Psychology: Food cravings may be a sign of depression

Erin wondered to herself why she was stuffing her kids' leftover Halloween candy into her mouth when she had been trying so hard to stay in shape. It was almost as if she had two different brains: one that knew the candy wasn't good for her and the other that kept putting it into her mouth.

Erin isn't alone with this conflict. Many adults struggle with carbohydrate cravings that urge them to try to satisfy some haunting hunger within. In some instances, these types of cravings may be a sign of depression.

To further add to the mystery, food cravings seem to become more prominent when darkness and cold signal the approaching winter season. Some scientists believe that these cravings are part of an age-old survival drive to "fatten up" before hibernation and the potential deprivations of winter begin. But this represents the double whammy of the season, since the onset of winter can contribute to both depression and carbohydrate desire.

Like most living creatures, humans gain a temporary sense of pleasure from food. This is one of the reasons why we tend to use food in a celebratory fashion to mark holidays and special occasions. Many psychological theories also link the desire for food to strong emotions based in survival needs, including nurturance and even love. This backs up the connection that seems to exist between depression and food cravings. Many people, for example, seem to crave carbohydrates like cookies, candy and ice cream when they are upset, lonely, unhappy or overtired.

Some scientists believe that the connection between emotions and carbohydrate cravings lies in the way the body manufactures and utilizes serotonin. Serotonin is one of the brain's major neurotransmitters, and it helps to regulate many important functions including sleep, appetite and mood. There is some evidence that depression may involve lowered functioning in the serotonin circuits of the brain, and it is believed that eating some carbohydrates may help to boost serotonin levels.

It is important to remember that symptoms of depression usually involve problems in both the physical and emotional realms of functioning. Studies of visits to primary care physicians have shown that a high percentage of patients actually have symptoms that are at least partially based in emotional difficulties and depression. Common physical symptoms include headaches, back pain, lethargy, fatigue, sleep disturbance, appetite changes, muscle pain, digestive problems and dizziness. Depression also can suppress immune system functioning, so there is also a greater tendency to get sick from colds, infections and the flu when depressed.

Emotional symptoms are more easily recognizable as depression, although men tend to speak about them less. Emotional symptoms of depression include sadness, weepiness, crying spells, pessimism, negativism, guilt, indecisiveness, anxiety and a loss of enjoyment in activities. Sometimes there are self-destructive or suicidal thoughts. Depressed individuals - even those in relationships - often feel lonely and unloved. They may also describe feeling "empty" or "hollow," and feeling like they are losing hope for a happy future. This may be another tie-in with food and carbohydrates because excessive eating may be an attempt to feel "loved" or to literally "fill" the emptiness.

Using food to try to quell personal unhappiness is ultimately a self-destructive act. As with any "substance" that temporarily alters mood or helps people to quickly feel better, there is usually a high cost in the long run. In fact, many people compare food to a drug because there are so many parallels in the long-term impact of both. With the destructive use or abuse of food there is ultimately a realization that involves guilt, personal unhappiness, weight gain and body image problems. These problems may then serve to increase the desire for even more food, which amplifies the depression that led to the food abuse in the first place.

So, instead of reaching for a bag of Halloween candy to temporarily quell bad feelings, it may be time to look for more effective solutions. The most important first step is to recognize that your "hunger" may actually be based in unhappiness or even depression. Once emotions are identified as the cause of this self-defeating behavior, it is easier to do something about it. This first step may be the most important because it involves taking the brain off "auto-pilot" and attempting to think about what we are doing and why.

As with many other human ills, counterproductive lifestyle issues can contribute heavily to the onset of depression. That is why it is important to spend some time examining how we live. Basic self-management involves making sure that we are living according to a reasonable schedule, getting adequate rest, exercising regularly, attempting to eat healthy foods, drinking enough water and balancing our work commitments with our recreation and self-care. Often, depressed individuals have not been living "well" for some time and their sleep/wake cycle, diet, exercise and recreation have become badly balanced, which only amplifies the depression.

Treatment for depression can be highly effective in reducing or eliminating symptoms. Many people respond to cognitive behavioral therapy that reduces negative and "depressogenic" thinking and behavior. Identifying the thoughts and behaviors that can cause depression and substituting them with healthier choices has been proven successful. If depression is stubborn or difficult to resolve, there are numerous medications that also help to "bump" people out of their rut so they can start enjoying life again.

Everybody loves a special food treat now and then, but if you find yourself reaching for them too often, it might be worth checking to see if depression may also be involved.

Dr. Scott E. Smith is a licensed clinical psychologist with Spectrum Behavioral Health in Annapolis and Arnold. For services or ideas regarding this column, call 410-757-2077 or write to 1509 Ritchie Highway, Suite F, Arnold, MD 21012.