What do most people misunderstand about eating disorders? Why do eating disorders often cooccur with major depressive disorder? Is it possible to overcome both illnesses at the same time? In this podcast episode, Dr. Cristina Castagnini speaks about mental health awareness, treatment, and eating disorders.


  • Why mental health and eating disorders are connected
  • Distinguishing major depressive disorder
  • A full recovery is possible!

Why mental health and eating disorders are connected

The most important thing that someone has to understand about eating disorders is that they are mental health illnesses.
Eating disorders also typically co-occur with other mental health diagnoses, and this is what I want to talk about and bring awareness to all of you today. (Dr. Castagnini)
Eating disorders often are symptomatic in themselves, meaning that they develop as an external symptom of an unresolved internal issue or problem. These problems could stem from past traumatic experiences or emotional turmoil that has not yet been addressed or resolved. Between 50 and 75% of people that struggle with an eating disorder will also experience symptoms (or share a diagnosis) with depressive disorder.

Distinguishing major depressive disorder

Even though there is a distinction between “going through a rough patch” and experiencing depression, the line is thin. So, if you are in a tough place and you are not sure which way to go, seek professional help.
I always encourage [people] to at least go in and get an assessment to know for sure. I [often see] people dismiss or discount what they’re experiencing rather than getting the help that they need. (Dr. Castagnini)
The criteria for someone to be formally diagnosed with major depressive disorder states that someone needs five or more of the following symptoms to have been present during the same two-week period which is different from previous functioning:
  • Depressed mood and loss of interest or pleasure
  • Marked diminished pleasure in all or almost all activities in the day
  • Significant weight loss or weight gain without an intentional shift in eating habits
  • Hypersomnia or insomnia
  • Psychomotor agitation or retardation every day
  • Fatigue or loss of energy every day
  • A feeling of worthlessness or excessive delusion or guilt
  • Diminished ability to think or concentrate or make decisions every day
  • Recurrent thoughts of death or suicidal ideation
What is crucial to note is that these symptoms should also be noticed by people around you and not only self-diagnosed. Additionally, these symptoms should be based on what someone is experiencing when they are sober. Meaning, without any substance or reaction to a medication, because then those would be considered side effects. In a more everyday sense, these symptoms would look like:
  • A sudden loss of interest in previously beloved activities
  • Mental fatigue and sluggishness
  • Trouble concentrating, understanding, comprehending, and explaining
  • Constantly zoning out and disassociating
  • Having trouble making decisions, even the small ones
  • Either constantly sleeping without feeling rested or struggling to sleep at all
Eating disorders are complex illnesses and there’s no one cause for why someone [experiences] one. They’re [typically] caused by a complex interaction of genetic, biological, behavioral, psychological, and social factors. And, depressive symptoms and behaviors can contribute to eating disorder development … but again, there’s no one cause why someone gets an eating disorder. (Dr. Castagnini)

A full recovery is possible!

Often, a person that is experiencing an eating disorder may be diagnosed with depression, or a person that is struggling with depression may develop an eating disorder. In any case, treatment is possible.
In treating cooccurring eating disorders and depressive symptoms, neither one is more or less urgent than the other, and they both must be treated together. (Dr. Castagnini)
However, in the case that the eating disorder is so severe that the person is medically unstable and is experiencing major physical consequences, becoming medically stable again is the first priority. After that, in step-down and in a lower level of treatment, then treatment for depression can begin. Listen to this episode for more information.
Recovery is possible! Do not let anyone tell you that you will always have your eating disorder to some degree in your life [because it’s not true] and you can achieve full recovery. (Dr. Castagnini)



  I am a licensed Psychologist and Certified Eating Disorder Specialist. While I may have over 20 years of clinical experience, what I also have is the experience of having been a patient who had an eating disorder as well. One thing that I never had during all of my treatment was someone who could look me in the eye and honestly say to me "hey, I've been there. I understand". Going through treatment for an eating disorder is one of the hardest and scariest things to do. I remember being asked to do things that scared me. Things I now know ultimately helped me to get better. But, at the time, I had serious doubts and fears about it. If even one of my providers had been able to tell me "I know it's scary, but I had to go through that part too. Here's what will probably happen...." then perhaps I would not have gone in and out of treatment so many times. My own experience ultimately led me to specialize in treating eating disorders. I wanted to be the therapist I never had; the one who "got it". I will be giving you my perspective and information as an expert and clinician who has been treating patients for over 2 decades. But don't just take my word for it...keep listening to hear the truly informative insights and knowledge guest experts have to share. I am so happy you are here!


Did you enjoy this podcast? Feel free to comment below and share this podcast on social media! You can also leave a review of Behind The Bite on Apple Podcasts (previously) iTunes and subscribe!