Co-occurring conditions require complete and focused care
People with eating disorders frequently experience additional health conditions such as trauma-related concerns or PTSD, depression, anxiety, OCD, self-harm, and substance use disorder. Co-occurring conditions require comprehensive treatment approaches that support all your health needs and address different disorders simultaneously to help you have a successful recovery.
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What are co-occurring conditions?
Co-occurring disorders are complex and require an integrated approach. Treatment that addresses both the eating disorder and other conditions is recommended; otherwise, recovery will be more fragile and feel incomplete.
There is a high overlap of PTSD, depression, anxiety, OCD, self-harm, and substance use disorder that impact those with eating disorders.
By getting supporting all areas of your health, you can have the best chance at long-term recovery.
Types of co-occurring conditions
Common co-occurring conditions and disorders include:
Anxiety
Anxiety disorders such as generalized anxiety and social anxiety, can be seen in up to 2/3 of patients with eating disorders. The anxiety, if untreated, can prevent individuals with eating disorders from tolerating the exposure therapy and eating involved in treatment; this is why we include screening and treatment of anxiety at every level of care at Monte Nido.
Mood
Mood disorders, such as depression or bipolar disorder, are also common in eating disorders. Some studies have shown that up to 80% of individuals with eating disorders have struggled with mood symptoms or disorders.
PTSD
One-third of patients presenting for care for their eating disorder at Monte Nido meet criteria for post-traumatic stress disorder (PTSD). This is a high enough number of patients that we have incorporated an evidence-based treatment for PTSD, called Cognitive Processing Therapy, or CPT, into all of our treatment pathways in residential and partial hospitalization programs throughout Monte Nido. Our outcomes combining CPT and eating disorder treatment have been published and have set a high standard, showing significant reduction in PTSD symptoms and eating disorder symptoms in those who undergo this combined treatment.
Substance Use Disorders
The National Center on Addiction and Substance Abuse found that approximately half of individuals with eating disorders abuse drugs or alcohol, and up to 35% of those with substance use disorders also have an eating disorder. At Monte Nido, we assess all clients for substance overuse disorders and treat appropriately; this may require inpatient stabilization first but we review all of this during our admission process and develop an individualized plan of care.
OCD
Obsessive-compulsive disorder (OCD) is a an anxiety-based condition characterized by intrusive thoughts and/or compulsive behaviors. It occurs in anywhere between 15-40% of patients with eating disorders. OCD and eating disorders can share many common features, such as ritualistic behaviors and rigid thoughts. In addition, malnutrition can activate centers in the brain that correspond to OCD-like pathways, making OCD behaviors quite common in eating disorders even if the full condition is not present. Exposure therapies and distress tolerance work are central to treatment in both OCD and eating disorders, and at Monte Nido we work to help at all levels of care to treat these disorders simultaneously whenever possible.
These conditions often share underlying causes and overlapping symptoms. Simultaneous treatment of eating disorders and other co-occurring conditions is essential to break the vicious cycle of one disorder exacerbating the other. An individualized approach to treatment is vital for addressing these comorbid conditions and achieving lasting recovery.
Signs & symptoms of co-occurring conditions
Whether it’s overlapping mental health, substance use disorder, or another co-occurring disorder, being able to recognize the signs can help you get the support you need for long term eating disorder recovery.
What does co-occurring conditonstreatment look like?
Monte Nido can help
Despite the frequency of co-occurring conditions, many hospitals or clinics admit patients for just one of the disorders, often overlooking others. One reason co-occurring disorders are commonly overlooked can be that individuals diagnosed with a co-occurring disorder or an eating disorder are typically sent to a facility specializing in only one condition. This, unfortunately, leads to gaps in care and poor outcomes.
Our approach to addressing co-occurring disorders with eating disorders is personalized, incorporating the treatment, therapies, and skills needed to guide our clients to a full recovery.
You will receive a complete physical and psychiatric evaluation, including an inventory of drug and alcohol use, by a team that includes a physician, psychiatrist, psychologist, nurse, nutritionist, and social worker. This will help us work together to better understand the areas of treatment to focus on to best support your recovery.
Our multidisciplinary, experienced, and dedicated team will work with you to develop a treatment plan that will help address all your co-occurring symptoms. Treatment for co-occurring disorders at Monte Nido includes comprehensive levels of care such as inpatient, residential, day programs, and alumni support. We offer a full range of programming for adults and adolescents with eating disorders and co-occurring conditions.
If you have more questions about co-occurring conditions, please reach out
Learn more about Co-Occurring Conditions
Associations between major depressive and bipolar disorders and eating disorder, PTSD, and comorbid symptom severity in eating disorder patients
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Taking a Look at How Eating Disorders and Body Image Are Connected – and Some Ways They Aren’t
Frequently asked co-occurring conditions questions
To ensure lasting recovery, your personalized treatment plan will include services targeting both disorders individually and their interrelation. These plans often involve various therapeutic techniques, medical care, nutritional support, and additional activities to enhance overall well-being.
Some of the services that may be included in a treatment plan for a patient with a co-occurring mental health disorder and eating disorder include:
- Medical care
- Nutritional programming
- Cognitive processing therapy (CPT)
- Dialectical behavioral therapy
- Cognitive-behavioral therapy
- Experiential therapies
- Psychodynamic therapy
- Support group meetings
- Interpersonal therapy
- Family education and family therapy programs
- Exercise
- Specialized mindfulness training
- To support and maintain motivation, explorations of spirituality, personal values, and self-comprehension are included
- Comprehensive discharge planning including referrals to providers and support system assessment
Trauma significantly influences the co-occurrence of eating disorders and PTSD. Individuals with trauma histories, especially childhood adversity, are more susceptible to both conditions. High comorbidity rates exist, particularly in bulimia nervosa and binge eating disorder.
Eating disorder behaviors may develop as maladaptive coping strategies for trauma-related emotions and PTSD symptoms, while eating disorders can worsen PTSD and trauma-related symptoms, creating a cyclical relationship. Individuals often have multiple, repeated traumas, leading to more severe conditions and comorbidities. Integrated, trauma-focused treatment is crucial to address this interconnectedness effectively.