In recent years, there has been much discussion about the poor state of mental health in the United States — and worldwide. There’s nothing like a global pandemic to make matters even worse.
For many of us, anxiety levels are reaching all-time highs as we struggle to cope with the new reality thrust upon us by COVID-19. We might feel irritable, anxious, fatigued or depressed. Perhaps our moods fluctuate throughout the day. All of this is completely normal, and it’s important to accept how we feel. However, there’s a hidden factor that might be contributing to our mental distress: blood sugar.
I had the privilege of speaking with Dr. Ann Childers, an Oregon-based psychiatrist and expert in nutritional psychiatry. She began tracking her patients’ blood sugar using continuous glucose monitoring and found that repetitive highs and lows (“the blood sugar roller coaster”) can dramatically impair mental health.
“I’ve seen people diagnosed with conditions like bipolar disorder or attention deficit disorder who have these kinds of blood sugar patterns,” she said. “Once the patterns resolve, they start feeling better.”
How might one prevent the blood sugar roller coaster? According to Dr. Childers, the answer is clear: avoid ultra-processed carbohydrates.
“These kinds of carbohydrates turn into glucose very quickly in the body and cause blood sugar spikes,” she said. “That’s really stressful for the body to manage.”
When blood sugar is too high (hyperglycemia), we can have trouble thinking or concentrating. When it is too low (hypoglycemia), we can feel irritable, anxious or depressed. The body also kicks into fight-or-flight when it senses low blood sugar, pumping out stress hormones like cortisol that signal an emergency.
Dr. Childers said people in a low blood sugar state almost instinctively reach for something that will quickly restore blood sugar — like a bagel or cookie. The body then produces insulin to clear the excess glucose from the blood, blood sugar drops and the cycle begins anew.
“People can have mood swings several times a day that are actually related to eating highly refined carbohydrates,” Dr. Childers said.
Ultra-processed carbohydrates include pasta, bread, cereal, rice, juice, soda, granola bars and sweets. In other words, starch and sugar — the cornerstones of processed food. Not only can these fast-acting carbs impact mental health, they can wreak havoc on the body as a whole by setting us up for metabolic syndrome.
What exactly is metabolic syndrome? It’s really just a fancy name to describe our metabolism when it stops working properly. Metabolic syndrome includes a number of markers like high triglycerides, high blood pressure, insulin resistance and increased waistline. In 2018, researchers from the University of North Carolina found that a mere 12 percent of Americans are metabolically healthy.
“Prevalence of metabolic health in American adults is alarmingly low, even in normal weight individuals,” the researchers conclude.
That’s bad news given that metabolic syndrome has been associated with a slew of modern chronic conditions like heart disease, diabetes, dementia, stroke, polycystic ovary syndrome (PCOS) and even some cancers. Most recently, metabolic syndrome has been linked to worse COVID-19 outcomes.
“As of today, ensuring a good blood pressure control and blood glucose control is of primary importance in ensuring better outcomes in people with COVID-19 infection,” researchers write in a recent journal article, “COVID-19 and Metabolic Syndrome: An Association Too Difficult to Ignore.”
In the past, people primarily died from communicable diseases, which are passed from person to person (like COVID-19). With the exception of our current global pandemic, people today are mainly dying from noncommunicable diseases, also known as chronic diseases. It might seem like diabetes and heart disease are an inevitable part of life, but they are actually a relatively new phenomenon.
“These are modern diseases,” Dr. Childers said. “They’re diseases that we really didn’t see much in ancient people.”
The good news is that we can choose to promote our metabolic (and mental) health with each bite of food we take — by selecting whole foods like vegetables, meat, eggs, fish and other fats like avocados and nuts.
If the thought of cutting out all ultra-processed carbohydrates is too daunting, Dr. Childers recommends starting with a no-carb breakfast like eggs (her personal favorite is muffin frittatas). This establishes a base of long-lasting energy that can mitigate the blood sugar roller coaster throughout the day.
“I think it’s a really good strategy for people who aren’t ready to take the plunge and get rid of all of their industrial foods yet,” Dr. Childers said.
Of course, there are a number of other strategies that can help promote mental health during these uncertain times. It’s a perfect opportunity to learn relaxation techniques like meditation and yoga that can help us break the stress cycle. Social connection is also extremely important, so we should utilize our array of technological tools to keep in touch with family and friends.
If you’re looking for extra help, there are all kinds of mental health professionals currently doing online work. Psychology Today has an extensive therapist database that can be sorted by location, insurance, approach and more.
Above all, we shouldn’t criticize ourselves for however we may feel. In these unprecedented times, we need to stop being our own worst critics — and start befriending ourselves again.
Dr. Ann Childers is a medical advisor for the Hypoglycemia Support Foundation. If you or anyone you know has symptoms associated with hypoglycemia, visit the Hypoglycemia Support Foundation or check out this handy infographic.