It's that damn lump in my throat...

December 19, 2005 9:42 AM

My appetite disappears when I'm stressed out.

It's been a rough semester. I'm in the last year of my undergrad, with all of the "what the fuck do I do after this?!" stress that that entails. I'm moving in (tomorrow) with people I don't know, who seem perfectly nice, but there's always an adjustment period. My boyfriend of over a year, the first I was ever serious about, broke up with me suddenly about a month and a half ago. I'm feeling burnt out, overwhelmed, sad, angry, uncertain of myself, you name it.

I've lost 15 pounds since the breakup. I feel nauseous or full most of the time. Some days, I forget about eating until pretty late in the day. I never vomit, but I often feel like I will. I've had ice-cream in the freezer for over 2 weeks and I'm just not interested, and that's just wrong. I'm taking vitamins, trying to eat as much as I can (usually about 1.5 meals/day if I really try), and trying to deal with all of this as best I know how (talking, letting myself cry, hanging out with friends, etc.). My family and friends are very supportive, and I'm sleeping well. Right now, my weight is in a healthy zone, but I'm afraid it will keep dropping. I know that this just takes time, that it's just going to suck for a while and that's the way it is, but I'd rather not become emaciated in the process.

I was on anti-depressants for 8 months last year for anxiety, and I haven't found that those issues are being triggered by this. I feel sad, but I have good reasons. I feel anxious about the future, but I think most university students do at this point in their schooling. I don't feel unnecessarily paranoid, I don't have the intrusive thoughts that I used to have. Some people have suggested anti-depressants, but my brain seems be doing okay, it's my stomach that isn't cooperating. I'm going to go for counselling next semester.

So, questions:
1. Should I go to a doctor about this, and if so, what is she likely to say about it?
2. Quick/easy/nutritious recipes? Something that isn't going to take much time/effort to make, but will keep me somewhat healthy and give me energy?
3. What helped you get through end-of-school/break-up stress? How long until this stops feeling so bad? I realise it takes time to deal with, but what do I do now?

posted by heatherann to health & fitness (28 comments total)

The more you worry about it the more it will get worse. It's just being fed by a vicious cycle. If you give it the time it needs and don't obsess over it, it sounds like a passing phase you'll forget to be mired in.

Exercise. It really helps the attitude, appetite, AND even the body.
posted by kcm at 9:45 AM on December 19, 2005

IANAD, but sounds like normal stress/anxiety (as opposed to an anxiety disorder). Which is good news, since it will probably go away. You're going through a temporary high-stress period (break-up, significant life changes).

There's probably nothing wrong with you, physically or mentally, but I would never advise someone not to see a doctor, just to be on the safe side.

Exercise, preferably early in the day, may help stimulate your appetite as well as lower your stress level. Does your school have a gym?
posted by justkevin at 9:53 AM on December 19, 2005

The counseling will definitely help. Talking to somebody who has nothing but an objective viewpoint on the matter will make you feel much better. They will also be more qualified with regards to suggesting medication (assuming it's not peer counseling). Try eating food that makes you feel good, something you just can't resist. Ice cream does it for me, but apparently not for you. It may not be completely healthy food, but it is better than not eating at all. Try Jello with mandarin oranges and a dollop of whipped cream. Treat yourself right now. Just don't make them bad habits.

You know what is good for you. You sound very intelligent, have a good support system, and motivation to be successful. Just hang in there and you'll get through it. And exercise is also a great suggestion.
posted by Roger Dodger at 9:55 AM on December 19, 2005

I'm just getting over the no-appetite post-breakup phase myself, and I also always lost weight at finals time, so I sympathize. Your reaction is totally normal, probably a remnant of the flight-or-flight response.

Try to focus on the foods that appeal to you, without worrying too much about the nutritional content, in order to make sure you're getting enough calories (especially if you're exercising too.) For me, it was peanut butter, whole milk yogurt, and orange juice that kept me from totally disappearing. Go to the supermarket and wander the aisles and what doesn't make you sick to think about eating. You may have to just force it down for a few more weeks.

The other thing that helped me tremendously (especially for finals stress) was exercise -- getting my heartrate up, and getting outside was totally therepeutic. Buy some nice warm workout clothes to get yourself motivated. Also, think about the time of day that works best for you. For me, it was great to go for a run in the early afternoon to have a nice break in the day and get focused for studying in the evening.

Good luck! You'll feel so much better in just a few weeks, I promise.
posted by footnote at 9:59 AM on December 19, 2005

When this happened to me (due to a break-up), lunch was the only meal I could manage -- I've always been unable to function without at least three meals a day, but I was suddenly too nauseated and depressed to deal with anything more than coffee in the morning and too much wine in the evening (which I *don't* recommend!). But I could generally manage lunch, which almost always ended up being a ridiculously rich macaroni & cheese from a restaurant near my office.

So maybe you can try to see if there are *times* when you can manage to get something down, rather than focusing exclusively on *what* to eat? Lunch worked for me, I think, because I woke up depressed and went to sleep depressed, but could generally hold it together in the middle of the day.

And yes, excercise, even if it's just wandering around dazed and upset. I did a *lot* of walking, and I think it helped, too.
posted by occhiblu at 10:01 AM on December 19, 2005

footnote's advice is good- I also lose my appetite when stressed, and when I do, I just try to eat whatever I can. Even if it means I eat a whole bag of Doritos for dinner.
posted by ThePinkSuperhero at 10:01 AM on December 19, 2005 [1 favorite]

Soup. I have been though The Stress Starve before several times, and I can always manage some sort of clear soup, somtimes with veggies, and often with noodles. Consume as much of that as you can, if you can. It warms you up and it is relatively easy to prepare. If you can't manage it, it rewarms in a cinch at a later time, it keeps for a good long time in the fridge, and you may find it piques the appetite for more susbtantial food.
posted by oflinkey at 10:17 AM on December 19, 2005

Oh, and as for recipes- do you like eggs? I love eggs, and they are easy and nutritious. Make scrambled eggs with cream and cheese, or make an egg-white omelette with tomato. I've found eating anything with protein is going to make me feel fuller longer. Peanut butter is probably good, too, if you like (I don't).
posted by ThePinkSuperhero at 10:26 AM on December 19, 2005 [1 favorite]

If you only make yourself eat one meal a day, try to make it breakfast. The more protein the better. Two eggs every morning is my routine (for years now, and no, my cholesterol levels are not abnormal). Until I got used to eating breakfast I had the most deranged eating habits.

You are most definitely at a difficult time right now but soon things will even out for you. Good luck and best wishes.
posted by macinchik at 10:53 AM on December 19, 2005

Regarding question 3: I was in a very similar place in my last year of school. What helped me most was having a creative outlet (making music, writing) to focus on. Exercise is probably an equally good suggestion, depending on your inclinations--either way, something you can immerse yourself in, get excited about, and feel refreshed by.

The counseling will probably help too. The question "how long until this stops feeling so bad?" seems like an indication that you need to talk it out. I feel for you.
posted by keatsandyeats at 10:56 AM on December 19, 2005

Metrex makes some sort of high protein bar. I like the chocolate/peanut one (and hated the cookie dough). Cut it in half...have half with whatever you have in the mornning...adn the other meal time.

The idea is to get something balanced into your system.
posted by filmgeek at 10:58 AM on December 19, 2005

Exercise. Best stress relief I know of. Go for a walk or better yet see if you can find a spin class. That is the one place I can turn my brain off and with my issues that is an important part of my selfcare.

As to food, how about smoothies?
posted by konolia at 11:05 AM on December 19, 2005

I was on anti-depressants for 8 months last year for anxiety, and I haven't found that those issues are being triggered by this. I feel sad, but I have good reasons. I feel anxious about the future, but I think most university students do at this point in their schooling.

Depression is possibly the worst named disease/condition in the universe precisely because its name makes people think about it this way. Anti-depressants do not exist to Make You Happy, they exist to make you capable of being happy. If you have previously been diagnosed with depression and you're finding yourself unable to properly cope with stressful situations, you likely are suffering from depression again.

Depression can manifest in a million different ways and apetite or lack thereof is classic top five. If you decide pills aren't for you, that's fine, but you shouldn't be dismissing them because you don't have the non-clinical definition of depression stuck in your head. There's no shame in getting into a funk you can't kick yourself out of and needing some assistance. The professor who changed my life did so with the simple statement "If you were a diabetic you'd take your damned insulin, wouldn't you?"
posted by phearlez at 11:10 AM on December 19, 2005

There's a good amount of easy snacks/light meals to get food into you suggested in this thread.
posted by desuetude at 11:37 AM on December 19, 2005

phearlez, I don't know who you're arguing with, because I absolutely agree. I give that lecture to people practically every week. Anti-depressants didn't make me feel happy, they cut down on the paranoia and intrusive thoughts and made me react normally. What I was saying in that paragraph is that being sad and anxious is probably a pretty normal reaction to my life right now, so I doubt that anti-depressants are a good answer. If they're not there to magically make me happy, and I'm already reacting normally to the situation...?

I took anti-depressants when I was reacting in ways that the situation didn't warrant. The way I'm reacting now? Pretty fucking warranted. My uncle refused to take anti-depressants and chose to drive his car into the river instead. I'm not about to react like he did, and you can bet that I take this shit seriously because of him. Right now, though, I'm sad because I just lost my best friend, not because my brain is broken.

Everyone else, thanks so much. It helps in some bizarre way to know that other people go through the Stress Starve, and that it's okay to just eat what I can until things get back to normal.
posted by heatherann at 11:41 AM on December 19, 2005

Wow, there is a lot of great advice here. I'd like to echo that this all sounds completely normal and add that you seem to be dealing with it (the lack of appetite) very maturely. That you're planning on going to counselling is great--most people will acknowledge they should but never do it.

I also echo the point about eating what you feel like, even if it's something crazy. (I alternated between tortilla chips with guac and tortilla chips with salsa con queso after my last big break up). Two benefits: getting calories, and taking a bit of pleasure where you can during a stressful time.

Also, the exercise/creative suggestions are good. Sometimes when I'm having these troubles, I feel a lot better after a trip to an art supply store and/or doing something creative. Even a trip to the Rite Aid to run an errand can help. And even a little bit of exercise will help with your appetite, and I find I crave healthier things when I'm getting more exercise. Just (for me) getting off the subway a few stops early and walking the rest of the way can both boost my appetite and relax me--nice, wind-down, "me time."

Recipes: I find chicken tenders to be useful for the stressful times. Healthy, they cook up fast, and they're a blank slate--use whatever marinade or seasoning you feel like. Add a veggie, bread, and rice/potato, you've got a balanced meal--nothing too heavy, but still hearty in a way. Smoothies are a good idea. You can just sip on one while studying or watching tv--before you know it, it's gone.
posted by lampoil at 11:47 AM on December 19, 2005

I had a very similar situation a few years back, except I was vomiting, and a lot. No appetite, nauseous all the the time, all due to stress. I went through counseling and Paxil and was able to determine that it wasn't in my head. I'll spare you all the details, but I eventually made it to a gastroenterologist to have a Upper GI (which was bitchin), and it turned out I had a hiatal hernia, resulting in acid reflux disease. I had none of the common side effects - just the nausea. Started up on Prilosec and the nausea and vomiting stopped immediately.

Not saying this is what's wrong with you, just anecdotally suggesting that a visit to the doctor is in order to make sure there is nothing physically wrong with you.

As for diet in the meantime, I found I could usually keep bananas down.
posted by mike9322 at 12:08 PM on December 19, 2005

Try dense foods--high calorie, small serving size, high nutrients. Peanuts (high fat) and Ensure (low fat) were particular favorites of the nutritionists I've worked with.

Change in appetite is a symptom of depression. Even if your brain "feels" ok, depression can be relative. I've been chronically depressed for most of my life--even my best days are riddled with anxiety and profound melancholy.

Anyway, the recipe for mental health, according to various therapists I've had, is:

Exercise
Nutrition
Adequate Rest
Spiritual Nurturing (This does not mean you must believe in God--it can be any activity that promotes inner peace. Meditation, painting, yoga, Tai Chi, etc.)

Depression interrupts most, if not all, of these things, making mental and physical well-being more difficult to achieve. And poor nutrition, bad sleeping habits, etc. can cause depression. It's a nice vicious cycle. So if you can, talk to a doctor, get some medication, set up some therapy. Ask your therapist to help you develop coping mechanisms for life stressors and make that a goal of your sessions with her/him.
posted by xyzzy at 12:44 PM on December 19, 2005

It could be acid reflux. I get acid reflux when stressed and it just kind of compounds it. It rears it heads in weird ways. Take some zantac and see if your hunger comes back, mine did.
posted by geoff. at 1:10 PM on December 19, 2005

I've been going through a tough breakup, picking up a second job, and generally stressing hard about my life. Similarly, I haven't been able to muster an appetite--I've lost about 12 pounds this month, and manage about one lackluster meal a day. Drinking tea helps; it's calming and helps prevent dehydration (a side effect of the OTC sleep pills I've been taking for probably too long). Bland food--tofu smoothies with peaches, tofu on spinach salad, bananas, pho with chicken--helps. I didn't feel up to working out for a while, but now that feels wonderful. Yoga in particular, followed by a hot bath, helps to stretch out my muscles and calm me down. I sometimes find I'm hungry once I'm calmer. Calling friends for dinner is also good--I'm more likely to eat when others are also eating.

Don't freak out--the more distance I get from my breakup, the stronger I feel, and the more fuel my body needs. You'll get there. Think of eating as another way of taking care of yourself--it's hard to eat when you're upset, and denying yourself can feel powerful, but after a while you'll have burnt yourself clean and need to start rebuilding.
posted by hamster at 1:26 PM on December 19, 2005

I went through a work-related stressout with similar symptoms not too long ago (except I stopped sleeping too). Counselling really helped.

Light excercise, a change of diet and self-hypnosis worked wonders for me. I had been eating fairly bland things without any improvement, but switching to a high-protein, lowish carb diet made a big difference. Hard-boiled eggs, tuna and nuts as snacks and things like steaks, stir-frys or a caesar salad for meals.

Walking in the sun for 15-20 minutes a day was good.

Self-hypnosis seemed weird at first but it's pretty cool. Email me if you want to know more.
posted by the duck by the oboe at 1:48 PM on December 19, 2005

Pretzels and exercise and renewing old friendships. Working on other relationships can help you get over romantic ones, I think. It can't hurt to get in touch with people you love and who will help you through tough times. How about friends from high school, your freshman year roommate, your elementary school pen pal, etc etc etc...
posted by srah at 1:56 PM on December 19, 2005

heatherann, it seems like you're in a pretty normal, if miserable, place right now. Most of us have been or will be there too. Hang in there -- you may get a bit skinny but either self-preservation or relief from anxiety and grief should set in before too long. (Though it's possible that prolonged stress and anxiety, even if justified, can cause the chemical imbalances leading to clinical depression -- which makes it hard to get past the stress and anxiety. Do watch out for the vicious circle.)

Let yourself process your grief over the relationship. Learn what you can about yourself as you gradually achieve some distance and perspective. There's no rushing it. But here's a few things you might consider to start getting your spirit and attitude up:

Realize that you are not your feelings, you are not your relationships, you are not your degree or career. You're a complete and self-sustaining person.

Make a list of 10 things that are great about you. Keep it nearby. Review it at bedtime & breakfast. Add things as they occur to you.

Keep a log, written or mental, of all the people you made smile or laugh each day. Try to increase each day.

Think of the universe not as a big scary place in which you must struggle to survive. The universe exists to bring you what you need and want, if you just let it.

Listen to energizing, happy music. Get some nice-smelling candles. Make yourself keep your place neat & clean. Ask a friend for help if you need it, but don't let your environment deteriorate - avoid the "broken-window" syndrome.

Take on a brand-new challenge, even a small one. Get a harmonica & instruction book. Master a card trick. Sit down by an interesting stranger at lunch once a week. Write a poem a day.

Practice letting go -- of thoughts, feelings, memories, attachments that aren't useful or productive. There's training for this called the Sedona Method. You could order the free intro CD & DVD. The web is full of useful philosophical tidbits like these, too.

Think of change as vital, neccessary, and exciting. You're graduating soon -- all kinds of doors are opening! You're single -- look at all the guys you can meet! You're moving in with new people -- imagine the potential for close friendships and the things you can learn from each other!
posted by Tubes at 2:05 PM on December 19, 2005

I took anti-depressants when I was reacting in ways that the situation didn't warrant. The way I'm reacting now? Pretty fucking warranted.

I'm sorry if I've offended you, but I do not agree. Your feeling unhappy is perfectly reasonable, but it's not the problem you described. What I am reacting to is this:

I've lost 15 pounds since the breakup. I feel nauseous or full most of the time. Some days, I forget about eating until pretty late in the day. I never vomit, but I often feel like I will. I've had ice-cream in the freezer for over 2 weeks and I'm just not interested, and that's just wrong.

You're having a physical reaction based on non-physical stimuli that's preventing you from bringing in enough calories to sustain your weight. You're also finding yourself unable to take joy in something that you would normally find to be a pleasurable activity. That's one possible description of depression.

As I said, cope with this how you see fit. Don't want to take anti-depressants? Don't. I am merely saying that your subsequent paragraph seems to indicate you think ADs exist to take a person who feels bad for no reason and make that person feel good, but have no purpose for someone who has a good reason to feel bad.

In reality, ADs are often useful for someone in a bad situation with good reason to feel bad who has fallen into a state where they can't go about the routines to help them get back to a better place. Maybe that's sleeping too much, maybe it's making self-destructive decisions, maybe it's not eating.
posted by phearlez at 2:16 PM on December 19, 2005

If you are at a university, they have counselors there to talk to people like you for free. That's their only job. Talk to them, now, it's free and it takes 30 min. Everyone has something wrong with them, it's all about how serious to make it seem to you.

If you don't have access to something free like that, and don't want to spend the money on some real help (not from AskMeFi), then go back to the basic human needs and do tons of it:

Excercise every day. Work up a sweat every other day and go for a walk the other days. If it's raining or you can't leave your house or you are too anxious to leave the house, do jumping jacks while watching TV. Try working on something on your body you feel could use some work.

Eat 3 times a day. It may seem hard and something you don't like at first, but this is something you don't have a choice over. You eat or you die, you choose. Salty foods create more saliva and make you want more food.

Sleep 8 hours a night. Be awake for a large portion of the daytime and cut down on how much night/darkness you see. This raises your energy. If you can't stay asleep that much, then lay there in your bed. Make yourself do it. Don't watch TV or listen to music hoping to fall asleep.

Do that or you die. Simple.

To make it easier, rent or buy or find a movie or series that shows overcoming hardships that make yours seem pathetic. Band of Brothers worked for my old roomate, he watched an episode each day and repeated the series many times.
posted by cleverusername at 3:18 PM on December 19, 2005

RE: Vitamins. You say you are taking vitamins. Make sure you take them with food, otherwise they could make your nauseous. Especially true if you are queasy anyway.

Best of luck to you.
posted by 6:1 at 6:20 PM on December 19, 2005

I too have always reacted to stress with loss of appetite and nausea. I am always slender but can get dangerously underweight under prolonged stress.

My practical advise, learned the hard way, is to stay hydrated. I am most nauseous when dehydrated. Gatorade and cherry limeade work for me. Also, I can usually drink an instant breakfast or smoothie to keep me going. Somehow sipping on some thing throughout the day isn't as hard as forcing down food.

I would disagree with cleveruseofname. Don't force yourself to eat, it only compounds the pressure and revulsion you may be feeling towards food. Also don't make yourself lie in bed, you will only worry.

I find listening to my favorite songs very calming and a lift to my mood, especially if I sing along.
posted by rintj at 8:50 PM on December 19, 2005

If anybody is still reading this thread they will probably jump all over me for this but here goes.

The symptoms you are describing fall into a classic acupuncture diagnosis of Liver (the free flow of energy and emotions) overacting on the Spleen/Stomach (the digestive system). To be clear, I am not talking about the liver and spleen we might be familiar with from a medical text but the Liver and Spleen systems conceptualized by the Chinese as they developed their classical medicine. Stress, anxiety and depression are signs that the Liver is not doing it's job of facilitating the flow of energy thru your body. Irregular periods/PMS/breast distention would also support this pattern. Lack of appetite and the fullness can be attributed to the Spleen being unable to perform well and the nausea is the Stomach rebelling.

I have found that acupuncture can be highly effective in treating emotional/mental issues. You may find that it mellows you right out and your digestive issues subside.

Dietary suggestions are simple: Bland, nutritious food. No fried foods, no spice, easy on the fat and dairy. Any thing that seems heavy to you is probably not a good idea. The ice cream is cold (hard on the Stomach) sweet and fatty (hard on the Spleen)- I think your body knows what it can handle in this case. Try to eat breakfast, try to eat regular meals, try not to eat late at night.

Congee, a rice gruel you can make simply by adding 2 1/2 times your normal water when you cook up white rice, could be real good for you. Cook it a long time. Try adding ginger, cardamon, fennel, carrot or chicken broth. If you are running warm take it easy on these and perhaps add some celery or some wheat berries.

There are some classic herbal formulas that could be of help to you and an acupuncturist with herbal training would be able to suggest an appropriate one.

Hope you feel better soon. There is a whole lot of caring and concern in this thread.
posted by pointilist at 12:17 AM on December 22, 2005