Understanding Eating Disorders and Sleep Disorders

Eating Disorders Introduction

  • Eating disorders are learned behaviors associated with food and how individuals act around it.

Types of Eating Disorders

  • Anorexia Nervosa
  • Bulimia Nervosa
  • Binge Eating Disorder
  • Other Types (PICA, Rumination Disorder)

Anorexia Nervosa

  • Definition: Anorexia nervosa is classified as a psychological illness, where 'nervosa' indicates its psychological aspect.
  • Description: Often described as a "slow burn"; individuals initially control calorie intake to assert control in their life, particularly when facing chaotic situations.
    • Example: A teenager may begin by attempting to lose a couple of pounds but this can evolve into an obsession with weight control.
  • Classification: Considered an addictive illness, sharing pathways with substance use disorders that activate similar reward pathways (e.g., dopamine release from consuming chocolate).
  • Average Onset Age: 17 years, but increasingly seen in middle school children as they become preoccupied with appearance, especially females.
  • Risk Factors: Often emerge due to life stressors (e.g., trauma, family dysfunction) and pressures in sports that require weight control (e.g., wrestling, boxing).
  • Personality Traits: Commonly associated with perfectionism, high personal standards, and rigidity in behavior rather than the stereotype of being merely tense or hyperactive.
  • Diagnosis Requirements: BMI must be below 16 for diagnosis, with intense fear of weight gain and significant distortion of body image.
  • Symptoms:
    • Extreme restriction of food intake leading to starvation.
    • Avoidance of eating in public; treatment involves group meals to counteract secrecy and shame associated with eating disorders.
  • Serious Consequences: Can lead to severe malnutrition, dehydration, and infertility; one of the deadliest psychiatric disorders.
    • Example: Mention of notable figures such as Karen Carpenter and Eugenia Cooney.

Bulimia Nervosa

  • Definition: Characterized mainly by binge eating followed by compensatory behaviors (purging).
  • Key Components: Binge eating and purging methods (e.g., vomiting, laxatives, excessive exercise, diuretics).
  • Differences from Anorexia:
    • Body weight is typically normal, unlike the severe underweight often found in anorexia.
    • Psychological aspect: Less intense control over eating compared to anorexia, still associated with anxiety and depression.
  • Complications: Can lead to electrolyte imbalances, dehydration, gastrointestinal issues (e.g., hemorrhoids from laxative use), and dental problems from vomiting (e.g., loss of teeth, dental caries).
  • Risk Factors: Often associated with trauma or abuse backgrounds, but individuals may not fit the stereotypical profile.

Binge Eating Disorder

  • Description: Involves consuming large quantities of food without purging afterward, leading to potential obesity.
  • Health Consequences: Associated with various health problems including diabetes, hypertension, and cardiac issues.

Other Eating Disorders

PICA

  • Definition: Involves eating items that are not considered food (e.g., dirt, non-food substances).
  • Common in children but problematic in adults (e.g., examples of foam or unusual substances).

Rumination Disorder

  • Definition: Involves regurgitating and re-chewing food, can occur in children and individuals with intellectual disabilities.

Assessments and Interventions for Eating Disorders

Short-Term Goals

  • Stabilization of existing medical issues is the priority before addressing psychological concerns.
  • For example, treating electrolyte imbalances and rehydrating patients, especially those with bulimia.
  • Care strategy includes daily weight checks, ensuring the patient is not aware of their weight for psychological stabilization.

Rehabilitation Challenges

  • Anorexia has a relapse rate of approximately 50% post-treatment due to rigid mindset.
  • Treatment often requires family involvement and could involve therapy focused on re-establishing normal eating patterns after long-term disordered eating behaviors.

Sleep Disorders

Overview

  • Sleep disorders can be categorized into primary disorders (physical abnormality) and secondary disorders (resulting from other issues like depression).

Types of Sleep Disorders

  • Insomnia: Difficulty falling or staying asleep.
  • Hypersomnia: Excessive daytime sleepiness.
  • Narcolepsy: Sudden sleep episodes without warning.
  • Breathing-related: Conditions such as sleep apnea, where breathing is obstructed during sleep.
  • Circadian Rhythm Disorders: Misalignment of sleep-wake cycles (e.g., elderly patients having days and nights mixed up).
  • Parasomnias: Abnormal behaviors during sleep (e.g., nightmares, sleepwalking).

Treatment Interventions

  • Primary treatment includes establishing regular sleep patterns, ensuring a comfortable sleep environment, and possibly using medications (e.g., melatonin) if behavioral strategies are ineffective.

Sexual Dysfunction Disorders

Overview

  • Sexual dysfunction can result from psychological issues (e.g., past trauma) or physical problems.
  • Importance of understanding sexual response cycles, which include desire, arousal, orgasm, and resolution.

Types of Sexual Disorders

  • Paraphilias: Intense sexual fantasies or compulsive behaviors.
    • Example: Porn addiction as a prominent issue today due to the accessible nature of pornography online.
  • Erectile Dysfunction: Inability to maintain an erection due to various psychological or physiological factors.

Treatment Approaches

  • Treatment often involves therapy, psychoeducation, and medical interventions for underlying issues.
  • Investigating a patient’s sexual history and addressing any potential trauma during their experiences is crucial for effective treatment.

Final Thoughts

  • Many psychiatric disorders, including eating disorders and sexual dysfunctions, require comprehensive and multifaceted approaches to treatment, emphasizing the importance of addressing both psychological and physical health.