Psychological illness are a difficult thing to deal with, and make living and doing everyday activities difficult for sufferers. While there are many different distinct mental illnesses that are characterized, many of them seem to be linked to similar root causes, and two of those linked diseases now include Bulimia Nervosa (BN) and Obsessive Compulsive Disorder (OCD). These diseases have been recently thought to involve some of the same pathological characteristics both related to psychological manifestations and with respect to brain chemistry.
Bulimia nervosa is a vicious cycle in which the person affected binges on food after a period of starving themselves, followed by throwing up the food because of feelings of guilt and shame. This is done in order to lose weight. This seems to ultimately come from the stigma against being overweight; people try to lose weight in order to feel better about themselves and live a better life. Unfortunately, environmental situations or genetic factors can make a person more susceptible to developing a mental illness, and often more than one will occur together. Bulimia and depression are very strongly linked: about 79% of people with bulimia also have depression.
It is important for society to look at mental illness not as a choice or weakness, but as a physical disease, to reduce the stigma associated with it. The chemical makeup of the brain is changed in specific ways that cause people to behave in ways that they do not truly have control over. In fact, with bulimia and OCD, the parts of the brain that are responsible for exerting control over our actions are dysfunctional, causing the disease in the first place. The idea of self-control is traditionally something that people are inherently born with, but it is actually more of a resource. This “resource” is actually a complicated system in the brain that uses neurotransmitters such as serotonin to control immediate emotion-based impulses that brain-healthy people take for granted.
This “resource” for effortful control is found as a linking system from the amygdala (responsible for experiencing emotions) to the prefrontal cortex. This signaling happens via dopamine. The prefrontal cortex then determines what to do with the information that the amygdala, and compares the demands from the emotional signaling to long-term goals. The prefrontal cortex can only inhibit these emotional responses with sufficient amounts of serotonin present. High levels of dopamine in these areas increase the power of the emotional signaling, while low levels of serotonin decrease the ability to inhibit the emotional signaling.
Binge eating stems from the prolonged effortful control that is required to maintain the intense dieting the precedes it. Once the self-control resources such as serotonin in the brain are used up, a bulimic person will binge eat, satisfy their hunger, but then feel bad for failing their weight-loss or dieting ideal. In the end, they purge the food and continue the cycle.
Treating these diseases permanently is very difficult, although relief is often achieved. The recovery depends on the severity of the symptoms and how ingrained the compulsive behaviors are for each individual person. Usually both of these diseases are treated with Selective Serotonin Reuptake Inhibitors (SSRIs) that increase the amount of serotonin in the brain. The importance of this treatment comes from increasing serotonin in specific areas of the brain responsible for controlling emotions that lack serotonin.
By understanding how bulimia and other mental illnesses develop, hopefully awareness of the disease as a physical illness (rather than some kind of weakness of the person’s soul) will make sufferers more likely to seek professional help.
Reducing the Stigma of Mental Illness: Bulimia Nervosa
