What Causes an Eating Disorder or Depression and If I Have it, Is My Child Doomed to Have it, Too?
Dr. Linda Shanti
The short answer?
It’s complicated.
The longer answer:
Genetics and temperament both play a strong role in the possibility of Depression or an Eating Disorder developing, but do not determine it.
The hopeful answer:
Even if your child develops an Eating Disorder or Depression, it is possible to recover. In this article, I will look at some of the risk factors that can lead to an Eating Disorder or Depression and stress the importance of your recovery in building protective factors for your child.
Eating Disorders: Are they inherited?
Eating Disorders develop as a combination of genetic vulnerability combined with temperamental traits and a facilitating environment. Some (but not all) risk factors named in Carolyn Costin and Gwen Schubert Grabb’s book 8 Keys to recovery from an Eating Disorder (W.W. Norton, 2012) that can contribute to developing an eating disorder include:
being overweight or dieting as a child
having a mother who diets or has an eating disorder
early menstruation
being bullied or teased
engaging in sports or activities with a focus on appearance or weight (for example ballet, cheerleading, ice skating, wrestling, gymnastics, modeling)
a history of childhood abuse
In a 2000 study in the American Journal of Psychiatry, results showed that anorexia nervosa has a heritability of 58%, but the authors were unable to rule out the contribution of environment. However, they did conclude that genetic factors influence anorexia and contribute to comorbidity of anorexia and depression.
Along with genetic links being discovered with both anorexia and binge eating, certain temperamental traits tend to foster the birth of an Eating Disorder. Ovidio Bermudez, in presenting at Eating Disorder Recovery Services conference* this past year discussed the following temperament traits as those at risk of developing an Eating Disorder:
Anxiety, Depression, or OCD
Low stress tolerance
Low distress tolerance
Sensitivity to real or perceived injury
So in other words, if you have a sensitive child who struggles with tolerating “distressing” feelings such as sadness, anger, or shame and you (or a family member) struggle with Depression, Anxiety or OCD, the ground is fertile for the seed of an Eating Disorder to sprout.
What about Depression?
At least 10% of people in the U.S. will experience Major Depressive Disorder at some point in their lives. According to statistics, two times as many women as men experience major depression. (There is a lot to be said there in terms of misdiagnosis of symptoms, gender bias, and who reaches out for support to mental health professionals, that can affect these statistics, but that is for another article.)
According to two Stanford doctors writing about genetics and brain function, genetics play a strong role in causing Major Depression (Levinson, Douglas F. M.D. and Nichols, Walter E. M.D., Professor in the School of Medicine Department of Psychiatry and Behavioral Sciences, Stanford, 2015). They write:
The heritability (or percentage of the cause due to genes) is probably 40-50%, and might be higher for severe depression.
The situation is a little different if the parent or sibling has had depression more than once (“recurrent depression”), and if the depression started relatively early in life… the siblings and children of people with this form of depression probably develop it at a rate that is 4 or 5 times greater than the average person.
What else contributes to Depression? And what about Postpartum Depression?
Stressful life events (trauma, loss of a loved one, moving/loss of support, having a baby) can lead to depression in and of themselves. When combined with a genetic risk, there is a stronger possibility of developing depression. And having one (or more) episode of depression increases the risk of having future episodes (Kendler, Thornton, and Gardner, 2001).
While many women experience some mild mood change or “the blues” during or after the birth of a child, 1 in 7 women (and some recent research says 1 in 5) experience more significant symptoms of depression or anxiety (Postpartum Support International).
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Risk factors for Postpartum Depression
Some women are more likely than others to develop Postpartum depression. The following factors put you at an increased risk:
Previous history of depression
History of severe PMS or premenstrual dysphoric disorder
Medical complications for you or your baby
Lack of support from family or friends
A family history of depression or another mental illness
Anxiety or negative feelings about the pregnancy
Problems with a previous pregnancy or birth
Marriage, Relationship, or money problems
Stressful life events
Substance abuse
How does Postpartum Depression impact children?
Postpartum Depression and other Perinatal Disorders (Anxiety, OCD, Psychosis) can affect children in the following ways:
Behavioral Problems
Delays in Cognitive Development
Emotional Problems and/or Depression
According to Zero To Three, a research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers, untreated Depression can have detrimental effects on children’s functioning and future outcomes (2009) .
The mental health of parents can affect young children… infants of clinically depressed mothers often withdraw from caregivers, which… affects their language skills, as well as their physical and cognitive development. Older children of depressed mothers show poor self-control, aggression, poor peer relationships, and difficulty in school.
If you have had or are currently suffering with and through (because it is possible to recover and get through it) an Eating Disorder or Depression, your child does have a risk. But that does not mean they are doomed. It means, even more important than ever, that you get treatment and recovery yourself! Individual therapy, group therapy/peer support and medication can all be essential aspects of the recovery journey. The best prevention you can offer your child is to do your recovery work. When I attended Postpartum Support International’s training on Perinatal Mood Disorders, the message that they gave was: There is Hope and You are not alone. It is possible to recover and in recovering yourself, you help build a more protected base from which your child can thrive and grow.
This article has originally been published on Dr. Linda Shanti's blog.
References/Resources:
Wade, Tracey D, Ph.D., Cynthia M. Bulik, Ph.D., Michael Neale, Ph.D., and Kenneth S. Kendler, M.D., “Genetic and Environmental Risk Factors Anorexia Nervosa and Major Depression: Shared Risk Factors,” Am J Psychiatry 2000; 157:469–471.
Eating Disorder Recovery Services The mission of EDRS (Eating Disorder Recovery Support), Inc. is to promote recovery and wellness for those impacted by eating disorders by providing support, information, and education to individuals, families, professionals, and the community at large regarding eating disorders and recovery resources. EDRS.net
Ovidio Bermudez, MD Dr. Bermudez has lectured nationally and internationally on eating pathology across the lifespan, obesity and other topics related to pediatric and adult healthcare, and has been repeatedly recognized for his dedication and advocacy in the field of eating disorders. eatingrecoverycenter.com
“Major Depression and Genetics” Douglas F. Levinson, M.D. and Walter E. Nichols, M.D., Professor in the School of Medicine, Department of Psychiatry and Behavioral Sciences (2015) Depression and Genetics
Zero To Three The Zero To Three policy Center is a nonpartisan, research-based resource for federal and state policymakers and advocates on the unique developmental needs of infants and toddlers. zerotothree.org
Link to Depression during and after Pregnancy Fact Sheet
Perinatal Depression Fact sheet
Link to study on teaching sleep with infants to prevent Postpartum Depression:
postpartum+depression+sleep
Link to study on effects of Lexipro on treatment of Postpartum Depression:
clinical trials postpartum+depression
Dr. Linda Shanti =is a licensed clinical Psychologist that works with women recovering from eating disorders, mood disorders, and body image distress. She knows the terrain of recovery because, prior to training as a Psychologist twenty years ago, she travelled it herself. She believes "you can't give it away unless you have it, and you can't keep it unless you give it away." Visit her website, Facebook, Twitter and Instagram.
