Biology of the Binge: The Biochemical Link Between Depression and Food

Many of us have experienced the instantaneous connection between food and mood. We may find ourselves crunching nervously through bags of potato chips when under pressure for example, or slurping down containers of cool and silky chocolate ice cream in distracted attempts to soothe our sadnesses. However, while an occasional hankering for sweet or starchy “comfort foods” is both normal and expected, for some, the link between negative feelings and out of control eating is far more profound. Recent studies suggest that the suspicious overlap in symptoms of major depression and food addiction may be due to deep biochemical connections that have gone largely ignored in treatment programs until now.


The coexistence of psychiatric diagnoses and problems with appetite is shocking common. One research study concluded that approximately 80 percent of patients with binge eating disorder (BED) and 95 percent of patients with bulimia met the criteria for at least one other diagnosis outlined in the Diagnostic and Statistical Manual of Mental Disorders. Overweight men and women are 25 percent more likely to suffer from mood disorders than the rest of the population. Between 15 percent and 40 percent of patients with eating disorders also struggle with substance abuse.

Strikingly, 75 percent of patients with eating disorders also suffer from depression. For those individuals with binge eating disorder who are overweight, one study found that rates of depression are even higher than for individuals who are overweight but do not have binge eating disorder. In this particular study, researchers found that symptoms of depression led to binge eating episodes. Other studies have found that depressive symptoms, including low self-esteem, predicted increases in binge eating, demonstrating further evidence of the relationship between depression and binge eating. These results suggest that for some binge eating is a way to regulate emotion, however they also reveal that there is something more to the association between food addiction and depression than previously thoughtsomething disruptive, persistent, and physiological.

A look into the intricate neurochemical underpinnings of depression and binge eating disorder provides a clearer understanding of the biological nature of their troubling comorbidity. Interestingly, depression and food addiction both involve alterations in neurotransmitters, the substances that relay messages from one brain cell to another and then to the rest of the body. We know that imbalances in any of the neurotransmitters can wreak havoc with brain circuitry and predispose individuals to mental and physical distress. Normal levels of serotonin, the neurotransmitter linked most closely to satisfaction, lead both to emotional satisfaction and a sense of fullness after a meal. Low levels, on the other hand, can lead to depression and a tendency to binge on sweet and starchy foods. In fact, one study looking at how depression and a gene associated with lower levels of serotonin related to binge eating found that depressed children and older females who carried this gene were more likely to engage in binge eating behaviors.

In the context of a biochemical perspective on binge eating, this correlation makes sense. For some binge eating foods begins as a way to find a moment of much needed relief from depressive tendencies, and to fill the emotional void left by a lack of serotonin. However, what begins as a seemingly innocent attempt to self-soothe, quickly gives way to a complex cycle of addiction in the body. The flood of endorphins from eating large amounts of food only temporarily alters the neurochemistry of the brain, providing brief periods of solace from emotional distress; but these are not lasting. Ultimately, the demand for food intake to achieve such pacifying effects only increases over time and the coping mechanism completely fails, exacerbating instabilities with mood.

More research is needed to examine the precise mechanisms by which a serotonin deficiency can affect food, appetite, weight gain, and mood, and the causal nature of this overlap. However it is evident from the current body of scientific literature, that a holistic approach to investigating the interplay between an individual’s relationship to food and co-existing mood disorders is essential in order for successful recovery opportunities to exist. Treating one problem in isolation is not enough. It is only by comprehensively assessing the neurochemical commonalities underlying such complex psychological conditions that sustainable treatment solutions become possible.

By Stephen B. Jones, M.D., psychiatrist.

Overwhelmed? 8 Tips to Avoid Burnout and Balance Your Life

For so many people these days, our life is like a house of cards. We teeter along shakily, just barely managing to hold up our sky-high pile of commitments and stressors. Sometimes it feels (accurately) that if you try to put just one more card on top, the whole mess will come crashing down. It’s not a good feeling. It’s not a fun way to live. Yet it’s normal for most of us. And we’re exhausted.

One of the things I remember most from the psychology courses I took in university is the classic Holmes and Rahe Stress Scale. These researchers examined medical records to determine the relationship between life events and the likelihood of getting sick. They ranked the 43 most stressful life events, assigning points to each based on the potential negative impact on health.

Some of the stressors are thankfully rare, such as death of a spouse (#1) and imprisonment (#4). But others are much more common, such as divorce (#2), marriage (# 7 – positive life events can be stressful!), change in health of a family member (#11), business readjustment (#15), change in financial state (#16) and even things we dream of, such as outstanding personal achievement (#25).

I recently went through a series of life shifts, some really wonderful and some more challenging. I held up pretty well for a while, but eventually started to feel a lot more moody, tired, and just plain overwhelmed. Whenever I go through a transitional season like this I’m always grateful for those early psych courses and my awareness of “The Life Events Scale”.  Too much change, too many demands, and eventually the human mind and body will cave in under all the pressure.

This has happened enough times now that I know what to do to get myself, my health, and my sanity back. If you’ve got too much change (or just too much, period) going on in your life, here are some tips to get yourself and your life back, ASAP:

1) Get the best sleep you can

If you’re stressed out, getting enough sleep should be your number one priority. Give yourself time to wind down before going to bed, and create the quietest, darkest sleeping space possible (my husband and I use black-out curtains, ear plugs, and white noise from the bathroom fan to block out street sounds). The more stressed out we are, the earlier we try to get to bed.

2) Meditate or pray in the morning

I normally spend quiet time in meditation every morning, but the numerous recent changes in my life had made it hard to maintain my old routine. I felt unhinged, and quickly felt so much better when I forced myself to find a few quiet minutes every morning again. Sitting for just five minutes, breathing deeply in and out, has been shown to create a sense of calm (and even lower blood pressure!) that lasts throughout the day.

3) Make yourself eat, no matter how crazy things are

The more stressed I am, the more I try to do before breakfast (and breakfast often ends up eaten at lunchtime). Skipping meals and snacks leads to low blood sugar, fatigue and brain fog, making you feel unable to cope. Discipline yourself to get some real food into your mouth as soon as you get up – you’ll feel much calmer, clearer and more focused. Make sure you eat throughout the day and don’t let yourself ever get too hungry. Don’t ignore your body’s cues for needing food and water, no matter how busy you are.

4) Load up on greens the easy way

I get a physical and psychological boost from superfoods, as I know how much my body appreciates them when stressed. I try not to go a day without the simple green smoothie I make in my blender, it takes less than five minutes to make and less than a minute to drink.

5) Get through one day at a time

As the ancient saying goes: “Do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” When life is particularly stressful, it really helps to just focus on getting through each day. I use my morning quiet time to get centered and ready to face the day, and that day alone. Life feels so much easier when you face it one day at a time.

6) Make no your default answer

I read a great blog post from Paul Angone the other day called “Stop Trying to Balance Your Life”. His thesis was that our fundamental problem isn’t our inability to balance it all, it’s overcommitment. I totally agree. I’ve written about this before: when you say yes to something new, you say no to something else. (see my previous post on Saying No) There isn’t an infinite amount of time available to you. When you say that yes it will mean something really important will be squeezed out: that time alone you desperately need, or that extra hour of sleep that would make all the difference, or the precious time with your spouse or kids that you all long for.

7) Take sanity breaks

Lose the go-go-go mentality, it will kill you. Take breaks whenever your body or mind start to feel tired. Have a snack. Get up and do some stretches. Rest your brain. Take your lunch outside and sit by a fountain with the sun on your face (I did that the other day, it felt so good). You need breaks, don’t tell yourself that you’re better off just plowing through.

8) Give yourself a Sabbath day every week

In this 24-7 world we live in, it’s easy to treat every day as another opportunity to tick off to-do list items. For a long time now I’ve saved my sanity by taking Sundays off, no matter how busy my life is. Whenever I’m tempted to work because I’m feeling panicked about some upcoming deadline, I remind myself that in the past I’ve somehow always gotten done what needed to be done, even if I’ve taken a day off.

One day a week, try to avoid doing anything that feels like work. Turn off your phone. Don’t go online. Take a nap. Read a good book. Spend some time with your family and friends. Go for a walk together. This day of rest and rejuvenation will refresh you and give you the energy you need to face the trenches yet again for another week. And you will still somehow get everything done.

Dr. Susan Biali, M.D. is a medical doctor, health and happiness expert, life and health coach, professional speaker, flamenco dancer, and the author of Live a Life You Love: 7  Steps to a Healthier, Happier, More Passionate You, dedicated to helping people worldwide get healthy, find happiness and enjoy more meaningful lives that they love. 

Copyright Dr. Susan Biali, M.D. 2013

Combating Depression with Meditation, Diet

In his book Spontaneous Happiness, Dr. Andrew Weil writes of an ‘integrative’ approach to mental health, warding off mild and moderate depression with an an anti-inflammatory diet, exercise and activities such as yoga and meditation, rather than antidepressants.  Listen to the Interview

Don’t Let the Sun Go Down on Me: Seasonal Affective Disorder and Depression During the Winter

There is a distinctive pallor that comes over our world at this time of the year; grey parking lots seem a lot harsher, people wandering into Starbucks this morning a tad glummer. But nothing seems tougher to deal with than a dearth of sunshine.  It feels as though Mother Nature has pulled down the shades and they ain’t coming back up anytime soon.

As I scrape the shellacking of quarter-inch ice off my windshield at 6 a.m. that had built up overnight before I drive into work, I find myself pining for spring, for the sweet smell of the soil bursting back to life.  But most of all, I yearn for the return of more sunny days, to the end of the great ball of light’s hibernation.

“One must maintain a little bit of summer, even in the middle of winter” wrote Henry David Thoreau.  Well, that’s not always easy for those of us stuck in office buildings behind desks.

For some, the lack of sunshine actually causes a type of depression called Seasonal Affective Disorder (SAD); a syndrome of god-awful crummy symptoms that affects about 14 million Americans during the winter. Symptoms of SAD include decreased concentration, increased appetite, weight gain (whereas some other forms of depression can lead to weight loss), social withdrawal, moodiness, and fatigue.

Some people chalk these nagging symptoms up to just being down in the dumps when in reality, SAD is really a form of clinical depression.  SAD is highly dependent on a person’s hormonal state, seasonal characteristics like ambient temperature, and exposure to natural light (which can influence the body’s production of melatonin).  Research has linked the prevalence of SAD to higher latitudes, regions that tend to have more intense and longer winters.   Just great, I thought. I live in Buffalo, New York.

But the lack of sun just doesn’t cause depression in those who might not ordinarily have it.  One study found that a lack of sunshine actually may cloud memory and other thinking functions in some people who already have depression to begin with.   Depressed adults from the least sunny areas were more than twice as likely to have impairments in memory and cognitive functions as those with the greatest sun exposure.  The sunshine-cognition link was not seen in adults without depression, however.

Here are some ideas to start feeling better:

Shake it in the morning.  For those afflicted with SAD, the time of day you work out matters.  Studies show that morning exercisers report better sleep, burn up more calories throughout the day, and have lower blood pressure.  Even if you don’t make it to the gym, just walking outside in the morning can really help.

Avoid the Pit Stop at The Olive Garden.  When I read that white pastas, bagels and bread could lower my mood, I just switched off my computer in protest – I love pasta as much as my mom and there’s no way I can possibly give it up. But I started watching as my mood did dip after consuming a leviathan portion of rigatoni. That’s so because simple carbohydrates – think white flour stuff – give us short-lived every boost, so it’s only a matter of time before we reach for that second helping of cake spackled with butter-cream frosting.  Instead, choose foods rich in protein and complex carbohydrates which release sugar into the body slowly and have a low glycemic index.  Check out foods that will actually help lift your mood.

Fill Up Your Calendar.  I know, I know.  It’s six o’clock and you just pulled in the darkened driveway on a freeze-your-ass-off day and you just want to eat dinner and park yourself in front of the old T.V. Even on weekends.  Yet research shows that people who suffer from depression report higher levels of well-being and satisfaction after positive social interactions.  Feeling a sense of belonging makes us all feel better, but all the more so when you’re feeling down.

Sleepless in Seattle.  Getting less slumber during these darkened days sounds like a crazy prescription for lifting one’s mood.  When we feel down and the world is dark, it seems like more sleep is what’s called for to make us feel better.  Not so say scientists. Instead, it’s very important to maintain a steady rhythm of sleep per night by waking up and going to bed at the same times every day – including weekends.

Light the (Artificial) Light Shine In.  A light therapy regimen can significantly reduce SAD symptoms, regardless of the condition’s severity.  Light therapy boxes range in brightness and type of light, so consult a physician before buying one.

Read Up.  Pick up a copy of Winter Blues by Dr. Norman Rosenthal, the psychiatrist who came up with the SAD term and has studied it extensively.  Check out his very informative website.

They say time heals all things.  If we can hang on just long enough, the days start getting longer and the sunshine becomes more plentiful.  In meanwhile, try these tips to make things more bearable and remember what the French philosopher Albert Camus once wrote,

“In the depth of winter, I finally learned that within me there lay an invincible summer.”


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