September is typically observed as Suicide Prevention Month. Often, within the conversation of suicide, there is a great deal of information linking suicide to depression or substance abuse, but very little information on the link between eating disorders and suicide. According to the current DSM (Diagnostic and Statistical Manual of Mental Health Disorders), almost all diagnoses of eating disorders present clients with an increased risk for suicide attempts (2013). According to a recent study, there were findings of 24.9% prevalence rates for Anorexia Nervosa, 15.7% for Anorexia Nervosa Restricting Type, 44.1% for Anorexia Binge-Purge Type, 31.4% for Bulimia Nervosa, and 22.9% for Binge Eating Disorder (2019). For some patients who have active suicidal ideation or a history of suicide attempts, the eating disorder can either develop or become a form of passive suicide. For other patients, suicide becomes more prevalent as we work on reducing eating disorder behaviors, even if they did not previously have a history of suicidal ideation or suicide attempts.
Much like depression or substance abuse, which we tend to hear more about, masking potentially highly distressing feelings leads to further struggles to process these emotions, which can ultimately lead to the patient feeling overwhelmed, helpless, hopeless, and out of alternative options of coping beyond attempting suicide. Whether the thoughts of suicide are present prior to treatment or come up during treatment, as a clinician we must prioritize assessing for suicide at each session, due to a prevalence of documented increased risk factors. As a team, between the therapist and patient, there needs to be a united front from the beginning of services to explore and implement healthy forms of coping, self-soothing, and grounding to address emotional dysregulation that could lead to more frequent suicidal thoughts or urges to complete suicide or suicide attempts.
Author – Gabrielle Latorre, M.S., LMHC. Therapist at Turning Tides Eating Disorder Treatment Center
(5th ed.). https://doi.org/10.1176/appi.books.9780890425596
Udo, B., Bitley, S., Grilo, C.M. (2019). Suicide attempts in US adults with lifetime DSM-5 eating disorders. BMC Medicine, 17(120). https://doi.org/10.1186/s12916-019-1352-3