Portfolio of Hope

Depression and Anxiety, whilst once thought to only effect our mental health, can in fact impact upon every aspect of our health, that being our psychological (mental health), and physiological (physical health). One such example of an element of our physical health that can be effected by depression and anxiety is our appetite, with it impacting upon, and sometimes even changing, the relationship that we have with food. In terms of how it can change our appetite, it can change how hungry we feel as we have an urge to eat more, or less, than usual (35% of depressed participants in a study conducted by the American Journal of Psychiatry concluded to have experienced an increase in appetite, while approximately 48% concluded to have exhibited depression-related decreases in appetite), and it can also change what type of food we have an urge to eat/our cravings (e.g., ‘unhealthy’ foods- foods that are higher in fat/sugar/salt- are often cravings felt by people with mental ill health, as such foods tend to increase dopamine production, thus leading to an increase in pleasure, a highly sought after feeling, being felt).

So, why exactly can Depression and Anxiety have an effect on ones appetite? To answer this question, we first need to determine what the conditions (Depression and Anxiety) actually are, so that we can go on to determine why they can impact upon how hungry we feel, and why they can impact upon what we feel like eating. This is something which I will explore below…

What is Depression and Anxiety, and why can they alter ones appetite?
Depression and Anxiety can be defined in a multitude of ways, though one of the most easy to understand definitions and, in my opinion- the best– is as follows;

‘An emotional response to prolonged stress.’

With regards to why this- an emotional response to stress- can change our appetite then, the reason is largely due to the inbuilt ‘programming’ that is in our bodies, programming that sees our bodies entering ‘fight-or-flight’ mode when faced with stressful circumstances, a result of a sudden surge in stress hormones entering the body. In such circumstances, physiological changes can occur in our bodies, changes such as an increase or decrease in appetite. In terms of the latter- a decrease in appetite- when our bodies go into ‘fight-or-flight’ mode, our appetite can become suppressed as our bodies prepare to put energy towards protecting us from the perceived threat. In other words, the body reacts to stress by prioritising survival above all else, including the need to eat, hence why people can lose their appetite in such circumstances, when people are so focused on their stress that they lose track of their appetite/hunger cues (their need to eat falls on the ‘backburner’ as they become so consumed/preoccupied with other, seemingly ‘bigger’ things, such as the source of their stress).

Our appetite can also become suppressed due to the gastrointestinal symptoms that can be felt in response to the surge of stress hormones flooding the body. This happens due to the fact that when we have severe anxiety, cortisol (our main stress hormone), becomes blocked due to our body alarming our fight or flight response. This causes our digestion to slow down or stop, causing pains in the stomach, as well as potentially causing us to experience nausea, diarrhea, and loss of appetite. If you feel like you’ve got a ‘knot’ in your stomach, or a ‘lump’ in your throat when you feel anxious, then its hardly surprising that you don’t particularly feel like eating, is it? Its important that you do continue to eat though, even if your hunger cues aren’t ‘working’, because, the longer you go without eating, the less you want to eat, and when you do try to eat, your digestive system will be in turmoil, and you’ll find it all the more difficult next time.

Furthermore, when someone is feeling Depressed or Anxious, like Cortisol, the levels of Serotonin in the brain also decreases. Because Serotonin is a neurotransmitter, it controls a wide range of functions in the body, from emotional wellbeing to muscle movements and, among other things, hunger cues.

Because serotonin decreases when someone is experiencing Depression/Anxiety/Stress, as mentioned above, the hunger signal of a Depressed/Anxious individual could essentially ‘disappear’, thus causing their hunger to dissipate entirely. Such a lack of serotonin is also the culprit of a lack of pleasure being felt by those experiencing Depression/Anxiety. Consequently then, whilst eating is usually a pleasurable activity for most people, for people who are in the midst of Depression and/or Anxiety, they might struggle to get any pleasure from eating, therefore causing food to lose its appeal as a result and leading to them refraining from eating all together. The problem with not eating though, is that failing to do so can actually worsen the symptoms of Depression and Anxiety, as depleting the body of nutrients can impact upon one’s energy levels and subsequently lead to weight loss and further health problems occurring, all being things that would be most likely to intensify their symptoms of ill mental health…

Not only are there physiological/physical symptoms of Depression and Anxiety that can effect one’s appetite, but there are also psychological/mental symptoms that can impact upon one’s appetite… This is because, Anxiety isn’t just a chemical reaction, it is also a state of mind. How one thinks when they’re anxious can impact upon their eating patterns- whether they eat or don’t eat and, if they do eat, how much they eat…

Because people experiencing Depression and/or Anxiety often struggle with low self-esteem, they might be of the mistaken belief that they don’t deserve to eat, thus resulting in them intentionally choosing not to eat. This, however, can lead to those struggling becoming trapped in a cycle that is extremely difficult to break, a cycle that might be the onset of an eating disorder– when people are choosing not to eat for reasons that lie deeper than them simply having ‘a bit of a stomach ache.’

To expand on the point above about eating disorders occurring in response to Depression/Anxiety induced stress, they occur as a result of one restricting their food intake in an attempt to seek relief (albeit short-term relief) from their challenging symptoms/ in a bid to increase their confidence/self-esteem. Not eating might provide them with a temporary sense of achievement/accomplishment and, as is often the case with eating disorders, a false sense of control over their lives, too, as it gives them an opportunity to feel something ‘other.’

The reason why Depression/Anxiety induced stress is often the source of many eating disorders, its because, people who experience high anxiety often feel that they lack control over much of their lives, and are therefore more likely to strive to ‘police’ their eating more as that is one thing that they do have control over.

The problem with restricting food intake, however, is that it is a cycle that can be incredibly difficult to escape from. Why? Because, not eating reduces the level of serotonin in the brain. When someone reverts back to a ‘normal‘ eating pattern, the levels of serotonin in their brain will rapidly increase which can subsequently lead to feelings of panic occurring, resulting in a similarly rapid increase in one’s symptoms of anxiety also occurring. This goes a long way in explaining why it is that people with restrictive eating tendencies (disordered eating) or Anorexia (Eating disorders) find the process of recovery such a hard one, because not only is it mentally extremely challenging (people who resume eating after a period of restriction tend to experience the opposite of what their disordered eating gave them, (a sense of accomplishment and a feeling of ‘mastery’), and are instead left feeling like they have ‘failed’), but also physically extremely challenging, too.

Although I have focused on Restrictive eating disorders such as Anorexia in the above paragraph, stress can also lead to eating disorders of alternative types, such as binge eating disorder (BED), for example. Both attempt to solve the same problem, but one sees those struggling overeating (BED), and the other sees them under-eating (ANA). It can be argued, in fact, that BED is, rationally, the more likely eating disorder to occur in response to stress (in physiological terms, that is). How so? Because, food, particularly more ‘indulgent‘ foods, tend to trigger the brain’s reward system, flooding it with feel-good hormones during times of distress. When someone is feeling worthless/depressed, they will seek any source of pleasure—external or internal- and eating? Its one of the easiest ways to stimulate the release of dopamine in the system, thus giving them the burst of the pleasure they so desire. It is for this reason why ’emotional eating’/binge eating often occurs in response to stress- because eating food alters the chemical composition of your brain, triggering one’s pleasure centers. People might eat more (and eat mindlessly) then as they seek comfort from food. This is not just as a result of psychological symptoms either, there are also biological reasons that contribute- because when you’re feeling stressed, your body sends out cortisol, known as the ‘stress hormone.’ Cortisol can make you crave food of the more ‘indulgent‘ kind (i.e., fatty, sugary, and salty food). Why? Because, as the ‘fight or flight’ response is triggered, your body thinks that it needs more fuel to ‘fight’ whatever threat is causing the stress.

So, now that you know how Depression and Anxiety can effect ones appetite, I’m going to outline some of the steps that can be taken to overcome the negative effects, even when (no, especially when) they’re faced with the stress associated with ill mental health…

How to overcome stress induced loss of appetite

Loss of — or decreased — appetite can be a difficult cycle to find oneself in, but it’s a cycle that can be broken. How? Well, the best way of breaking the cycle is by ensuring that, even when one is in the midst of depression and they have no desire to eat, they continue to eat regardless. Why? Because, failing to do so would in fact most likely worsen their symptoms of depression and anxiety, as lower energy levels would, in turn, contribute to their mood declining further. To ensure that one stays ‘on track’ with their eating, they should consider setting a reminder on their phone that sends a notification to them every three to four hours, reminding them to eat something, even if they don’t feel particularly hungry at those times. Eating regularly (3 meals + 1 or 2 snacks per day) and sticking to a routine around eating is one of the best ways to regulate appetite. Furthermore, we should also be aiming to engage in regular exercise, as doing so is another great appetite regulator, being particularly helpful for people who struggle with a lack of appetite when dealing with stress. Exercising can not only improve one’s mood due to the ‘feel good’ hormones (endorphins) that are released, but it can also improve one’s appetite, what with their energy outtake most likely translating to greater hunger being felt as a result.

As well as partaking in regular exercise and eating regularly in order to regulate one’s appetite and improve their overall mood, there are also certain foods that can help to boost one’s mood too, with these foods including; foods that contain the amino acid- tryptophan-including eggs, spinach and salmon, foods that are rich in folic acid, including avocado and spinach, foods that are rich in omega-3 acids, including salmon and tuna, foods that contain vitamin B12, including fish, lean meat, poultry and breakfast cereal…

Whilst this post has focused on the importance of food, water is also of paramount importance when it comes to preserving one’s mental health. This is because dehydration slows circulation, which in turn leads to less oxygen travelling to your body, including your brain. This can impact upon the brains ability to regulate one’s mood. It can not only impact ones mood, but also their energy (fatigue) and their ability to think clearly. We should be aiming to drink 6-8 glasses of water per day, (or 2 liters), to ensure that we stay adequately hydrated.

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