Recovery

Sweet and Sour

Thinking of reaching for a chocolate? Think again.

Are you worth your weight in sugar? The average American eats more than 125 pounds of white sugar a year, comprising 25 percent of our daily calorie intake. According to Rita Elkins MH in "Solving the Depression Puzzle," (Woodland Publishing, 2001): "We have become obsessed with sugar, not fully recognizing what excessive sugar consumption not only does to the body, but also the mind. Sugar is a powerful substance that can have a druglike effect, and it is considered addictive by a number of nutritional experts. In fact, excess amounts of sugar can be toxic."

Cutting down on your sugar consumption, the author recommends, can be one of the best things you do for your health. It can also be one of the hardest.

Sugar and Depression

The author cites studies by Richard Wurtman MD and Judith Wurtman PhD of MIT (authors of "The Serotonin Solution"), who found that sugar and starch in carbohydrates boosted serotonin levels, and that people who excessively craved carbohydrates were also prone to depression. Additionally, depressed people are drawn to sugar and fat combinations such as those found in cookies and chocolate.

Chocolate comprises 50 percent fat and 50 percent sugar and contains phenylethylamine, all which combine to create an endorphin effect, particularly in women. Low blood levels of phenylethylamine have been found in depressed patents. (Researchers at Nottingham Trent University (UK) claim phenylethylamine to be a byproduct of exercise and the cause of the euphoric mood called "runner’s high.")

On the face of it, then, a meal of nachos, buttered noodles, white bread, root beer, sugar donuts, and chocolate mousse would represent all the major food groups to a person with a mood disorder, but the opposite is probably the case. A 2002 University of Texas Southwestern Medical Center survey published in Depression and Anxiety of six countries found those populations with higher per capita refined sugar consumption corresponded with higher rates of depression (the depression data was based on a landmark 1996 epidemiologic study). At the bottom was Korea with less than 100 sugar calories a day and a two-plus percent annual depression rate. Topping the list was New Zealand at almost 500 calories and a nearly six percent annual depression rate. In between were the US (300 calories/three percent depression), and France, Germany, and Canada (300-400 calories/4.5 to five-plus depression).

Arthur Westover MD, co-author of the study, cautioned that it is premature to jump to any conclusions, though "eating healthy is a good idea whether there is any relation to mood disorders or not."

Sugar Crashes

According to Rita Elkins, excess consumption results in a crash and worse. Soon after a carb or sugar binge, even though the stomach is full, the brain is signaling for more. Food-wise, you have enough in your tank to see you through a parched sub-Saharan summer, but craving-wise your brain is telling you you’re in the middle of winter in the Donner Pass. Now we have a problem, for speed-dialing Domino’s or whatever 911 equivalents you have to rushing carbohydrates to the scene can stimulate insulin overproduction which can paradoxically lower blood sugar and result in further cravings.

Women are in double jeopardy, for the sugar cravings that many experience during PMS, pregnancy, or menopause could be a response to the ebbs and flows of estrogen. Estrogen may have an impact on serotonin levels.

Robert Hedaya MD of Georgetown in "The Antidepressant Survival Program" (see article) says the quick energy rush of sugar and carbohydrates is followed by an inevitable crash, leaving one sluggish, drained of energy.

The medical term for low blood sugar is called hypoglycemia, a condition that does not readily lend itself to accurate testing. According to the Rita Elkins, "some studies have shown that up to 77 percent of people who experience low blood sugar suffer from depression." The vicious cycle does not stop there, however, for the weight is starting to pile on, leading to loss of energy and the type of low self-esteem associated with depression.
Smart Dieting for Depression

But don’t think a crash diet will change everything. Ironically, according to the author, starvation diets decrease supplies of the neurotransmitter norepinephrine, which can result in feelings of indifference. Dieting also brings serotonin levels down, which may set one up for a carbohydrate binge and a return to the vicious cycle. The author cites the Wurtmans for the proposition that diets free of carbohydrates will ultimately fail because they are not "brain friendly."

Since "Solving the Depression Puzzle" is about using holistic approaches to treating depression, the author recommends a cocktail of vitamins and nutrients along with sensible diet choices. Other recommendations include: avoid eating when you are anxious, bored, depressed, lonely or frustrated; avoid nibbling when the meal is over; don’t use food as a reward; drink when you have the urge to eat (and then eat if you are still hungry); and join a support group.

If you think you can cheat by going to a sugar substitute, think again. Some people are particularly sensitive to aspartame (NutraSweet), and Ralph Walton MD, a professor in clinical psychiatry at Northeastern Ohio Universities College of Medicine, argues people with mood disorders are at special risk (see article).

That leaves us with the simple remedy of smart power (as opposed to dumb old will power), which even though it's free seems to be in very short supply. Accordingly, husband your resources wisely: Don't set unrealistic goals. A little at a time does it. This is a life-time project with no deadlines.

Updated Oct 14, 2003, reviewed Feb 10, 2008