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Is Anorexia Nervosa a Psychosis?

Written by: Gunborg Palme, certified psychologist and certified psychotherapist, teacher and tutor in psychotherapy.

First version: 22 Jul 2008. Latest revision: 11 Aug 2008.

Question:

 Is Anorexia Nervosa a psychosis?

Answer:

Some experienced therapists say that anorexia is a psychotic disorder since the individual doesn't have any awareness of illness. Another view is to see anorexia as an addictive condition, and here the addict also often has no awareness of illness. Hunger reduces mental suffering. If the intake of calories is less than 400 kcal a day, the sensation of hunger disappears, the person becomes calm and gets a feeling of control.

There are two types of anorexia:

  • One type is like bulimia, although the excessive eating is followed by starvation or vomiting, and the final result is to weigh too little.
  • The other type continually eats far too little.

Self-starvation reduces the amount of the hormone serotonin which can be experienced as anxiety and distress. The type of anorectics who continually eat too little are often individuals whose levels of serotonin are too high, and consequently they experience anxiety and distress. Starvation reduces the high levels of serotonin and makes their raging emotions calmer.

The type of anorexia which is really a variation of bulimia is (as well as bulimia) is caused by insufficient levels of serotonin. The excessive eating combats the depression which may follow the production of insufficient serotonin.

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