Starvation of the Spirit

At a clinic for anorexia sufferers, I found real girls behind the sensationalized images of this tragic disorder.

June 1, 2007 - I remember sitting in the waiting area, where “lucky” bamboo grew in glass pots on the receptionist’s desk, nervously swinging my platform-sandaled foot and fingering my great-grandmother’s locket.  I could hear the voices of the other girls, but even if I stretched my neck, I could only glimpse one angular elbow—the rest were blocked from view.  All I wanted was to see them, and I only wanted to see them so I could compare myself to them.  I was so afraid that I would be the fattest girl at McCallum Place, an eating-disorder treatment facility in St. Louis.  I wanted desperately to be a “legitimate” anorexic.

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Fortunately, with a little maturity, therapy, and support, I finally realized that neither my appetite nor my emotions should be controlled - but rather fed, even indulged. Most important, they had to remain separate from each other. By ordering the entire left side of the menu, I was learning to listen to my body; my only rule was to stop when I was full. There couldn't be any restrictions, or my bulimic side would eventually rebel.

And it worked. After a year on my "liberation" diet, I was relieved to find that when I let my body choose what it wanted, it picked pretty well. Not perfectly: It preferred butter to olive oil and had a hard time passing up carrot cake, hungry or not. Still, my weight was stable and healthy, and I was ordering only one meal at a sitting, thank you very much. And that's how it was for about 15 years.

But a while ago I realized that my relationship with food was in trouble again - although this time, the signs were different. I was at a deli on my lunch break, chewing something healthy - I knew as much because of the dry, mealy texture. So I took a sip of water. Wow. That sure didn't help - now I had a floury paste on my tongue.

I looked down at my fake egg salad, mortared together with tofu mayonnaise, on seven-grain bread that probably would have tasted better had they quit at two or three. Why in the world, I suddenly wondered, was I eating this horrible thing?

For the previous 5 years, I'd been an editor covering health and nutrition - phytochemicals, antioxidants, good carbs, bad trans fats. It was a demanding job. I also married and had twin girls, and was running as fast as I could to meet work deadlines and fill my family's every need. I was trying to be perfect - again - only now I wasn't a teen counting calories; I was an adult using nutritional criteria to provide rules so I could feel in control of my chaotic life.

Whole grain "good" carbs? Check. Source of lean protein? Got it. Two of my five daily servings of fruits and veggies? Roger that; so, yes, I finished that disgusting sandwich, then ate a fruit salad, replete with antioxidant-rich blackberries. I hate blackberries.

That afternoon, I mindlessly grabbed a fistful of jelly beans from a coworker's candy bowl. Then I furtively nibbled the icing off a cupcake, even though I wasn't hungry. I felt like I was sneaking, but who was I hiding from?

According to my own anything-goes approach, I could eat a whole cupcake if I wanted. But lately I wasn't in touch with what I wanted. And just like in my bad old days, I felt compelled to steal some sweetness in rebellion.

Some people, I guess, can learn a lesson and be done with it, while others have to learn it again and again. In the hectic craziness of my life, I'd forgotten that I need to nourish myself emotionally as well as nutritionally.

Since the sandwich that left a lump in my throat, I've traded my job for freelancing to buy more time. Now I have enough energy to help out at school for Vivian and Sasha - and to be nicer to my husband, exercise, and occasionally see friends.

I'm back to indulgence mode, although not necessarily fistfuls of jelly beans. Now, when I become too concerned with what's healthy - and not concerned enough about what sounds good for lunch - I take it as a sign to step back and figure out what I really need to feel satisfied. Sometimes, it's a plain bagel (not whole wheat) with plenty of real cream cheese - hold the tofu stuff, please.

2. Fill your plate with essential antioxidants

Damaging molecules called free radicals are produced in our bodies during normal body functions – and these free radicals contribute to aging and dysfunction. Antioxidants such as beta-carotene and vitamins C and E combat the effects of free radicals. Antioxidants have been shown to tie up these free radicals and take away their destructive power.

Studies show that the brain is particularly at risk for free radical damage. Although there’s no way to stop free radicals completely, we can reduce their destructive effect on the body by eating foods high in powerful antioxidants, including:

• Sources of beta-carotene: apricots, broccoli, cantaloupe, carrots, collards, peaches, pumpkin, spinach, sweet potato. 

• Sources of vitamin C: blueberries, broccoli, grapefruit, kiwi, oranges, peppers, potatoes, strawberries, tomato. 

• Sources of vitamin E: margarine, nuts and seeds, vegetable oils, wheat germ.

3. Eat “smart” carbs for a calming effect

The connection between carbohydrates and mood is linked to the mood-boosting brain chemical, serotonin. We know that eating foods high in carbohydrates (breads, cereal, pasta) raises the level of serotonin in the brain. When serotonin levels rise, we feel a calming effect with less anxiety.

So don’t shun carbs – just make smart choices. Limit sugary foods and opt for smart carbs, such as whole grains, fruits, vegetables, and legumes, which all contribute healthy carbs as well as fiber.

4. Eat protein-rich foods to boost alertness

Foods rich in protein, like turkey, tuna, or chicken, are rich in an amino acid called tyrosine. Tyrosine boosts levels of the brain chemicals dopamine and norepinephrine. This boost helps you feel alert and makes it easier to concentrate. Try to include a protein source in your diet several times a day, especially when you need to clear your mind and boost your energy.

• Good sources of protein foods that boost alertness: beans and peas, lean beef, low-fat cheese, fish, milk, poultry, soy products, yogurt.

5. Eat a Mediterranean-type diet

The Mediterranean diet is a balanced, healthy eating pattern that includes plenty of fruits, nuts, vegetables, cereals, legumes, and fish. All of these are important sources of nutrients linked to preventing depression.

A recent Spanish study, using data from 4,211 men and 5,459 women, found that rates of depression tended to increase in men -- especially smokers -- as folate intake decreased. The same increase occurred for women -- especially those who smoked or were physically active -- but with a decreased intake of another B-vitamin: B12. This wasn't the first study to discover an association between these two vitamins and depression. Researchers wonder whether poor nutrient intake leads to depression or whether depression leads people to eat a poor diet.

Folate is found in Mediterranean diet staples like legumes, nuts, many fruits, and particularly dark green vegetables. B12 can be found in all lean and low-fat animal products, such as fish and low-fat dairy products.

6. Get plenty of vitamin D

Vitamin D increases levels of serotonin in the brain. Researchers, though, are unsure how much vitamin D is ideal. There are individual differences based on where you live, the time of year, your skin type, and your level of sun exposure. Researchers from the University of Toronto noticed that people who were suffering from depression, particularly those with seasonal affective disorder, tended to improve as their levels of vitamin D in the body increased over the normal course of a year. The recommendation is to try to get about 600 international units (IU) of vitamin D a day from food if possible.

7. Select selenium-rich foods

Selenium is a mineral that is essential to good health. In a small study from Texas Tech University, supplementation of 200 micrograms a day for seven weeks improved mild and moderate depression in 16 elderly participants. Other studies have also reported an association between low selenium intakes and poorer moods.

It is possible to take in too much selenium so that it becomes toxic. But this is unlikely if you're getting it from foods rather than supplements, and it can't hurt to make sure you're eating foods that help you meet the recommended intake for selenium, which is 55 micrograms a day. The good news is that foods rich in selenium are foods we should be eating anyway. They include:

• Beans and legumes
• Lean meat (lean pork and beef, skinless chicken and turkey)
• Low-fat dairy products
• Nuts and seeds (particularly brazil nuts)
• Seafood (oysters, clams, sardines, crab, saltwater fish, and freshwater fish)
• Whole grains (whole-grain pasta, brown rice, oatmeal, etc.)

8. Include omega-3 fatty acids in your diet

We know that omega-3 fatty acids have innumerable health benefits. Recently, scientists have revealed that a deficit of omega-3 fatty acids is associated with depression. In one study, researchers determined that societies that eat a small amount of omega-3 fatty acids have a higher prevalence of major depressive disorder than societies that get ample omega-3 fatty acids. Other epidemiological studies show that people who infrequently eat fish, which is a rich source of omega-3 fatty acids, are more likely to suffer from depression.

• Sources of omega-3 fatty acids: fatty fish (anchovy, mackerel, salmon, sardines, shad, and tuna), flaxseed, and nuts.
• Sources alpha-linolenic acid (another type of omega-3 fatty acid): flaxseed, canola oil, soybean oil, walnuts, and dark green leafy vegetables.

9. Watch your lifestyle habits

Many people who are depressed also have problems with alcohol and/or drugs. Not only can alcohol and drugs interfere with mood, sleep, and motivation, they can also affect the effectiveness of your depression medications. In addition, drinks and foods containing caffeine can trigger anxiety and make it difficult to sleep at night. Cutting out caffeine or stopping caffeine after noon each day can also help you get a better night's sleep.

10. Stay at a healthy weight

Findings published in the journal of Clinical Psychology: Science and Practice, show a link between obesity and depression, indicating that people who are obese may be more likely to become depressed. In addition, according to this study, people who are depressed are more likely to become obese. Researchers believe the link between obesity and depression may result from physiological changes that occur in the immune system and hormones with depression. If you have a weight problem, talk with your doctor about healthy ways to manage it with diet and exercise.

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