, just assumed that it was a dirty secret, you know like I was quite jealous of people who were anorexic because it seemed to me much cleaner and more becoming you know? Whereas Bulimia was this disgusting violent act, do you know? Like, so it was like I couldn’t, I just felt absolutely, yeah, I dreamt of being anorexic, but I was so badly with bulimia, it’s not like you can choose what illness you get.
It was difficult for Jennie to not understand the causes of her problems with eating.
It was difficult for Jennie to not understand the causes of her problems with eating.
SHOW TEXT VERSION
PRINT TRANSCRIPT
It got to the stage where obviously my friend end, ended up intervening, telling my parents, and my parents like just asked me out right, and I just said, “Oh I’m not going to lie to you, yeah I am on, not eating.” And they were like, “Why?” And I was like, “Well,” and I like explained about the thoughts and like, “Well why, what’s the reason for these thoughts?” And like, “I can’t tell you.” And they thought, they understood because obviously they’d gone through depression, so that was good for me, apart from again when my Dad, my Dad was sort of obviously frustrated that I felt like that, and wanted to know a reason and then like sort of, had to keep on reminding himself, look there’s not always a reason, but he’d like always ask, “Oh come on, tell me the reason, tell me the reason.” And obviously, I were, I was on the, I’d just like sort of slipped into the category for anorexia, so for me it didn’t get to the really bad stage where I was really underweight, I mean I did look very, very emaciated, because obviously I’m quite tall, and but then it was a case of being watched while I was eating, and friends at school had to make me eat my lunch, and it was like, “For God’s sake, why won’t people leave me alone?
For some, it was years until anyone else realised they had a problem with eating:
“I ended up in hospital and that was my first stint sort of ten years after my initial problems began, when I was even seen by a professional, you know making myself sick 7 or 8 times a day and nobody picked up on it kind of thing. Or if they did they didn’t say anything.”
A couple of people had really wanted the help but hadn’t been able to get it. One woman said she was desperate for any adult figure to notice she had a problem, to take it seriously and help her. She kept trying to lose more weight so someone would notice how ill she was because she felt unable to speak up and approach anyone. Another woman said she and her GP had to “beg” to get into specialist care for depression and the eating disorder. After several suicide attempts she had been admitted as an outpatient and put into an “eating programme”.
Parents’ reactions varied. Some parents had been very supportive, actively looking out for information and different interventions, others were unaware of the problem. One woman said her parents didn’t quite know how to handle her eating disorder and had just told her to stop doing it. One woman said her parents knew she was regularly making herself sick at home but they hadn’t intervened. It was her teacher who’d noticed her vomiting in the toilets and approached her about it.
Ruby's parents knew she had a problem with eating and food but didn't intervene.
Ruby's parents knew she had a problem with eating and food but didn't intervene.
SHOW TEXT VERSION
PRINT TRANSCRIPT
I came home once when I was about 16, I moved in with my Dad and there was a post-it note on the toilet seat saying, “You’ve blocked the fucking drains again.” And he’d gone off to live with his girlfriend ‘cos he couldn’t be bothered to get a plumber. My Mum once heard me being sick in the shower, and she was like, “Why do you keep doing that when you go in the bathroom?” And I’m like, “I swallowed some shampoo.” And she was like, “No you didn’t, you make yourself sick.” And I was just like really embarrassed, like a hot flush. That’s the only thing they ever said to me about it.
And they knew. They knew, they really knew. But didn’t do anything.
What did you think about that at the time? Do you remember?
Um, being glad that they didn’t know. But when you look in hindsight and you think actually they did, that doesn’t, well, that doesn’t make me angry it just makes me like, “Why?” Like, why, who wouldn’t worry about that in their own daughter, do you know what I mean? Like, to them they just thought it was this silly, I don’t know how they saw it actually, it’s never been raised, as an issue. Like, I’m not close to them anyway so but then it’s never been. Nothing’s ever been said about it, other than those two comments.
Talking treatments (therapy and counselling) had been useful but also “hard work” for many. In addition, a couple had also been on antidepressants to help with their low moods. One woman said she got help from CBT because she’d learnt cognitive “activities” she could apply to other areas of her life too.
Jennie has found CBT really helpful and says she's had to put a lot of work into it herself.
Jennie has found CBT really helpful and says she's had to put a lot of work into it herself.
SHOW TEXT VERSION
PRINT TRANSCRIPT
And we found out about this Insight, and that really helped ‘cos, like whereas at the Child Mental Health Team it was more, it was more aimed at younger people, and ‘cos I was at sort of, at the age limit everything they was do, they were doing was like, I was like, well this is ridiculous because I’m not that age, and why are you doing this? And why keep on changing my tablets? And I just kept on getting frustrated and getting, finding the counselling session pointless ‘cos more and more times I would go in and not getting anything out of it, and I was just like, “Right, let’s just try on my own,” and obviously that didn’t work, and then this Insight Team like, really focussed on cognitive behavioural therapy at a more adult level. And they, like they said, you get as much out of it as you want to. You’ve gotta put the work in, and probably because I’d got so frustrated and like down heartened by the Child Mental Health team, I didn’t put the effort in ‘cos I thought well this is pointless. Whereas I had a clean slate, wanted to put the effort in, and it really worked, and like even now it’s hard sometimes, but by putting the work in, and, you, as long as, like once you’re established and they know how to do it, it’s a lot easier to do it. But you need the initial, like help, to be able to do it, whereas some people don’t.
A few people had been hospitalised as their weight had gone down so much or because they’d attempted suicide. One woman felt the experience of staying on ward negative and she felt controlled:
“Everyone who wanted to help were just trying to control me basically, not really trying to help, they just wanted to control and take over. It felt like I had like no control, so my self-harm was basically my way of controlling my food.”
Sian stayed 12 months in eating disorder units and then moved to a children's home.
Sian stayed 12 months in eating disorder units and then moved to a children's home.
SHOW TEXT VERSION
PRINT TRANSCRIPT
And just sort of went on like that for two years bullying in primary school, and I was referred to, when my Mum had found out about my diary and I was also referred to CAMHS. I was under two horrible women, called Anorexic Nurses and they, they basically weighed me every time I went, which was once a week. So I used to like hide things in my socks and things, just little pennies and things that I thought would add weight on. Which didn’t, my weight continued to fall.
I was put into a unit in [town name] and then I stayed there for eight months while they got my weight on target and things. came out after eight months and I just went rapidly downhill again. I was diagnosed with depression and things and when I was in [hospital name], when I was in the unit in [town name] and then, ‘cos thing just got worse after I came home, I was put in another unit, called [hospital name] in [place name], and I wasn’t too good so I just used to like people to, tend to like kicked off, ‘cos like [laughs] I used to like just get really angry with people and things, so then after that they put me, they referred me to a social worker, ‘cos my Mum was at like, my Mum really just couldn’t cope, so my Mum then turned me over to social services, so I was then put in care, sent to a secure unit, and for welfare. So I was put in a secure unit for 3 months, then I went to a children’s home and basically it was a therapeutic unit and we used to do stuff together and things, great time really, and then I’ve just gone down the support side of things really. I’m on my own now currently, living on my own, with support. And that’s it basically.
For a few, problems with eating had been the trigger for them to get help with their depression for the first time. Many said they were still working through their issues in counselling and that a level of awareness of food and eating was still present in their everyday lives.
For information see our eating disorders website.
Last reviewed June 2017.
Copyright © 2024 University of Oxford. All rights reserved.