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When I mentioned this topic to one of my patients recently, she replied, “I wish I had less mood and more food!” In a way, that about sums it up. Mood and food are closely linked in the minds of many women, especially those struggling with feelings of depression. Some women crave sweet carbohydrates or fatty foods to manage sad moods and stress. If the pattern continues, it can disrupt healthy eating and lead to weight gain, which in turn leads to guilt, shame and hopelessness. These feelings can trigger or worsen symptoms of depression, and so the destructive cycle is established.
And there is more bad -- or as we psychologists prefer to frame it -- “challenging” news. A major depressive episode can be effectively treated with antidepressants, but many of those medications tend to lead to weight gain. This is a complicated topic. Let’s sort it out.
Some facts: Most women (98 percent) and men (68 percent) report having some food cravings over time. Many people have positive associations with the comfort food of their childhood years -- usually high-fat, high-carbohydrate meals, like pasta with meat sauce, roasted or fried meat and potatoes, or rich desserts. Women use food more often to manage mood, and are diagnosed with depression twice as often as men. There are different explanations as to why women turn to food for mood management. One obvious reason is that food plays an enormous role in the female culture. Women are bombarded with advertisements about cooking and, just as often, with ads for the latest miracle weight-loss products. Young girls therefore tend to diet rather than exercise as a weight strategy. And although times are changing, women continue to cook for their families more often than men. There are some hormonal factors as well. Women who have premenstrual dysphoric disorder (the bad-mood symptoms of PMS) tend to crave fattening foods.
New research points to biological reasons for food cravings and overeating. In a small yet intriguing Belgian study, volunteers fed a solution of fatty acid were less affected by cues of sadness than those given saline. This is an important finding, because sad moods were associated with more hunger. After examining magnetic resonance images (MRI) of the brain, the authors concluded that fatty food might facilitate coping with negative emotions on a neurobiogical level by affecting the parts of the brain that control emotions. Also, a study from the Rudd Center for Food Policy and Obesity at Yale University found that woman who scored high on a food addiction test had patterns of activation in their brains similar to those of people who abused alcohol or drugs, suggesting that for some women, eating is clearly an addictive behavior.
Although the situation is complicated, there are ways to break the negative cycle. You can learn to manage your moods in healthier ways:
- Eat mindfully. Too many of us rush through our meals, snack while preparing a meal and gulp down lunch at our desks. If food is pleasurable, take the time to really taste it; chew slowly and appreciate the texture.
- Use a diary to identify your specific patterns of using food for mood management. Then, make a plan to replace mood-management eating with healthier techniques. This will take time, so tackle only one or two changes at first, like taking a short break to visualize a relaxing scene to reduce stress instead of scarfing a candy bar. Another idea: Schedule time to email or call a friend in the evening if you are lonely rather than consuming an extra meal at night.
- Give in -- a little. If you have a specific craving, you may be feeling deprived either psychologically or nutritionally. Women on overly restrictive diets often experience food cravings, and if you deny yourself completely, you might begin to visualize the craving and obsess, intensifying the situation. It’s a good idea to allow yourself a small portion of your craving. An ounce or two of chocolate or a small serving of low-fat ice cream will do.
- Retrain yourself. Many food cravings involve visualization. Try visualizing a ripe, juicy, sweet peach rather than a large chocolate chip cookie. Or imagine a crunchy salad mix. (In a rare event, one woman told me that she turns to salad as a comfort food because she grew up in Southern California in a family of vegetarians.) Have fun developing a detailed scenario based on many details of taste, texture and smell as well as the visual image.
- Ask for help. If you suffer from a more specific clinical condition, you will benefit from at least a consultation and sometimes treatment with a mental health professional. Women with seasonal affective disorder (SAD), premenstrual dysphoric disorder (PMDD) or major depressive episodes often report more severe frequent food cravings. If you believe that you have one of these clinical conditions, seek professional help.
- Get smart about meds. If your physician recommends an antidepressant, be sure to raise your concerns about weight gain. Some antidepressants are less likely to be associated with weight gain, but psychiatrists justifiably caution that your primary goal in choosing an antidepressant is to effectively treat your depressive symptoms. And it is not always clear that the medication is actually causing the weight gain. Some feel that the weight gain is a response to a previous weight loss that was a symptom of depression. Preventing weight gain while taking antidepressants is another great reason to exercise.
- Talk it out. Also remember that psychotherapy alone, especially cognitive behavior therapy and interpersonal therapy, can be very effective treatments for depression as well.
Above all, be patient and don’t lose hope. The food-mood dilemma is common and complicated, but if you are persistent, you can stop comfort eating. Click through this slideshow for more ways to separate food from mood.
Carol Landau is a clinical professor of psychiatry and medicine at Brown University’s Alpert Medical School.
Got a question about food and mood? Dr. Landau will be answering your questions on a special iVillage message board from Monday 10/10 through Friday 10/15. Why not post a question now?