How Does Mental Health Affect Your Sleep?
Contributed By: Rose MacDowell, Sleepopolis
Expert Verified By: Dr. Nicole Moshfegh, Psy.D.
The term mental health describes emotional, cognitive, and social well-being. Mental health is important at every stage of life, from childhood and adolescence through adulthood. Mental health affects not just how we feel, but how we think and behave. Our psychological condition determines how we handle stress, relate to others, and make choices.
There are more than 200 types of mental illness, which is defined by the American Psychiatric Association as “a health condition involving changes in emotion, thinking, and behavior.” Mental illness is based in the brain and can have a significant impact on relationships and quality of life.
Note: The content on Sleepopolis is meant to be informative in nature, but it shouldn’t take the place of medical advice and supervision from a trained professional. If you feel you may be suffering from any sleep disorder or medical condition, please see your healthcare provider immediately.
Mental Illness: Causes and Symptoms
Mental health problems can affect self-esteem, happiness, and basic functions, such as eating and sleeping. (1) Social and financial success is strongly influenced by psychological wellness, including self-awareness and our ability to exercise self-control.
Many factors contribute to mental health issues, including:
Genes and brain chemistry
Family history of mental health problems
Life experiences, such as trauma or abuse
Mental health issues run the gamut from minor difficulty with daily living to full-blown psychosis. Treatment can have a significant impact on the course and outlook of psychological issues, making early detection crucial.
Mental illness can appear in early childhood or not until adulthood. (2) Some psychological issues may not emerge until later in life and can be influenced by certain drugs and medical conditions. There are numerous warning signs of mental health issues. These vary depending on the nature of the condition, and may include:
Eating or sleeping too much or too little
Withdrawing from relationships and usual activities
Having low or no energy
Feeling numb
Experiencing unexplained aches and pains
Feeling helpless or hopeless
FAQ
Q: What is the most common mental illness?A: Depression, a mood disorder that affects 300 million people worldwide, is the single most common mental illness. Anxiety disorders are more prevalent overall.
Psychological difficulties increase the risk of troubled relationships with family and friends. (3) Interpersonal conflict can be caused by irritability and mood swings, or feelings such as fear and anger. Other cognitive signs associated with mental health issues include worry, confusion, memory loss, and intrusive thoughts.
More serious mental disorders may cause hallucinations, including hearing voices or believing things that are not true. Suicidal behavior or thoughts of harming another person are also common signs of psychological issues. A person suffering from mental illness may experience paranoia, imagined physical ailments, or the need to abuse drugs or alcohol.
Types of Mental Health Disorders
Each type of mood disorder is characterized by unique signs and symptoms and may co-occur with other disorders. For example, anxiety might occur along with substance abuse, physical complaints, or a sleep disorder like insomnia.
The following are some of the most common mental health disorders:
Anxiety Disorders. People with anxiety disorders respond to certain objects or situations with fear and dread. Anxiety disorders can include panic disorders, generalized anxiety disorder, and phobias. (4) Symptoms of anxiety include:
Fatigue
Feelings of restlessness or irritability
Difficulty focusing or learning new concepts
Chronic pain or muscle tension
Trouble controlling feelings of worry
Problems sleeping, including the inability to sleep, unsatisfying sleep, or excessive sleeping
Psychiatric Disorders in Children. Common psychiatric disorders in children include attention deficit hyperactivity disorder (ADHD) a neurodevelopmental disorder that usually persists into adulthood. Symptoms include impulsiveness, trouble focusing on tasks or conversations, restlessness, and feeling easily frustrated. Oppositional defiant disorder is part of a spectrum known as disruptive, impulse-control, and conduct disorders. Symptoms of oppositional defiant disorder include hostility toward and lack of cooperation with teachers, parents, and other authority figures. (5)
Eating Disorders. Eating disorders involve extreme emotions, attitudes, and behaviors related to weight and food. Common eating disorders include anorexia, bulimia, and binge eating.
Substance Use Disorders. Mental health problems and substance abuse disorders often occur together. (6) Substance abuse can be a cause or a result of psychiatric issues, and may be an attempt by some patients to self-medicate or reduce symptoms.
Mood Disorders. Almost one in ten people aged eighteen or older have a mood disorder. Mood disorders involve persistent feelings of sadness, or feelings that fluctuate between extreme happiness and extreme sadness. Mood disorders include:
Depression. Approximately 17.3 million people in the US — 7.1% of adults — suffered from one or more major depressive episodes in the last year. Depression is characterized by sadness and lack of usual enjoyment that continue for two weeks or longer. Grief and sadness related to a change in life circumstances are different from depression, which doesn’t improve in response to external events
Bipolar disorder. Bipolar disorder affects approximately six million adults in the US, and impacts men and women equally. The disorder is characterized by severe fluctuations in mood, behavior, and thought patterns. Fluctuations can last from a few hours to several months, and may be affected seasonal and light changes
Personality Disorders. People with personality disorders have inflexible personality traits that are distressing to the sufferer and may cause problems in work, school, or social relationships. (7) These disorders are highly resistant to treatment, and include the following:
Antisocial personality disorder, or APD. People with antisocial personality disorder exploit, manipulate, and disregard the feelings of others. APD describes the behavior of sociopaths and psychopaths. Psychopaths do not have a conscience, whereas sociopaths have a conscience that is severely disordered
Narcissistic personality disorder, or NPD. Approximately 1% of people are afflicted with NPD. The disorder is associated with lack of empathy, feelings of superiority, and a need for admiration. Narcissists tend to be easily hurt and are unable to tolerate criticism. Treatment is generally ineffective because people with NPD don’t believe they have a mental health issue
Borderline personality disorder, or BPD. People with borderline personality disorder have trouble regulating their emotions. They tend to act impulsively, resulting in career and relationship difficulties. Of the 1.4% of the population with BPD, 75% are women, though this number may represent misdiagnosis in many men with the disorder
Psychotic Disorders. Psychotic disorders are characterized by abnormal perceptions such as hallucinations and delusions. Hallucinations are false perceptions that involve hearing or seeing things that don’t exist. Delusions are false beliefs, such as being pursued by authorities or people wishing to do the sufferer harm. The most common psychotic disorder is schizophrenia, which typically appears in the mid to late twenties. Possible causes of schizophrenia include genetic and environmental factors, disordered brain circuitry, trauma, and drug abuse.
Psychosis
Psychosis describes mental conditions that involve loss of contact with reality.
Mental Health and Sleep
One common sign of mental health difficulty is trouble sleeping. (8) The sleep disorder most closely associated with psychiatric disturbances is chronic insomnia. Some common mental illnesses and their effect on sleep include the following:
Depression. Clinical depression often presents with persistent insomnia, or the inability to sleep. (9) Hypersomnia, or excessive drowsiness, can be a sign of depression, as well. Sleep disorders are associated so strongly with depression that some medical practitioners advise caution in diagnosing depression in patients without symptoms of a sleep disorder. Up to 75% of people diagnosed with depression also suffer from insomnia.
Bipolar Disorder. Bipolar disorder is strongly associated with the inability to fall asleep, stay asleep, fall back to sleep, or all three. People in the manic phase of bipolar disorder often have difficulty sleeping, whereas those in the depressive phase may sleep much more than usual. Studies show that sleep deprivation can aggravate the struggles with emotional regulation that are common in people who are bipolar. (10) For many sufferers, trouble sleeping can be an indication of an approaching manic phase.
Anxiety Disorder. Anxiety is a principal cause of chronic insomnia. Even common anxiety related to work and life circumstances may trigger insomnia. A primary cause of chronic insomnia is conditioned anxiety related to sleep and the bedtime routine. Anxiety’s impact on the body includes hyperactivity of the central nervous system and excessive release of stress hormones, such as adrenaline and cortisol. Studies show a strong association between a history of insomnia and anxiety disorder, panic disorder, and social anxiety disorder. (11)
Borderline Personality Disorder. BPD sufferers with insomnia typically experience the daytime consequences of sleep loss, including sleepiness, difficulty concentrating, and irritability. Symptoms of BPD can be worsened by insomnia, leading to a vicious cycle of sleeplessness and behavioral issues.
Personality Disorders. Some personality disorders may be associated with disturbed sleep patterns. (12) One study revealed that people with circadian rhythm disorder are more likely to have a personality disorder than people with normal sleep and wake cycles.
Psychotic Disorders. Psychotic disorders such as schizophrenia can have a profound impact on sleep. Sleep disturbances are often an early sign of schizophrenia and can precede psychiatric symptoms by months or years. Schizophrenia patients are more likely to suffer from other sleep disorders, as well, including:
Obstructive sleep apnea
Restless legs syndrome
Periodic limb movement disorder
Circadian rhythm dysfunction
FAQ
Q: What is circadian rhythm dysfunction?A: Circadian rhythm dysfunction is caused by a loss of synchronization between sleep-wake cycles and natural light and darkness signals. Symptoms include the inability to fall or stay asleep, cognitive dysfunction, and trouble maintaining a traditional sleep schedule.
Does Depression Cause Insomnia, or Vice Versa?
It was once thought that insomnia symptoms resulted from psychiatric disorders and depression, not the other way around. Now the evidence isn’t so clear. Sleep problems may not just be the result of emotional disturbances, they may increase the likelihood of suffering from them, as well.
Medications to treat psychiatric disturbances may also cause insomnia. Psychotropic medications can have stimulating effects that contribute to interrupted sleep. Restless leg syndrome and periodic limb movements may be triggered or exacerbated by antidepressants and other drugs used to treat mood disorders.
An analysis of major studies revealed that volunteers who suffered from insomnia symptoms were twice as likely to be diagnosed with depression as those without sleep difficulties. Why? Though the connection between mood disorders and insomnia isn’t entirely understood, it is well-known that hormones and neurotransmitters are affected by poor sleep. Sleep is a restorative activity that reduces stress in the body and areas of the brain, especially the axis between the hypothalamus and adrenal and pituitary glands. Excess secretion of cortisol — also known as “the stress hormone” — may play a role, as well.
Lack of sleep and the resulting physiological stress may predispose insomnia sufferers to major mood disturbances, making early treatment of sleep disorders essential, especially in people with a family history of mental health issues. (13)
Depression and Other Sleep Disorders
Insomnia is not the only sleep disorder associated with depression and anxiety. (14) Sleep apnea is a common cause of depression, as is hypersomnia. Sleep apnea is characterized by blockage of the airway and repeated awakenings during the night. Chronic sleep apnea can result in weight gain, increased risk of heart attack and stroke, and memory problems.
Hypersomnia is associated with excessive time spent sleeping and daytime sleepiness. The disorder can be caused by medical conditions, certain drugs, and immune system dysfunction. Though most people need between seven and nine hours of sleep each night, the need for significantly more can indicate a mood disorder. Like sleep apnea, hypersomnia is related to a greater likelihood of heart attack and stroke.
Hypersomnia
A sleep disorder associated with excessive sleeping. Hypersomnia includes narcolepsy, an autoimmune disease that can cause extreme sleepiness and muscle weakness.
Psychiatric Medications and Sleep
Medications to treat psychological disturbances can have a positive or negative impact on sleep. (15) Most antidepressant medications influence the neurotransmitters dopamine, serotonin, and norepinephrine, all of which help to regulate sleep and wake cycles. Some can have stimulating effects that contribute to insomnia.
Restless legs syndrome and periodic limb movements can be triggered or exacerbated by antidepressants and other drugs used to treat mood disorders. (16) These medications can be helpful in patients without movement-related sleep disorders who suffer from hypersomnia.
Other medications such as older tricyclic drugs can help establish healthy sleep patterns in depressed patients with insomnia. Once a depressed patient starts taking medication, insomnia may be the last symptom to improve. Newer antidepressants such as selective serotonin reuptake inhibitors can suppress the REM stage of sleep, as well as the vivid dreaming that occurs during REM sleep.
Antipsychotic medications can help with insomnia, a common issue for schizophrenia sufferers. Some of these drugs can also cause daytime sleepiness, which may be preferable to insomnia. (17) Hypnotic medications are often prescribed along with antipsychotics, and may initially help with insomnia due to their sedative effects. However, many patients become tolerant of hypnotics or develop a rebound response, which can limit their usefulness for insomnia over the long-term.
Suicidal Behavior and Sleep
Suicidal behavior is a common feature of certain psychiatric conditions, including bipolar disorder and depression. Suicidal thoughts and actions can also occur in the absence of a psychiatric condition. Suicide is the second leading cause of death in people between 15 and 24. Suicide is more likely to be completed by people with access to guns.
Signs of suicidal thoughts and behavior may include the following:
Speaking about suicide or the desire to die
Feeling or talking about feeling hopeless
Researching ways to commit suicide
Appearing anxious or depressed
Excessive use of alcohol, or use of drugs
Exhibiting unusual behavior, such as rage, mood swings, or agitation
Suicidal behavior is often caused by psychiatric conditions, but may also be triggered by difficult life events, stress, loss of a loved one, or past trauma such as emotional, physical, or sexual abuse. Suicidal behavior is also more common in people suffering from post-traumatic stress disorder or chronic pain.
Recent research reveals that suicidal behavior and lack of sufficient sleep are related in adolescents and adults. (18) People who completed their suicidal actions were more likely to have suffered from insomnia, hypersomnia, or another sleep disturbance. Though further research is needed to better understand this link, existing studies reveal a strong association between mental health and sleep.
FAQ
Q: What is suicidal ideation?A: Suicidal ideation involves thinking about, planning, or considering suicide.
Last Word From Sleepopolis
Mental health is critically important to happiness and well-being. Research reveals a connection between mental illness and disturbed sleep, an association that may exist months or years before psychiatric symptoms appear.
Medications and other mental health treatments can help regulate sleep patterns, but may also cause or worsen insomnia, hypersomnia, and other sleep difficulties. Adjustment of medications or separate treatment of sleep issues can help establish healthy sleep patterns and improve quality of life for people suffering from mental health disorders.
References
Amy C. Watson, Self-Stigma in People With Mental Illness, Schizophrenia Bulletin, January 25, 2007
William Copeland Ph.D., Cumulative Prevalence of Psychiatric Disorders by Young Adulthood: A Prospective Cohort Analysis From the Great Smoky Mountains Study, Journal of the American Academy of Child & Adolescent Psychiatry, March 2011
Alan R. Teo, Social Relationships and Depression: Ten-Year Follow-Up from a Nationally Representative Study, Plos One, April 30, 2013
Peter J. Norton, Transdiagnostic models of anxiety disorder: Theoretical and empirical underpinnings, Clinical Psychology Review, August 2017
Martin B. Keller, MD, The Disruptive Behavioral Disorder in Children and Adolescents: Comorbidity and Clinical Course, Journal of the American Academy of Child & Adolescent Psychiatry, March 1992
Robert E Drake, et al. A systematic review of psychosocial research on psychosocial interventions for people with co-occurring severe mental and substance use disorders, Journal of Substance Abuse Treatment, January 2008
Tyrer P, Mulder R, Crawford M, Newton-Howes G, Simonsen E, Ndetei D, Koldobsky N, Fossati A, Mbatia J, Barrett B., Personality disorder: a new global perspective, World Psychiatry, February 2010
Krahn LE., Psychiatric disorders associated with disturbed sleep, Seminars in Neurology, March 25, 2005
Chiara Baglioni et al., Insomnia as a predictor of depression: A meta-analytic evaluation of longitudinal epidemiological studies, Journal of Affective Disorders, December 2011
Harvey AG, Talbot LS, Gershon A, Sleep Disturbance in Bipolar Disorder Across the Lifespan, Clinical Psychology, New York State Psychiatric Institute, April 8, 2012
Heidemarie Blumenthal, et al., The Links Between Social Anxiety Disorder, Insomnia Symptoms, and Alcohol Use Disorders: Findings From a Large Sample of Adolescents in the United States, Behavior Therapy, January 2019
Yaron Dagan, High prevalence of personality disorders among Circadian Rhythm Sleep Disorders (CRSD) patients, Journal of Psychosomatic Research, October 1996
Liu X, Buysse DJ, Gentzler AL, Kiss E, Mayer L, Kapornai K, Vetró A, Kovacs M., Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression, Sleep, January 30, 2007
Nutt D, Wilson S, Paterson L., Sleep disorders as core symptoms of depression, Dialogues in Clinical Neuroscience, September 2008
DeMartinis NA, Winokur A., Effects of psychiatric medications on sleep and sleep disorders, CNS and Neurological Disorders Drug Targets, February 6, 2007
Staner L., Sleep disturbances, psychiatric disorders, and psychotropic drugs, Dialogues in Clincal Neuroscience, December 7, 2005
Waite F, Myers E, Harvey AG, Espie CA, Startup H, Sheaves B, Freeman D., Treating Sleep Problems in Patients with Schizophrenia, Behavioural and Cognitive Psychotherapy, May 2016
Goldstein TR, Bridge JA, Brent DA., Sleep Disturbance Preceding Completed Suicide in Adolescents, Journal of Consulting and Clinical Psychology, February 17, 2010
Original article: https://sleepopolis.com/education/how-does-mental-health-affect-your-sleep/
Rose MacDowell
Rose is the Chief Research Officer at Sleepopolis, which allows her to indulge her twin passions for dense scientific studies and writing about health and wellness. An incurable night owl, she loves discovering the latest information about sleep and how to get (lots) more of it. She is a published novelist who has written everything from an article about cheese factories to clock-in instructions for assembly line workers in Belgium. One of her favorite parts of her job is connecting with the best sleep experts in the industry and utilizing their wealth of knowledge in the pieces she writes. She enjoys creating engaging articles that make a difference in people’s lives. Her writing has been reviewed by The Boston Globe, Cosmopolitan, and the Associated Press, and received a starred review in Publishers Weekly. When she isn’t musing about sleep, she’s usually at the gym, eating extremely spicy food, or wishing she were snowboarding in her native Colorado. Active though she is, she considers staying in bed until noon on Sundays to be important research.
Eating disorders linked to exercise addiction
New study is first to calculate risk factor
January 28, 2020
Science Daily/Anglia Ruskin University
New research shows that exercise addiction is nearly four times more common amongst people with an eating disorder.
The study, led by Mike Trott of Anglia Ruskin University (ARU), was published this month in the journal Eating and Weight Disorders -- Studies on Anorexia, Bulimia and Obesity.
The research is the first to measure rates of exercise addiction in groups of people with and without the characteristics of an eating disorder, The meta-analysis examined data from 2,140 participants across nine different studies, including from the UK, the US, Australia and Italy.
It found that people displaying characteristics of an eating disorder are 3.7 times more likely to suffer from addiction to exercise than people displaying no indication of an eating disorder.
Trott, a PhD researcher in Sport Science at Anglia Ruskin University (ARU), said: "It is known that those with eating disorders are more likely to display addictive personality and obsessive-compulsive behaviours. We are also aware that having an unhealthy relationship with food often means an increased amount of exercising, but this is the first time that a risk factor has been calculated.
"It is not uncommon to want to improve our lifestyles by eating healthier and doing more exercise, particularly at the start of the year. However, it is important to moderate this behaviour and not fall victim to 'crash diets' or anything that eliminates certain foods entirely, as these can easily lead to eating disorders.
"Our study shows that displaying signs of an eating disorder significantly increases the chance of an unhealthy relationship with exercise, and this can have negative consequences, including mental health issues and injury.
"Health professionals working with people with eating disorders should consider monitoring exercise levels as a priority, as this group have been shown to suffer from serious medical conditions as a result of excessive exercise, such as fractures, increased rates of cardiovascular disease in younger patients, and increased overall mortality."
https://www.sciencedaily.com/releases/2020/01/200128114642.htm
Persistent low body weight in young kids increases risk for anorexia nervosa later
January 31, 2019
Science Daily/University of North Carolina Health Care
A new study has found that a persistent low body mass index (BMI) in children, starting as young as age 2 for boys and 4 for girls, may be a risk factor for the development of anorexia nervosa in adolescence.
In addition, the study, published in the February 2019 issue of the Journal of the American Academy of Child and Adolescent Psychiatry, found that a persistent high BMI in childhood may be a risk factor for later development of bulimia nervosa, binge-eating disorder, and purging disorder. This large population study is based on analysis of data from 1,502 individuals who participated in the Avon Longitudinal Study of Parents and Children in the UK.
"Until now, we have had very little guidance on how to identify children who might be at increased risk for developing eating disorders later in adolescence," said Zeynep Yilmaz, PhD, study first author and an assistant professor of psychiatry and genetics at the UNC Center of Excellence for Eating Disorders in the University of North Carolina School of Medicine. "By looking at growth records of thousands of children across time, we saw early warning profiles that could signal children at risk."
Co-author Cynthia Bulik, PhD, Distinguished Professor of Eating Disorders also from UNC highlights, "Clinically, this means that pediatricians should be alert for children who fall off and stay below the growth curve throughout childhood. This could be an early warning sign of risk for anorexia nervosa. The same holds for children who exceed and remain above the growth curve -- only their risk is increased for the other eating disorders such as bulimia nervosa and binge-eating disorder."
Yilmaz said that although eating disorders are psychiatric in nature, the study highlights the need to also consider metabolic risk factors alongside psychological, sociocultural, and environmental components. "The differences in childhood body weight of adolescents who later developed eating disorders started to emerge at a very early age -- way too early to be caused by social pressures to be thin or dieting. A more likely explanation is that underlying metabolic factors that are driven by genetics, could predispose these individuals to weight dysregulation. This aligns with our other genetic work that has highlighted a metabolic component to anorexia nervosa."
Corresponding author of the study is Nadia Micali, MD, MRCPsych PhD, Full Professor at University of Geneva Faculty of Medicine and Head of Geneva University Hospitals' Division of Child and Adolescent Psychiatry.
"Our results also highlight the multi-factorial composition of eating disorders, as well as the need to develop early detection tools that could be used as part of routine checks by all pediatricians. Indeed, the earlier the problem is identified, the better it can be managed, especially if support is provided to the family as a whole, rather than just the individual," Micali said.
https://www.sciencedaily.com/releases/2019/01/190131143436.htm
Eating disorder treatments need to consider social, cultural implications of the illness
November 13, 2017
Science Daily/University of East Anglia
People in treatment for eating disorders are poorly served when it comes to addressing the cultural aspects of eating problems, according to new research. This emerges as part of an overall set of findings that suggest contemporary eating disorder (ED) treatment in the UK pays little attention to the cultural contexts for eating problems, such as gender.
This emerges as part of an overall set of findings that suggest contemporary eating disorder (ED) treatment in the UK pays little attention to the cultural contexts for eating problems, such as gender. Although EDs affect people across different genders, ethnicities and ages, women and girls are disproportionately affected by eating problems.
But this quite obvious connection between eating disorders and cultural expectations surrounding femininity is woefully neglected in much treatment, said lead researcher Dr Su Holmes, a reader in UEA's School of Art, Media and American Studies. The research is published in the journal Eating Disorders.
Dr Holmes said that although there is now extensive evidence on how EDs are bound up with cultural ideas surrounding gender, the contemporary focus on evidence-based treatment, and particularly the rise of cognitive behavioural therapy (CBT), has all but forced these issues off the agenda. If cultural elements are addressed, it is through a limited focus on 'body image' work, which often invokes the significance of the media in perpetuating unattainable images of the body.
The paper said more culturally-focused perspectives on eating problems have argued that 'disordered eating may not necessarily be motivated by the drive for pursuit of thinness or any "distortion" of body image, but rather by wider experiences' of gender expectations and pressures.'
Dr Holmes' previous research with people who had received treatment for an ED showed that even when a patient specifically asks to talk about questions of gender, their request may be ignored -- either because such issues are seen as a low priority, or because health professionals have little training in this sphere.
In response to this, Dr Holmes and Ms Sarah Drake, an occupational therapist and lecturer in the School of Health and Social Care at UEA, devised and ran a new treatment intervention at an inpatient clinic that specialises in the treatment of EDs.
The group, which was run over 10 weeks at Newmarket House clinic Norwich, was called 'Cultural Approaches to Eating Disorders', and included all the patients who were resident in the clinic at the time. These were all female, with a diagnosis of anorexia, and their ages ranged from 19-51.
Each week, the programme examined what role culture might play in EDs, including:
· Gendered constructions of appetite
· Cultural expectations surrounding female emotion and anger
· 'Reading' the starved body in relation to cultural prescriptions of femininity
· The dynamics of 'healthy' eating/living and fitness cultures' aimed at women
The group used media, such as television adverts, Disney films, press articles, image bank photography to social media, to stimulate debate about the particular issue being explored. But the media were not consistently positioned as the 'cause' of anorexia, as so often happens in suggestions of how society influences eating problems. The study found that people living with EDs find that the tendency to portray women with anorexia as the passive victims of media influence is often seen as patronising and simplistic by those living with the illness.
One patient said that suggesting seeing "a skinny model in a magazine" influenced the development of EDs "completely trivialises" the many reasons people develop body- and eating distress.
Looking at the wider contexts that shape ideas about gender in society -- such as beliefs about 'appetite' -- was seen as helpful by the participants. This focus took in food advertising aimed at women as well as wider ideas about 'appetite', such as the ways in which girls and women are still expected to exercise more restraint in sexual appetite than boys and men -- and are sex- or slut-shamed if they don't.
Participants in the group said they found it useful to situate their problem within society, thus moving away from the more individualised focus of medical perspectives that may encourage self-blame -- but it also raised questions about recovery.
One patient said: "But then, as the groups went on it's like OK, maybe this society's norms are quite disordered. But then it's like ... if society's norms are disordered ... then ... I don't know, how am I meant to change kind of things?"
Dr Holmes said: "The medical framework may offer the patient a greater sense of personal agency when it comes to feelings of control in recovery. Given that anorexia in particular is seen to be tightly intertwined with issues of control, this is clearly worth some thought."
The research shows, however, that there is room for more work and exploration in this area, and the group is now being re-run with the hope of adapting it for other services in the region.
Dr Holmes said: "It is important to stress that the study does not work on the assumption that issues concerning gender identity are only relevant to the experience and treatment of eating disorders in girls and women. The focus on how eating- and body distress may be used to negotiate dominant ideas about gender and sexuality is similarly applicable to male patients, as well as gender minorities, even whilst the cultural constructions at stake may be different."
Indeed, she said, given that recent research indicates how transgender individuals may be particularly at risk from developing eating problems, this arguably adds credence to the idea that EDs may be bound up with the pressures and difficulties posed by dominant gender norms.
Dr Holmes said: "The bottom line is that, although eating disorders are now widely recognised as being shaped by biological, psychological and social factors, the social aspect of the equation is poorly served."
Get more information at: https://ueaeprints.uea.ac.uk/64112/
https://www.sciencedaily.com/releases/2017/11/171113095529.htm
Bisexual and questioning women have higher risk of eating disorders
September 2, 2015
Science Daily/Drexel University
Lesbian women are no more likely to develop eating disorders than straight peers
Young women who are attracted to both sexes or who are unsure about who they are attracted to are more likely to develop an eating disorder than those attracted to only one sex, according to a new study.
However, the results of the study suggest that females attracted to the same-sex are no more likely to experience disordered eating symptoms than their peers with opposite-sex attractions. This finding is contrary to previous assumptions that same-sex attraction plays a protective role against eating pathology in females.
"The results of this study suggests there may be notable differences in disordered eating symptoms across LGBQ persons," said lead author Annie Shearer, outcomes research assistant for Drexel University's Center for Family Intervention Science in the College of Nursing and Health Professions. "Given the severe physical and emotional repercussions of eating disorders, these findings underscore the need for primary care physicians to ask about both sexuality and disordered eating symptoms during routine visits."
The study also found that males who were attracted to other males or both sexes had higher rates of eating disorders than males only attracted to the opposite sex, which is supported by previous research.
"While there is a lot of research indicating gay and bisexual men exhibit higher rates of eating disorders than heterosexual men, findings have been mixed with respect to women," said Shearer. "Moreover, bisexual and -- to an even greater degree -- questioning persons are often excluded from these studies."
The study, "The Relationship between Disordered Eating and Sexuality amongst Adolescents and Young Adults," is now available online and will appear in a forthcoming print issue of Eating Behaviors, an international peer-reviewed scientific journal publishing human research on the etiology, prevention and treatment of obesity, binge eating and eating disorders in adults and children.
In order to examine disordered eating symptoms and sexuality in adolescents and young adults, the researchers recruited participants from ten primary care sites in Pennsylvania and administered a Behavioral Health Screen -- a web-based screening tool that assesses psychiatric symptoms and risk behaviors -- during a routine visit. More than 2,000 youths, ages 14-24, were surveyed.
Participants' eating behaviors were assessed through questions such as, how often do you think that you are fat even though some people say that you are skinny? How often do you try to control your weight by skipping meals? And, how often do you try to control your weight by making yourself throw up?
Sexual attraction was computed based on participants' gender and to which sex participants reported they felt most attracted to: either males, females, both or not sure. In order to define sexual behavior, participants were asked whom they had engaged in sexual activities: males, females or both.
As expected, males who were attracted to other males exhibited significantly higher disordered eating scores than those only attracted to members of the opposite sex. Males who engaged in sexual activities with other males also exhibited significantly higher scores than those who only engaged in sexual activities with females.
Amongst females, there were no significant differences in disordered eating scores between females who were only attracted to females and those only attracted to males. Those who reported being attracted to both sexes, however, had significantly higher scores, on average, than those only attracted to one sex.
More surprisingly, according to the researchers, females who were unsure of who they were attracted to reported the highest disordered eating symptoms scores of all.
"This study highlights the need to increase sensitivity to the unique needs of sexual minority youth as a group and for the particularly sub groups in that population," said Guy S. Diamond, PhD, associate professor in the College of Nursing and Health Professions, director of the Couple and Family Therapy Doctoral Program and director of the Center for Family Intervention Science, who co-authored the study. "But it also demonstrates the value of standardized, comprehensive screening for mental health concerns in primary care."
http://www.sciencedaily.com/releases/2015/09/150902093253.htm