In trying to understand anorexia, it is of paramount importance that one delineates the psychological effects of anorexia nervosa. This is important as for a full recovery, one has to address the psychological part of the illness. People with anorexia are often depressed. It can be a “which came first, the chicken or the egg” type of thing. Did they develop anorexia because they were depressed, or did they become depressed because they are anorexic? Probably some of both. The depression and anxiety will usually get worse as the disease progresses. People with anorexia also have a low self- esteem. They experience feelings of hopelessness and helplessness (which are also symptoms of depression).
They may develop other self-destructive behaviours, such as slashing of wrists, or pulling of the hair. These are ways of coping with their painful emotions. People with anorexia often withdraw from social situations, particularly those involving meals and food. Relationship difficulties may develop and a lack of a support system often develops due to this behaviour, which usually leads to isolation. The anorexic is often secretive about how much food they eat and may become angry when people express concern about their food intake or weight. Due to fatigue, which is a symptom often reported by the anorexic, resulting from low intake of food, there is lack of energy and lack of interest in doing things that were previously enjoyed by the person. This, and low-self esteem may be partially responsible for the withdrawal from social situations and the difficulty maintaining relationships.