ANOREXIA NERVOSA & PSYCHOTHERAPIES
Today, with the constantly changing perception of beauty and the influence of popular culture, people try many ways to have a body shape that is liked by everyone. In order to reach the body dimensions and the phenomenon of beauty that are liked and accepted by everyone, many people are unwittingly enslaved by mental disorders. disorders. It has been observed that individuals in this period produce emotions related to their physical appearance and body phenomena with the deterioration of body shape, increase in weight gain, acne on the face and many other factors observed in adolescent age groups. In this period when emotions and productivity are at the highest level, the individual may have to cope with many psychopathological disorders such as anxiety, depression (mood disorders), body dysphoria, social phobia, obsessions and compulsions. In addition to these psychopathological disorders, eating disorders, which are seen as deterioration in bodily functions together with mental disorders, are quite common in this age group, which is already obsessed with their weight and body shape. Although it is observed that there is a problem in the external appearance of the person in eating disorders, psychological and spiritual problems are experienced. It is not possible to determine the cause of eating disorders precisely and clearly. However, it is undoubtedly a fact that psychological, social and biological factors have a great impact on eating disorders. Of course, the effect of care and attitudes given by parents to feeding activities from infancy should not be ignored.
Eating disorders are a type of psychopathological disorder in which eating behaviors are completely and vitally impaired. Anorexia nervosa and Bulimia nervosa are the most common types combined with physical and mental symptoms in the eating disorders diagnosis group. These two types are diseases that are mostly seen in adolescents and should be considered especially in terms of being fatal. Anorexia Nervosa is a state of obsession with being overweight with the desire and effort to have a weak body and a constant fear of getting fat. The patient perceives himself as fat in the mirror, although he is actually thin and at his ideal weight. Individuals with anorexia who have misperception problems engage in activities that limit their food intake. In addition to these activities, people may make themselves vomit, spend their days with excessive exercise, and try to control their body weight with diuretic and laxative products.
According to DSM-V, in order for the person to be diagnosed with Anorexia nervosa, the person should not accept the minimum weight that is considered normal for his/her age and height, or a weight above it, and avoid or avoid energy intake. gaining weight and making intense efforts to gain weight despite having a lower-than-expected weight. fear, body weight and deformity of the person should ignore or deny this disorder in his own self-evaluation, and finally, these symptoms should have been shown within the last 3 months.(APA,2014) An individual with anorexia nervosa is as follows; The person first follows a diet, before this diet, pastries, sweets and candies are removed. Then, the way of nutrition is started with calorie calculation. This diet is accompanied by diuretic and laxative products. As the person loses weight, the idea of being thin turns into an inevitable obsession for the individual. The person loses weight rapidly until their excessive behavior to control their weight is noticed by others. As a result of rapid weight loss, psychological and physiological disorders occur in the person. Psychologically, the person finds himself emotional, withdrawn, sleepless, nervous and unable to communicate with the opposite sex. Physiologically, the person experiences hypotension, dryness of the skin and hair, lanugo hairs on the skin may complain of hypothermia, skin thickening and hardening of the skin due to vomiting in the fingers. can occur at any time in a person’s life. Although there is a perception that anorexia nervosa is usually seen in adolescent girls, this perception is completely wrong. Many men nowadays become obsessed with the desire to build muscle and strength and suffer from anorexia nervosa. In summary, although the incidence of anorexia nervosa is higher in young girls, it can occur at any time in the person’s life and in both sexes as a result of psychological, sociocultural, genetic, environmental and familial factors.
Psychological factors affecting Anorexia Nervosa may vary from person to person. Low self-esteem, cognitive distortions, impulsive and obsessive behaviors, caring for other people’s opinions, and constantly trying to please others can play a large role in the development of anorexia nervosa. In addition to these psychological factors that affect anorexia nervosa, there are also some psychological diseases that combine with anorexia. These; 65% depression, 35% social anxiety disorder, 25% obsession-compulsion. In addition to these diseases, other psychopathological diseases that develop with anorexia are anxiety, panic and PTSD.
If we associate anorexia nervosa disease with sociocultural factors; Tozzi et al. In 2003, we can understand that social pressure is an effective and important risk factor in eating disorders, but it is not enough on its own (Arıca et al., 2011). In addition, the social perception of beauty in developed and western countries is at a level that gives excessive importance to thinness. These factors play a major role in the etiology of anorexia nervosa and other eating disorders.
Another factor that Anorexia Nervosa greatly affects is familial factors. Eating problems are more common in anorexic families. The person’s family structure, lack of freedom and freedom of movement within the family, and unsatisfied relationships with one’s family may make the person more prone to anorexia. In addition, habits show that families of individuals with anorexia do not fit into a typical family pattern. However, as in all eating disorders, it is emphasized that the disorder in the early mother-infant relationship is a determining factor in anorexia nervosa (Erbay&Seçkin,2016). Studies in patients with anorexia nervosa and eating disorders have yielded striking results in terms of psychodevelopment. . These studies have revealed that people may experience eating disorders in later ages due to malnutrition during infancy and childhood.
When all these factors come together and we think that there are physiological deteriorations in the body of a person with anorexia nervosa due to excessive weight loss, when we consider the perception problem of the person, it is the eating disorder with the highest suicide rate. .
It is known that many factors are effective in the emergence of anorexia nervosa. Although there are many factors that cause the emergence of the disease, the treatment methods of anorexia nervosa vary. Therefore, the treatment phase of anorexia nervosa requires teamwork. Specialists such as psychiatrists, dietitians, family therapists, gastroenterologists should be part of this team. This team should examine the patient with anorexia nervosa from a nutritional, social, psychological and medical point of view. The primary goal in the treatment of anorexia is to regain a healthy weight. The second is to treat the psychological problems of the person related to the eating problem. Finally, it is the elimination of the behaviors or thoughts that cause the patient’s deficient, wrong and irregular nutrition and prevention of their recurrence.
The most effective method for the successful realization of these stages is psychotherapy. The most effective psychotherapy method for anorexia nervosa patients is group or family-based therapies. Especially in cases seen in adolescence, family-based therapy is more effective when the family has a say in the nutritional habits and diet of the individual. On the other hand, the person recovers faster thanks to the support and supportive therapy method he receives from his relatives. Some argue that a combination of supportive approach and medical intervention will be more effective. During the recovery period of anorexia nervosa patient, the person should be supported with mood stabilizer drugs and nutritional rehabilitation in addition to psychotherapy.