Panic Attacks, Comfort Foods, and Carb Cravings: It All Makes Perfect Sense

I’d like to present what I believe is need-to-know information for panic and anxiety sufferers. I don’t think it’s front page news that what we eat and drink has great impact upon the onset and intensity of panic and anxiety. And one of the most prolific examples is the ingestion of food and drink loaded with simple sugars, a.k.a. simple carbohydrates. Now, one might think staying away from potential trouble would be an easy decision to make; however, as we all know, it all too often isn’t. And here’s why.

Let’s first review a bit of physiology. Something known as the HPA Axis is the integrated functioning of the brain’s hypothalamus and pituitary gland, and the adrenal glands, which sit on top of the kidneys. In concert, they manage our reactions to stress and regulate body functions such as mood, digestion, immunity, sexuality, and energy usage. Corticotropin-releasing hormone (CRH), produced and secreted by the hypothalamus, stimulates the secretion of adrenocorticotropic hormone (ACTH) by the pituitary gland. The pituitary, in turn, sends a message to the adrenal glands to secrete hormones known as glucocorticoids, most notably cortisol. And it’s cortisol, the “stress hormone,” that launches a very animated blood sugar and blood pressure popping response to stress. This response ultimately leads to norepinephrine (noradrenaline) flipping the switch on our fight/flight response.
 
I believe it makes perfect sense that what we just reviewed would ramp-up the participation in compulsive and pleasurable activities. And within the context of this article, we’re talking about the ingestion of simple sugars, as well as fats. Indeed, “comfort foods.” Now, cortisol stimulates abdominal fat storage. This particular type of fat build-up actually generates a signal to inhibit the presence of what are known as the catecholamines; most notably norepinephrine, epinephrine (adrenaline), and dopamine, as well as CRH. And this holds the potential to make us more physically, mentally, and emotionally at ease. Ah, the beauty of overindulging in comfort foods.

The bottom-line is, consciously or not, people consume comfort foods in an effort to calm stress, hoping for an elevation in mood and a reduction in anxiety. And, no doubt, eating these foods can flat-out cheer one up, making them function and feel one heck of a lot better. But, again, there’s a price to pay in the currency of abdominal obesity. I guess we knew that, didn’t we. And as unfortunate as it may be, this particular type of obesity is strongly associated with type 2 diabetes, cardiovascular disease, stroke, and death (ouch). Now, if you think about it, if one lived in a culture where ongoing access to comfort foods was low, you could make the case for the benefits of occasional munching in an effort to reduce anxiety and stress, and elevate mood. However, access to comfort foods isn’t an issue in the good old U.S.ofA. So, habitually attempting to relieve stress, anxiety, and the blues by pounding comfort foods may certainly make us feel better, but it just isn’t congruent with a long and happy life.

Now, let’s increase the intensity level of the consumption of comfort foods and talk about carbohydrate cravings or sugar cravings. As the name implies, this is the sudden and very overwhelming drive to consume carbohydrate-rich foods, such as breads, cakes, chocolate, cereal, cookies, crackers, fruit, ice cream, chips, pretzels, sugary soft-drinks, and popcorn. Now, sugar substitutes, alcohol, and monosodium glutamate (M.S.G.) are known to trigger carb cravings; however, they’re most often caused by a rebound biochemical reaction to low blood sugar levels (hypoglycemia), along with that infamous one-two punch we know all too well by now, low mood and stress. For the record, I find it very interesting that many of the depression sufferers I see also report being hypoglycemic. Hmmm. Well, let me ask you a question. Ever bit your nails off over the desire to pound carbs when you were bummed or stressed? Come on, fess up.   

Look, this stuff can become very confusing, very fast; so how ‘bout we do a slow walk-through with regard to the workings of this carb-craving, fluctuating blood sugar business. As we take our walk, let’s operate under the assumption that low blood sugar, depression, and stress are in-the-moment presenting problems. Okay? So, bammo, in response to these troublesome issues we find ourselves hitting the junk-carbs fast and furiously. As a result, our blood sugar level, and perhaps our mood, increases appreciably. Well, the surge in blood sugar leads to an increase in the production of insulin. Insulin, produced in the pancreas and known as the “hunger hormone,” now becomes a major player in that it manages the metabolism of carbohydrates, most notably glucose, a simple carbohydrate/sugar. The hormone, glucagon, also produced in the pancreas, plays an important role as well, as it’s released when glucose levels are low. Glucagon causes the liver to convert stored glycogen into glucose and release it into the bloodstream. This action is in opposition to that of insulin, which directs our cells to absorb glucose from the blood.

Well, when this rush of glucose hits home, insulin reacts with great speed and force, resulting in an immediate downward surge in blood sugar levels. This dynamic is known as functional or reactive hypoglycemia. For the record, the medical term for this business of excess insulin release after eating and drinking carb-rich foods and drinks is post-prandial reactive hyperinsulinemia, or just plain old hyperinsulinism. Some would say the term dysglycemia ought to be incorporated to account for unstable, not just low, glucose levels. At any rate, hyperinsulinism leads to reactive hypoglycemia. Whoa, huh?

Well, the really bad news is chronic hyperinsulinism can result in insulin resistance. And when that happens our bodies shut-down, if you will, in that insulin can no longer facilitate the introduction of food energy, in the form of glucose, to muscle, nerve, and organ cells. As this occurs, on come the physical, mental, and emotional symptoms of low blood sugar – more intense carb cravings, irritability, fatigue, trembling, headache, weakness, feeling faint, confusion, and the potential for panicky reactions to these and any number of internal and external stimuli. It’s interesting to note that epinephrine (adrenaline) is also playing a part in the presentation of these symptoms, as the body secretes excess amounts of it in an emergency reaction to alarmingly low blood sugar levels.

Oh, and by the way, since blood sugar can’t get to its targeted cells, it ends up being railroaded into fat cells, and that equals poundage. Worse yet, as this manic insulin ride continues, even the fat cells will ultimately shut-down; and with no place left to go blood sugar holes-up in the bloodstream. And that equals type 2 diabetes, often referred to as adult-onset diabetes.

Lots of information here, I know. But, haven’t you ever wondered why you may be pounding carbs? And what about the times you’d walk through a blizzard to secure chocolate? Well, I know these questions were of great interest to me, and that’s what led to my research. There’s no doubt in my mind that each and every panic and anxiety sufferer is all the better for understanding these dynamics.

After a winning bout with panic disorder, a career in the business world, and a part-time job working with socially challenged adolescents, Bill found his life's passion and work. So he earned his master's degree and counseling credentials, and is doing all he can to lend a hand to those having a tough time.

Bill authored a panic disorder education and recovery eworkbook entitled, "Panic! ...and Poetic Justice," which is available on his website and online store for immediate download. Also available is information regarding a collection of poems he wrote along his panic disorder and recovery journey entitled, "The Poetry of My Life." And now he's managing a blog. Lots of good stuff going on and much more to come.

In addition to doing psychiatric emergency work, Bill continues to do a lot of writing. He's conducted numerous mental health workshops for non-profit organizations and remains available to present more. Bill is a national and local member of the National Alliance on Mental Illness (N.A.M.I.).

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