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Cravings may indicate anxiety, not depression

20 September 2002

Chocolate cravings and excessive sleeping are more likely to be symptoms of anxiety rather than of atypical depression, says a leading Australian psychiatrist.

Some patients consequently could be misdiagnosed with atypical depression when they actually had primary anxiety, said Professor Gordon Parker, director of The Black Dog Institute at the University of NSW.

Anxiety often showed as panic and social phobic symptoms, he said.

'There are individuals who have these panic and social phobic features who, as a consequence, are . . . prone to feeling rejected or devalued, particularly in interpersonal relationships.

'When they are under such stress and difficulty, they don't get the typical features of depression — losing sleep, appetite and weight — they get the opposite.'

These 'opposite' features — hypersomnia (oversleeping) and hyperphagia (overeating) — helped patients cope, Professor Parker said.

For example, hyperphagia could bring on cravings for foods rich in L-tryptophan.

'Carbohydrates, especially chocolate, have a comforting effect, triggering the release of endorphins and promoting 'feel-good' sensations,' Professor Parker wrote in the American Journal of Psychiatry (2002; 159: 1470-79).

'It is feasible that hypersensitivity to rejection is satiated by eating sugar-rich products that release multiple gut and brain peptides . . . known to modify cognition.'
 

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