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What is causing loss of appetite while I am stressed or depressed?

Answered by
Dr. Jonas Sundarakumar


Practicing since :2003

Answered : 2190 Questions

Posted on Mon, 7 Jan 2013 in Mental Health
Question: Hello,
I have a nutrition problem. Whenever i am under stress, i just lose appetit and can go days without feeling the need or envy to eat. I usually end up getting a coke or sugar after days when i feel weak or dizzy.
I clearly know that i should feed myself, but when im depressed, i just dont want to eat.
This year has been particularly awful in that. I had weeks where i lost 8 to 10lbs in one week. I am 5"2, 125lbs normally and size 2 or S in clothes. But i can easily go to size XS or 0 in less than 2 days.
Right now i have issues at work, so i spent my entire day at work without eating. I tried to force myself with snacks or bringing food, but they usually end in the garbage. Beside that my mom is currently very sick, so i jst lost my appetit. I just dont want to eat, i dont see why i should make efforts to eat if i can still go without eating. Im not hungry or if i feel hungry, it doesnt last that long, i can repress it. I mae food for my mom everyday to make sure she follows her diet, then she beg me to eat and i will just bite an XXXXXXX
Please help me,give mesome tricks to beanle to swallow food when im stressed out or depressed.

Thank you verymuch
Answered by Dr. Jonas Sundarakumar 1 hour later
Welcome to Healthcare Magic and thanks for your query.

I can see that you have been going through a stressful time lately, which in turn is causing you to lose your appetite. Now, appetite is indeed closely liked to mood, and loss of appetite is one of the major symptoms of depression. In fact, both the regulation of mood and the regulation of appetite is mediated by the same neuro-chemical called Serotonin. So, the reason why you don't feel hungry during times of stress / depression may be more that just a lack of interest in food due to your low mood; it may be due to a neuro-chemical imbalance which is causing both your depression as well as your loss of appetite.

Your Body Mass Index (BMI) works out to 23.5, which is within the normal limits, and so, it is unlikely that you have a primary eating disorder. I think that you are actually going through recurrent episodes of depression and your inability to eat is just a "manifestation" of the underlying depression. Still, the drastic loss of weight whenever you go through these depressive episodes, for example, the recent loss of about 10 lbs in one week, is very concerning, and such a drastic weight loss can sometimes result in medical complications also.

In my opinion, it is important to first treat your underlying depression and prevent prevent you from going through further depresive episodes since this itself will sort out your eating problem automatically. Moreover, you do seem to be in the midst of multiple stressful situations - at home, at work, etc. and so, I think you need professional help for managing and coping up with these stressors.

Now, there are effective treatment options available - both in the form of medication as well as psychotherapy, which can help you control and prevent these depressive episodes and thereby tackle your eating problem as well. There are certain specific anti-depressant medication like Mirtazapine, which is not only effective for depression, but also has an appetite stimulating property. So, I would strongly advise you to consult a psychiatrist for starting treatment as early as possible.

In addition, you can try the following tips to help you eat better during your periods of stress / depression:

- Eat small quantities at frequent intervals, rather than trying to have a big meal at once.
- Take high-calorie foods so that even if you eat less, you may still get the required energy. Examples are potatoes, dry fruits, dates, nuts, fresh fruit juices, chocolates, nutrition bars, etc.
- Avoid oily or fatty foods as these can have an effect of quickly causing satiety and decrease appetite.
- Make a list of your favourite foods and keep them stocked at home - this will increase your chances of a better intake.
- Avoid spicy foods, carbonated drinks, caffeine, etc. as these can cause gastric irritation, increase the acid production and cause ulcers, all of which may cause you to feel nauseated and less hungry.
- Start with less quantities initially and gradually keep increasing your intake. This way, you won't develop an aversion when you see large quantities of food.
- Avoid cooking (if possible). Often the continuous smell of food during cooking itself can be a turn-off for your appetite, especially during such times when your appetite is poor.

Wish you all the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Jonas Sundarakumar 21 hours later
Thank you very much Doctor.
I tried your tips today. Even tho i dint feel hungry, but just dizzy, i made myself something i usually like and i was able to finally have a meal after almost days of functionning with either normal coke which give me energy or liquid food supplement such as Ensure. I also took some high calories foods you listed.

Regarding the underlying cause of my situation, i know myself that im in a chronic depression for years now. It is on and off. Things just got worse this year as all parts of my life are affected. I have time i literally feel empty, lost, exhausted, like in a tight bottle that is closed or, trapped. I face so many situations where it is hard to stay positive.
My mom disease just adds more stress as she fully depends on me right now.

However, i dont think i can go to a therapist and openly discuss about my life. Im a very reserved and private person and the idea of talking to a perfect stranger about my life doesnt seem attractive to me. Also, no one really know that im depressed. For my family, im the rock, they all count on me as i look stronger. Even at work, i just deal with all that is going on showing a strong face even tho XXXXXXX inside im suffering. No one around me can believe i have many break down moments when i cry all my tears. So for me, go to talk to a stranger, therapist or not will just sound like the bottom, like i definitely lost it.

Im very realistic about my situation and i think i can handle it. With few tips to help me feed myself, i think i can make it until i see the light one day at the end of the tunnel. Anyway life is just up and down. You laugh today and the next day you go through the Worse. Sometimes i wish there is a "game over" button that we can use to reset our life, but no, it does not exist. We have to face it and it is what i do evryday.

Thanks again for helping Doctor. I copied your tips to try to apply them. Thanks

Answered by Dr. Jonas Sundarakumar 9 hours later
Hello again XXXXXXX,

I'm glad that you found my suggestions helpful and it's good to hear that you ara quite realistic and positive about your situation. Many a time, we may not be able to do much about the situation we are in, but what is important is to ensure that we keep de-stressing ourselves periodically, so that we don't let too much steam bulid up.

I can understand your view that it may be difficult to discuss about personal and emotional issues to a stranger. Maybe, you can try talking to a close friend regularly, at least so that you feel a little more emotionally supported and less burdened. Please make sure that you also spend some quality time for yourself, say at least 1/2 an hour a day, when you can unwind or do something which you really enjoy. This can be a form of relaxation and a good de-stressor.

When you feel overwhelmed by the stress, tell yourself that this is just a passing phase and that you just have to 'stay afloat', till this bad phase passes away. Practising relaxation techniques like XXXXXXX breathing, listening to relaxing music, etc. can help relieve stress. Ensure that you get 7 - 8 hours of continuous sleep everyday. When you’re sleeping too little or too much, your mood suffers (...and so will your appetite). So, get on a better sleep schedule by practising proper sleep habits. Do at least 20 minutes of regular physical exercise (at least a jog or brisk walk) everyday. This not only keeps your body healthy, but also helps your mind.

All these suggestions, though may appear simple, often help a lot during stressful times. So, keep up your positive attitude and if at any time you feel that it's getting too difficult to handle, please don't hesitate to seek help. If you would like to have a chat with me, your most welcome anytime. You can catch me at:

Best regards,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Jonas Sundarakumar 13 hours later
Thank you very much Doctor for helping.
I had a discussion today with my mother's doctors that just disturbed me. My mother suffers from an onset of vision loss since mid November. She has been suffering from optic nerve swelling for over 5 months that went misdiagnosed, so poorly treated. From daily visual eclipses or blackout that will dim her vision for less than 15sec and then go back to normal painless, she finally found herself with almost no vision today. Even to walk in the house or eat is difficult for her.

After lot of exams at the beginning of this month to find out what causes her bilateral papillitis, (MRI, x-ray, CT Scan, tons of blood checks that all came back normal), doctors did a lombar puncture which also came normal. She was laying on her stomach when they did this flouroscopic spinal tap. They then said her intracranial pressure was a little high, at a level of 30. So her Neuro-ophtlmologist put her on Diamox to treat an idiopathic intracranial pressure. However, she started getting a very blurred vision. So we went back to the doctor on friday evening to check it up. They said nothing as changed.

But during a complemenary exam today, they told me all her vision tests are contradictory, and that they dont really understand why she has vision loss. They said her spinal tap wasnt done on the proper position, laying on the side to confirm a high pressure. They seem to believe that with the swelling she has, she should still be able to see better and not be so shut down. They said maybe she will need another kind of doctor i.e a psychologist or psychiatry to help her find out what is going on in her life. They wonder if she is not depressed or stress out.

Obviously this answer brings more worries for us. She clearly has a swelling for months in her eyes. There is a visible problem with her optic nerve that is swelling. So i have a very hard time understanding how stress, depression or any kind of emotional disorder can cause someone to lose her vision. This has been going on for months with no explanation, now she cannot see and all her doctors (neurologists, ophtalmologists, rhumatologists, infection experts) at the hospital just cannot save her vision and want her to go to talk to a therapist for an obvious swelling.

As a psychiatrist, does this make any sense to you? Is it possible to lose vision because of some deeply hidden life issues one is not aware of? If possible, how to restore vision then? Thank you very much for shedding some light on this as im just so heartbroken to see my mom so reduced and fully dependant on me for a month now.
Thank you very much Doctor.
Answered by Dr. Jonas Sundarakumar 20 hours later
Hello again,

I'm sorry to hear about your Mom's deteriorating health and I understand that you must be quite troubled and distressed by the recent turn of events.

Though I may not be in a position to give a definitive opinion on her diagnosis, since I don't know her complete clinical details and findings, I can shed some light on the possibility of a psychological cause.

On a general note, it is possible that psychological stress and inner conflicts can manifest or present as purely bodily symptoms. This is called a "conversion disorder", where a person's severe psychological stress or conflict gets 'converted' into a physical or bodily symptom. The commonest presentation of this disorder is via neurological symptoms - like weakness / paralysis, blindness, sensory loss, fits, etc. ( the absence of an actual medical or neurological cause). However, I would also like to mention that a diagnosis of a conversion disorder has to be made only after all possible medical causes have been ruled out.

In your Mom's case, there is evidence of swelling of the optic nerve head. However all tests to determine the underlying cause for the swelling have come out negative. So, the key questions here are:
- How significant is the swelling, especially when no causes (neurological, ophthalmological of other systemic) can be traced?
- More importantly, is the clinical swelling "significant enough" or "severe enough" to cause a total loss of vision?

Well, her doctors seem to think that it is not significant enough to produce a total loss of vision and this is probably the reason for asking for a psychiatric consultation.

I think that talking to a therapist would be worthwhile, as it will help in two ways:

1) To have a detailed psychological assessment, to see if there could be any psychological conflicts or emotional stress which could be causing or worsening her visual symptoms.

2) To offer her some form of emotional support and help, especially since she must surely be going through a stressful time with all the multiple medical tests and procedures, as well as dealing with her disability.

I hope I have been able to give you some clarity on this issue.

Best wishes,
Dr. Jonas Sundarakumar
Consultant Psychiatrist
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

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