Warning: This story discusses the topics of disordered eating behaviors and anorexia.
A few months ago, my appetite up and left while my taste for nutrient-rich foods outright disappeared. In its place was a growing desire for easy-to-make things like sugary bowls of cereal with oat milk and boxes of instant mac and cheese. Why? After a period of heightened anxiety, I found myself in the midst of a major depressive episode. In addition to not being hungry and only being able to eat such basic things, there were plenty of sleepless nights, stomach problems, and more.
The common phrases “that made me sick to my stomach,” or “I just lost my appetite” are around for a reason, says Dr. Amanda Tinkleman, psychiatrist working at Brooklyn Minds, a mental health practice in Brooklyn, New York. According to her, many people lose their appetite when they’re feeling anxious or depressed. “Oftentimes, people with anxiety have physical symptoms of stomach ache, nausea, or even diarrhea,” she says.
It’s no wonder this type of discomfort generally makes people not want to eat. “With depression, it can be harder to feel pleasure; we call this anhedonia,” the psychiatrist explains. “While eating is usually a pleasurable activity, when you cannot feel that pleasure as much anymore, eating loses some of its appeal.”
Recently, I’ve found myself in both of these situations, and even have experienced all of the symptoms listed above when my anxiety or depression has been particularly intense. Patrice N. Douglas, marriage and family therapist based in California, says this happens due to the fact that when we have severe anxiety or anxiety attacks, cortisol (our main stress hormone) is 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, nausea, diarrhea, and loss of appetite,” she tells HelloGiggles.
“When people experience depression or chronic anxiety, their automatic nervous system becomes dysregulated, which can impair their signals of hunger and fullness,” explains Allie Lewin Deehan, licensed psychotherapist who works with patients on dealing with anxiety, depression, and disordered eating. “Chronic anxiety and depression can be seen as emotional responses to prolonged stress and our bodies have programmed responses to such stress that cause physiological changes, such as an increase or decrease in appetite.” So, 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.
Moreover, Tinkleman adds that “some people, on the other hand, eat more when [they’re] depressed, especially carbs or sugar-heavy foods.” Often, she says, this is thought to be an attempt to increase or sustain their low energy due to the depression, or an attempt at self-comfort. Okay, so this explains why when I can muster the appetite to eat something, I often resort to eating 10 bowls of cereal in one single day.
According to her, while depression has been associated with too little serotonin in the brain, too much serotonin has more recently been linked to a chronic state of anxiety. Therefore, although people with chronic anxiety seem to have higher-than-average levels of serotonin, not eating may temporarily decrease their anxiety symptoms since it decreases serotonin production. “Over time, the body adapts to this serotonin depletion by increasing sensitivity to the neurotransmitter, so when eating does occur, there is a surge of serotonin leading to feelings of panic (as seen in someone with restrictive tendencies or anorexia who get extremely anxious after eating),” says Lewin Deehan.
In addition, Lewin Deehan says eating disordered behavior can become a way of regulating self-esteem and provide a false sense of control, which often feels lacking when someone is chronically anxious. For someone with anxiety or depression who believes they aren’t good at anything, skipping a meal, whether it’s intentionally or unintentionally due to loss of appetite, may feel like an accomplishment and provide “a sense of mastery,” according to the therapist. “This problematic eating behavior can feel rewarding in the moment,” explains Lewis Deehan, “But consequently resuming what was once normal eating may bring about feelings of failure, which exacerbates the symptoms of anxiety and depression that the original eating disordered behavior was meant to ameliorate.”
For people like me who’ve struggled or are struggling with disordered eating, these circumstances can be especially tricky because the loss of appetite may reinforce disordered eating patterns, says Juli Fraga, licensed psychologist based in San Francisco, who focuses on women’s health and wellness. But what is disordered eating? “I would define disordered eating as a pattern of abnormal eating behaviors that causes distress and/or impairment in one’s quality of life, but doesn’t meet the criteria for a full-blown eating disorder diagnosis,” offers Lewin Deehan.
In my experience, disordered eating has often meant not eating at all due to stress. “Disordered eating can be caused due to feeling the need to be in control of your eating habits and not just a stomach upset due to anxiety,” offers Douglas. “When we experience high anxiety and feelings that we aren’t in control of anything in our life, we tend to police our eating more because that is one thing we do have control over.” If you find yourself feeling severely anxious and having the need to restrict your eating in order to gain control of your life, whether it’s by not eating enough or losing or gaining weight, Douglas asserts that you may need to seek professional help as it can be an eating disorder happening or going to happen soon.
Douglas also says that in order to assist with your stomach issues, it’s time to start taking inventory of what you’re eating. “Caffeine and processed sugars, for example, are the wrong foods to eat if you have anxiety because it can heighten the symptoms,” she explains. Alternatively, eating more nutrient-rich foods, such as vegetables, natural sugar foods, and nuts, can keep you full and won’t likely trigger your anxiety; however, it’s a case by case basis, as every body and eating disorder is different. “But if your stomach is still often upset; it’s always recommended to see a doctor to rule out any medical issues,” says Douglas.
To eat again on a regular basis, Lewin Deehan suggests making an appointment with a registered dietician to work on the nutritional side of the issue while you get emotional support from a mental health specialist, and if you struggle with disordered eating, make sure the dietician has experience with this.
If you’re looking to be more mindful of eating throughout the day, Lewin Deehan recommends to set a reminder on your phone to eat something every three to four hours, even if you don’t feel particularly hungry at those times; capitalize on moments of decreased anxiety and eat at that time even if that’s not when you typically eat; and do something calming before mealtime, such as a warm bath or a restorative yoga practice. Excuse me while I go try all of these solutions.
If you or someone you know is struggling with an eating disorder, please visit the National Eating Disorder Association (NEDA) for more information and support or text “NEDA” to 741-741. Or, if you know someone who may be struggling with body dysmorphia, please visit The Body Dysmorphia Disorder Foundation for more information.