Why do we eat our sadness?

Our theme this month is my office is eating emotions.  What do I mean by that? When we encounter an emotion that we perceive as being negative (sadness, loneliness, emptiness, frustration, hopelessness), we typically want to “fix” that negative emotion.  We want it to go away – to be replaced by a more positive emotion – something like joy, pleasure, happiness, love, etc. That’s human nature. One of the most powerful emotions that we want to “fix” is sadness.  When we see someone crying, our human instinct is to try and take that sadness away. With words, with actions, with something – anything. Many of us do the same thing to ourselves – when we feel sad, we want to replace that sadness with something more positive.  

Although sadness is a normal human emotion, it’s a very unpleasant one for most of us.  It makes us feel uncomfortable and uncertain. Most of us shy away from it. We try to shove it into a dark corner inside of ourselves to be ignored.  We might promise to revisit it someday – but realistically, who wants to dig that out someday when things are going well? Sometimes we can’t ignore it completely and we cry big bucket tears of sadness – either alone or with someone that we care about – but for most of us, that’s not the normal way we handle it.  

In our society, we are taught from a very young age to do this.  How many times growing up were you told to stop crying, to toughen up, or to get over it?  That your sadness wasn’t acceptable?  

In addition to being uncomfortable, sadness is also an emotion that is very socially unacceptable.  Sometimes we have to shove it deep inside and save it for later because to let it hang out there might cost us our job.  Jane can’t sob her way through the board meeting because she just found out that her friend was diagnosed with breast cancer.  She has to nod and look engaged, even though she is mentally checked out. Although Chris had to transfer his aging father to hospice last week, he also has to be responsible for submitting payroll and processing everyone’s PTO forms without messing up, so he shoves that sadness down from 8-5 each day.   

Now, ignoring all of that sadness takes a toll.  The act of bottling it up and shoving it down deep takes something out of us, so typically, we need something to replenish ourselves after we accomplish it.  We need something pleasurable to make the energy expenditure worthwhile. Unfortunately (or fortunately – depending upon how you look at it) in today’s world, there are a plethora of things out there that give us immediate pleasure.  Quick fixes that can fill the void where the sadness used to be – or at least slide on top of it and cover it up.

Some people turn to alcohol or drugs to cover up the sadness.  Some turn to gambling or shopping to fill that void. Sadly, it’s easy to judge the people that do.  What most of us don’t realize is that we do the same thing on a regular basis. Not with drugs or alcohol, but with a different drug that is much more socially acceptable.  Food. Not just any food – typically sugar or some type of highly processed food. I’ve been practicing Obesity Medicine now for over five years and I have never had a patient tell me that they eat eggs or olives when they are sad and need something to pick themselves up.  It’s usually sugar. Liquid sugar in the form of mocha lattes or cherry limeades or solid sugar in things like cookies, cake, or candy. Sometimes it’s a highly processed, fat-laden starches like pizza or macaroni and cheese or french fries. I think it comes down to personal preference and accessibility – and not a different type of food “therapy” – although I could be wrong.  

Why do we seek out these junk foods when we are sad?  Why do we use them to fill that emptiness inside of us?  Because they offer a quick, intense, fleeting fix of dopamine.  Of pleasure. And grabbing a candy bar is much more socially acceptable than having a shot of bourbon or doing a line of cocaine!  And dopamine is the hormone in our brain that we associate with pleasure. Not happiness or contentment (more on that another day), but pleasure.  

Pleasure is a rush.  Pleasure is a bump. It’s finding a twenty-dollar bill on the sidewalk.  It’s pulling a slot machine and getting coins dumped all over your lap. It’s watching the Kansas City Chiefs finally win a Superbowl!  Pleasure, in all it’s simplicity, is dopamine. And there’s absolutely nothing wrong with having a little dopamine from time to time. It feels good – and I’m certainly not going to tell you that feeling good is bad for us.  

However, overdoing the dopamine-causing behaviors typically gets us in trouble.  Not usually right away, but slowly and gradually. A person doesn’t wake up one day and decide to be an alcoholic.  They typically start slowly, realizing that drinking often takes away the bad feelings. One night a week of heavy drinking grows to two, then just a little bit on the other nights as well – to take the edge off.  Pretty soon, the little daily dose gets bigger and bigger until the pattern is so ingrained that it’s hard to stop. Especially because at first, each day, the alcohol does make the bad feelings go away. The long-term effect is usually more bad feelings and more negative emotions, but at first, that drink makes the feelings go away.

The same thing happens to many of us with sugar.  We eat a cookie to make the sadness go away – and it does.  Problem solved. We make a positive association between cookies and feeling better.  Then we get sad again, and we repeat the behavior. We keep it up. Eventually, it takes two cookies.  Maybe even two cookies and a frappuccino. We graduate to having some sugary creamer every morning in our coffee to start us off with a little dopamine – at least enough to get us to our mid-morning chocolate chip granola bar or piece of chocolate.  This gives us enough dopamine to get to lunchtime, where we can have something more filling – usually one of the starchier foods like pizza or french fries. A few hours later (during our mid-afternoon slump – or dopamine crash) we grab a soda, then dessert to follow dinner, then a few hours later, something to munch on while watching TV.

Most of us are so busy getting dopamine bumps from our food that we don’t even realize we are are doing it.  We might realize it when we sit down and eat an entire box of Oreos after a break-up but we don’t usually see the gradual evolution of the process as it is happening.  And many of us don’t even see it when the idea is introduced. I ask all of my new patients if they are emotional eaters and about 25% say they are. Yet, a lot more than 25% struggle with what to do to bring themselves happiness when I take away the sugar.  When the junk foods are removed, many patients feel completely lost – or punished. They are miserable. Why? Because in taking away the sugar and junk, I have essentially stripped them of their coping mechanism. And if you take away someone’s coping mechanism, then they don’t have a way to deal with the thoughts and feelings they were trying to avoid by using the substance in the first place.  If the removal of sugar and processed foods causes utter misery, it means that they were not just being used – they were being abused.  

A good rule of thumb is that if you can add the word “-aholic” to the end of the word, it’s something that activates the dopamine (or pleasure) pathway in the brain and can be abused.  

Now some people don’t cross that line from use to abuse.  Some people live their entire lives drinking alcohol intermittently without becoming an alcoholic.  Most of us try tobacco at some point in our lives and only a small percentage get addicted to tobacco products.  Similarly, some people enjoy sugar from time to time and get a dopamine rush from it, but they don’t abuse it. When we take sugar away temporarily from these people, they shrug and put one foot in front of the other.  They don’t like giving it up, but they aren’t devastated by the removal.  

Others cry.  Literally, they cry big bucket tears.  They try and negotiate. Try to find “hacks” – or “healthy” versions of the substance.  Many talk about how miserable they are and how they feel punished. To me, that means that they have been using sugar (or some type of unhealthy food) as a coping mechanism.  As a way to cover up some sort of negative emotion that they don’t want to deal with. Without the coping mechanism, all those negative emotions are raw and exposed.  

I’m not a therapist, but I have learned a lot working closely with them.  I send a lot of patients to therapists to deal with this issue. I coach a lot of patients through this issue.  Although most people want to work on the coping mechanism as the problem (the food or the alcohol or whatnot), we have to dig deeper.  We have to work on figuring out what we are trying to avoid by using these coping mechanisms. If we are using food to bump away our sadness, we need to work on acknowledging our sadness and dealing with it.  Sometimes we need to cry about things that make us sad. Sometimes we need to talk to someone about the things that make us sad. Sometimes we have to give ourselves permission to be sad – and just live in the sadness long enough to accept it and make peace with it.  After all, it’s OK to be sad when someone you love is dying. It’s OK to be sad when you don’t get the promotion you wanted. It’s OK to be sad when you realize the guy you’ve been obsessing about is already happily married. It’s Ok to be sad because the purse you wanted isn’t on sale anymore or that it rained on the day you had planned a picnic lunch with your kids.  It’s OK to just be sad sometimes.  

Along those same lines, it’s OK to use coping mechanisms from time to time to get through isolated events.  Not daily and regularly and in an unhealthy way, but occasionally. Like most things, moderation is key. Use – not abuse.  

I have spent almost twenty years of my career practicing obstetrics and gynecology.  It’s a wonderful field most of the time – full of excitement and birth and happiness and new beginnings.  However, when it’s sad, it can be really, really sad. Most of the time, when these sad things happen, my role as the doctor is to be the clinical person – to talk about facts and risks and to remain clear-headed while the family cries.  Thankfully, I can usually keep my emotions in check while I’m at work and can cry on the drive home afterward. But when I can’t seem to keep it in, I’ve found that eating a few cookies will allow me to bump myself to a better place long enough to do my job before those negative emotions come crashing back to me.  It works. I don’t do it often, but when the situation demands it, it’s a pretty decent coping mechanism. Although a shot of tequila would likely accomplish the same thing, I certainly can’t do that at work without risking my medical license – so cookies it is!  

The difference between using and abusing a substance is important.  Learning why we do what we do and why we struggle with what we struggle with is key.   It takes work to dig into this stuff but it’s so incredibly gratifying when we start to free us from our negative habits and behaviors that give us temporary pleasure – while at the same time robbing us of our long-term happiness.

Thanks for giving me so much of your precious time this week! 

Courtney Younglove, M.D.

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