Whereas most people know the basic meaning of the term depression, not many know the actual criteria used by mental health professionals to diagnose the disorder. Most people know that depression causes sadness and withdrawal, but it also causes anxiety, irritability, fatigue, feelings of helplessness and worthlessness, changes in eating and sleeping patterns, and sometimes even physical symptoms like chronic pain.
These changes in eating patterns can refer to either an increase or a decrease in the amount eaten. For some people who are depressed, life seems worthless and they are unable to see a time when things will be better. For some of these people eating anything at all is difficult and they tend to lose their appetite altogether, whereas for others watching their weight when they feel so bad about themselves already, seems pointless. When considering the feelings of guilt experienced by many depressed people, it is easy to see how a pattern of over-eating or under-eating may occur. People who over-eat or binge feel guilty about doing this, and this guilt in turn exacerbates the depression, and then the worse they feel the more they eat. The vicious cycle is evident, but also very hard to break. Fad diets can often worsen this situation. Being depressed already makes it very difficult to stick out the first slow weeks of a diet, and any cheating that occurs can trigger the guilt-eating cycle again. These people already have a low self-esteem and negative attribution styles, so any cheating will cause them to feel they are a failure and not strong enough, and will therefore cause them to give up a lot more easily.
On the other hand feelings of guilt may cause the person to stop eating altogether. It is easy to see why eating disorders like anorexia and bulimia have been linked to depression. Often treatment of the underlying depression "cures" the eating disorder. The causes of depression and eating disorders are also similar e.g. adult survivors of childhood sexual abuse are often suffering from depression, an eating disorder, or both. The prevalence rates of these disorders are both high, and both on the increase. Obesity as well as a fear of fatness are on the rise, with eating disorders being diagnosed in girls as young as 9 years old.
Research has shown that more and more people are dissatisfied with their bodies, and in our media dominated society, where image, especially body image, is emphasised, this is not surprising. Although thinness has become the image of success to which all women aspire, and which seems to have permeated the male mentality, the body weight of the average women has increased over the last thirty years. The surge in weight loss related businesses shows the very real pressure people are feeling to conform to society’s idea of the “perfect body”. The media’s portrayal of the image of the perfect body has been shown to be unattainable for between 98 and 99% of the population. These unrealistic expectations are leading to higher numbers of people feeling dissatisfied with their bodies, which in turn affects self-esteem and can result in higher levels of depression.
This preoccupation with body image is undoubtedly detrimental to mental health, but seems to be part of a bigger problem in our society. Nowadays it seems our culture of mass consumption has resulted in a kind of self-consciousness, where people have learned not only to judge themselves against others, but also through others’ eyes. This "body image" is our mental representation of ourselves, and as well as being influenced by feelings and moods, it also actively influences much of our behaviour, self-esteem and psychopathology. The connection between mind and body is critical. It is a two-way self-perpetuating process. When we feel bad about anything our body satisfaction plummets, and when we hate our bodies our mood takes a dive. Ron Heymann of the Anorexia and Bulimia Family Support Group says “There is a definite correlation between depression and the eating disorders. Both are related to low self-esteem and definitely affect each other”.
It is important to understand how body image and mood are related. We will find it easier to understand why we have “fat days”, and will stop being so hard on ourselves. For some people no amount of dieting and exercise will ever enable them to have the body they desire and according to mental health professionals, the most psychologically healthy solution to this dilemma is to get plenty of exercise, focus on healthy eating rather than dieting, and learn to accept yourself the way you are rather than try to mold yourself into a narrowly defined and arbitrary ideal.
For some people this seems logical, but others may think it is easier said than done. For counselling and referrals the Depression and Anxiety Support Group can be contacted Monday to Friday, between 8am and 8pm, and on Saturdays, between 8am and 5pm, on (011) 783-1474/6. The Anorexia and Bulimia Family Support Group can be contacted on (011) 646-2809, and Overeaters Anonymous can be paged on (011) 321-0000 code 20925. The trick to a healthier self-image and better overall mental health are summed up in the following 11 tips:*
· Develop criteria for self-esteem that go beyond appearance
Change your priorities and find new benchmarks for self-evaluation, like success at work etc.
· Cultivate the ability to appreciate your body, especially how it functions
Learn to appreciate what your body can do and what it enables you to do. In an inspirational letter written by a middle-aged woman, it states: “I have always wanted to write an article called ‘I have a beautiful body’. No, I don’t look like Jane Fonda. I look like a normal 46-year-old woman who has had three children. But my body is beautiful because of all it does for me. I have two eyes that can see, a large nose for smelling, a large mouth for eating and smiling, two hands that can hold and hug, two breasts that have nursed three sons, an abdomen that was home to three babies, two legs that can walk everywhere I want to go, and two feet to take me there.”
· Engage in behaviour that makes you feel good about yourself
Join a dance class or buy an item of clothing that enhances your appearance.
· Reduce your exposure to noxious images
Stop comparing yourself to women who are paid millions to be thin. Comparing yourself to models can have a very strong and negative impact. Realize that it is okay to be female and that the average female body is not skinny.
· Exercise for strength, fitness and health, not just weight control
Stop focusing on how your body looks, but rather on how it feels and what it can accomplish. This attitude change can be very satisfying.
· Seek out others who respect and care about your body; teach them how to talk about and touch your body
Be with someone who makes you glad to be in your body with its unique shape and dimensions
· Get out of abusive relationships
There is a difference between someone who encourages and supports weight loss for health reasons and someone who constantly criticizes and belittles.
· Identify and change habitual negative thoughts about your body
Every time you look in the mirror try to say good things about your body. Try to focus on the positive. Positive self-talk about personal goals and feelings can help a great deal.
· Decode more complicated thoughts about the body
Some people have realized that underlying their distorted body image was a problem that ran much deeper. Examples here would be a history of abuse or shyness and a lack of social skills. Once the underlying problem is worked on, many people find that they worry less about their appearance. Sometimes it is advisable to seek professional help in this regard.
· If you can't get over your bad body image, consider seeking professional help
This entails a lot of hard work and support from family and friends, but can be an experience that allows you a far better quality of life.
· Control what you can, forget about what you can't
It eventually comes down to a simple realization: work on improving what you can realistically can, and don't spend time worrying about the rest.
* Taken from: The 1997 Body Image Survey Results, David Garner Ph. D.
Psychology Today (February 1997)