Teenage son with anxiety and depression... but mostly only when hungry?

[SanDiegoMom]

So my son, who is 14, has always had underlying anxiety.  My parents both have pretty severe anxiety, I struggle with it but have made a lot of great progress, and my son seems to have had it since he was young.  It's always been relatively manageable, but the last couple of years he's been lonely and we knew that homeschooling wasn't quite working well enough, especially where we lived. We have moved to our forever home and put them in school, only to have the pandemic and virtual school and no in person events. (sister goes to ballet in person every other week, but his main extras were going to be through the school -- robotics, math team, maybe drama, and none are meeting in person). 

So that's all the background, which contributes to his being lonely and bored.  We've been trying to do more stuff with him (hiking and baking) and he's seeing a therapist (online) which of course makes him even more anxious! But he's got friends back home and they play like every other day and do Dungeons and Dragons on the weekend.  

So I can understand when he's feeling sad, but typically the really BIG feelings happen when he's hungry.  And it's not just being hangry.  Last night he was falling apart before bed and I made him some peanut butter toast and after he ate it he asked why is it that when he's hungry he literally feels like he's in the depths of despair.  He feels life is meaningless, he is angry at us at times, ALWAYS saying he's just so TIRED and can't do anything... schoolwork is impossible and overwhelming... if I accidentally tell him he has an appointment or a meeting or just anything that is a responsibility he completely freaks out and covers his face or curls up.  Then I get him food and he's FINE.  It's just so.... extreme.  It happens twice a day now if I am not careful, and I am being careful now! 

An example -- Saturday we were ready to build furniture for his room -- we completely re-did his room to try to lift his spirits since he does his classes in his room and it was always crowded and messy. We asked him to help us build the furniture but he just fell apart at the thought of all the stuff to move and things to build.  My husband ran out and got these huge sandwiches from the neighborhood deli to lift his spirits, he ate his sandwiches and then all of a sudden he was building the furniture himself without being asked.  Then that night we got pizza (it was a long day and no one wanted to cook) and he had four slices.  It was thin crust though.... and that night he just lost it. Was just so sad and depressed.  I made yet another sandwich and he felt better.  This repeats almost every day, and it's always pretty extreme and overwhelming feelings. Not just irritable or down.  But ANGER or DESPAIR. 

The changes we are making:  MORE PROTEIN.  We eat ok.  Mostly home meals, probably too much sugar (Chobani yogurt has sugar, he usually has a small serving of m and m's twice a day and on weekends we indulge in a brownie or bowl of ice cream.). We have switched him from the bowl of chocolate granola for breakfast to a fried egg and cheese sandwich, then he'll have yogurt with granola and banana at 10, lunch at noon (usually turkey sandwich with carrots and fruit) , Dinner at 5 (usually chicken, soup, pasta, etc), and now I am adding a snack at 9.   I am working to make sure he has protein all the time. It could be that simple --  the worst days were when he and his sister made nachos for lunch (which has hardly any protein) or when dinner was light.  It could be puberty (he's not reached his full height I'm guessing, but I don't really know -- he's like 5'7 now).   He really could just be always hungry. I only had a sister growing up and he's my only boy.  And he doesn't every say he's hungry.  He just falls apart dramatically. 

This is such a  long post! Is this normal? I remember him having this issue even at 5 years old -- the teacher asked me to send  a snack because he falls apart every day at the same time, and it was always at recess.  She thought maybe that his blood sugar levels dropped a lot.  Is this a medical issue or just a hey, be careful how you eat and always eat protein or else you might feel utter hopeless despair? 

[hippiemamato3]

Low blood sugar  can cause really panicky, awful feelings of anxiety, depression and anger. The PB toast is a great idea. Make sure he eats small meals with some protein every couple/few hours and it should be much better. 

[prairiewindmomma]

This is an issue here. It’s a not uncommon issue in my kids’ friend circle. In addition to protein, add fat. 
We go through a lot of cashews here. 
 

In addition, teach your kids not to trust their feelings and brain chemistry. Teach them when they feel that way to eat and then re-evaluate.

[Amy Gen]

I have 2 kids like this. I remember my brother being totally out of control. Then he would eat almost an entire roast and turn into the happiest kid ever. 
 

I keep a “snack cart.” with things that they can grab quickly 24 hours a day for a quick fix. I make eggs and either bacon or sausage every morning. I try to get them to eat one more meal, but I don’t force them to eat.(obviously)

They are very thin but athletic and need quite a few calories a day, but it is hard to get it in them. 

[happi duck]

Blood sugar has a huge effect on mood, ime.  Depression was the symptom that caused a doctor to send me for a certain test related to blood sugar.

 

[prairiewindmomma]

Forgot to add: yes on packing snacks. Exercise, impending illness and other things can all cause instability even when you manage your meals well. For Youngest, albuterol makes her an absolute train wreck. She has to eat every 2 hours when her asthma flares.
 

When my kids were in public school, they kept snacks in the front office or in their backpacks (depended on how their teacher wanted to handle it) that they could access out of mealtime. They could either request or teacher could request that they eat.

Do keep an eye out for reactive hypoglycemia or diabetes—especially if there is a family history.

[klmama]

Yes, nuts are excellent for helping to stabilize blood sugar - it's the fat/protein combo.  Is he eating what you serve him, or is he choosing how much to eat?  I ask because I've known many, many boys who ate 2-3 times the amount it looks like your ds eats in a day.  

[PinkTulip]

Mom of 4 boys here, and that’s about the age where mine hit the “bottomless pit” stage. They were hungry all the time, and could eat everything in sight. I’m talking like 14 taquitos or an entire box of cereal in one sitting. So in my experience, what your son is experiencing is completely normal. 
 

I agree with the suggestions of lots of protein that is always accessible: nuts, cheese, lunch meat, burritos, even just a spoonful of peanut butter. And the key is to make it always accessible - don’t limit things to just mealtimes or snack times. My boys were constantly grazing throughout the day at that age. 

[kbutton]

32 minutes ago, klmama said:

Yes, nuts are excellent for helping to stabilize blood sugar - it's the fat/protein combo.  Is he eating what you serve him, or is he choosing how much to eat?  I ask because I've known many, many boys who ate 2-3 times the amount it looks like your ds eats in a day.  

Maybe also more veggies...seems like that would stabilize the ups and downs of carbs similar to how protein does. My kids eat more veggies than that, though sometimes it's not until supper. 

Also the noon to 5 span mentioned sounds like a really big jump to me. My kids have snack timers set for that span because that is their most likely time to have a blood sugar meltdown.

[SanDiegoMom]

Well this all makes me feel a lot better.  It looked so extreme, and when combined with the move and no friends here had me questioning what was related to what.  And I really have no experience with boys.  My two closest friends have girls and they have been wondering along with me what the heck is going on with him. 

My other two are girls, and one literally exists on air -- really I don't know how she survives on so little and yet she NEVER has mood swings. She is the same all day and night.  It's so weird.  I think with my son he does fill up when he eats -- so he doesn't like eating a big meal, but he's hungry again two hours later and doesn't realize it.  There might even be a sensory issue, where he doesn't know he's hungry and mistakes it for something else.  Both he and my oldest have minor sensory issues.  My oldest doesn't feel pain and never gets cold.  Maybe my son never knows he's hungry!

I will try more nuts, good idea.  More healthy fats.  

He did just start actual exercise too -- he's never been much into exercising but he's taking PE and you log your exercise every day, and it's been so great to get him out for bike rides and hikes.  But that's burning more calories and without changing the amount he eats!

So finally I think I will be forced to really eat healthier as a family as a way to avoid epic teenage meltdowns.  That's definitely a compelling reason!!

 

[Junie]

I was reading the posts and some of it sounds very familiar -- yet different.

I had a difficult time keeping my blood sugar regulated, especially as a teen -- but I wouldn't get depressed I would get grouchy and loud.  I realized, though, that I have the same reaction to steroids (prednisone) while others get weepy and cry.  I wonder if it's a similar mechanism.

[prairiewindmomma]

@Junie—steroids raise your blood sugars, which makes you more prone to instabilities and crashes. The effect lasts longer than the days you actually take the pills/longer than the boost from an injection. Steroids act on other hormones too, but wanted to point out the blood sugar thing as some doctors don’t warn on that point.

[Arcadia]

4 hours ago, SanDiegoMom said:

I remember him having this issue even at 5 years old -- the teacher asked me to send  a snack because he falls apart every day at the same time, and it was always at recess.  She thought maybe that his blood sugar levels dropped a lot.  Is this a medical issue or just a hey, be careful how you eat and always eat protein or else you might feel utter hopeless despair? 

DS15 and I had to eat every two hours. When I was in public school, my teachers just pretend they don't know I am "secretly" eating in the classroom. It is a medical issue. DS15's issue isn't as bad anymore but he is kind of done with growth spurts. For me, it was so obvious that teachers (preschool to college) never bother to ask me for a doctor's note. I ate M&Ms and chocolate bars during exams in college (my engineering school is lenient on food and drinks in exam hall). My fasting glucose level is very low. I don't fast for blood draws unless I have to, in which case I let the nurse know there is a pretty good chance I might faint. 

When I am out, I try to have dried fruits and jerky in my bag as emergency rations. When my blood sugar is low, I feel dizzy. That is my warning to eat something or drink hot cocoa, or worst case when outside is to buy and drink a can of Coca-Cola or coffee. 

1 hour ago, prairiewindmomma said:

@Junie—steroids raise your blood sugars, which makes you more prone to instabilities and crashes. The effect lasts longer than the days you actually take the pills/longer than the boost from an injection. Steroids act on other hormones too, but wanted to point out the blood sugar thing as some doctors don’t warn on that point.

The steroid inhaler for asthma cause me to puke and faint. I stopped that and only use the rescue inhaler and recovered much better. 

[EmilyGF]

8 hours ago, prairiewindmomma said:

This is an issue here. It’s a not uncommon issue in my kids’ friend circle. In addition to protein, add fat. 
We go through a lot of cashews here. 
 

In addition, teach your kids not to trust their feelings and brain chemistry. Teach them when they feel that way to eat and then re-evaluate.

Yes! My brother feel off the deep-end whenever tired, so my mom had a rule about not trusting feelings after 10 pm. 

I get really anxious when I eat too much sugar, and it helps when I can ID it as chemical. Of course, in the moment, it feels like it'll never go away even with the training that brain chemistry isn't always to be trusted.

Emily

[Carrie12345]

Food/hunger definitely impacts my anxiety.  I can’t say that I get to the point of being famished because my hunger levels generally don’t swing very far but, if I feel myself getting more hyped up than my average baseline, I get a snack and some water. It makes a difference the majority of the time.  If it’s progressed to where I really don’t even want to take the steps to make a snack, I’ve got some individual protein drink boxes that work just as well.

[Danae]

9 hours ago, PinkTulip said:

Mom of 4 boys here, and that’s about the age where mine hit the “bottomless pit” stage. They were hungry all the time, and could eat everything in sight. I’m talking like 14 taquitos or an entire box of cereal in one sitting. So in my experience, what your son is experiencing is completely normal. 
 

I agree with the suggestions of lots of protein that is always accessible: nuts, cheese, lunch meat, burritos, even just a spoonful of peanut butter. And the key is to make it always accessible - don’t limit things to just mealtimes or snack times. My boys were constantly grazing throughout the day at that age. 

My 14 yo makes himself an entire extra meal mid-afternoon. Omelet, or bagel sandwich or burrito mostly. I try to recommend an apple or carrot sticks on the side occasionally, other than that I leave him to to it.  

[SanDiegoMom]

2 hours ago, EmilyGF said:

Yes! My brother feel off the deep-end whenever tired, so my mom had a rule about not trusting feelings after 10 pm. 

I get really anxious when I eat too much sugar, and it helps when I can ID it as chemical. Of course, in the moment, it feels like it'll never go away even with the training that brain chemistry isn't always to be trusted.

Emily

This is how my son feels -- like THIS is it and he will always feel this way, and unfortunately I have always responded to the emotions by trying to help/fix things ,which lasts like 15-20 minutes until he says maybe I'm hungry... and then after eating magically all the problems go away.  But the cycle just repeats, and impacts things like homework, whether he feels up to attending his clubs online, how well he deals with appointments, whether he goes to bed and reads or goes to bed and cries... 

[SanDiegoMom]

1 hour ago, Danae said:

My 14 yo makes himself an entire extra meal mid-afternoon. Omelet, or bagel sandwich or burrito mostly. I try to recommend an apple or carrot sticks on the side occasionally, other than that I leave him to to it.  

Wow!  I'll have to suggest that.   Especially since my dinners are often light (chicken and rice, sometimes tomato soup and grilled cheese, etc) it might be good to have a pre-dinner! 

Now that I think about it, I remember when I was a teenager and my boyfriend (now husband) would come over to dinner, he was usually done with his whole plate before the rest of us had had 3 bites.  My mom cooked small portions since they and my sister and I didn't eat a ton.  My boyfriend was 16 and still growing,  however.  AND he had two brothers so him mom cooked tons of food all the time!

[bethben]

When my ds was around 12, there were times when I wouldn’t even talk to him unless he had eaten.  I remember one time in particular.  He got into the car after some activity and was complaining and arguing with me.  I told him I would not talk to him until he had eaten a banana (I kept snacks I the car for this very reason).  He ate his banana and within minutes was back to his normal happier self.  My ds is getting to be like that also.   The blood sugar crabbiness is a thing for sure!

Edited October 28, 2020 by bethben

[BeachGal]

I have this book on my reading list. It discusses our individual microbiota and how that affects our mental state. The brain, central nervous system and gut microbes communicate with one another which influences how we feel.

The Psychobiotic Revolution: Mood, Food and the New Science of the Gut-Brain Connection (link to Amazon)

Quote

Written by the leading researchers in the field, this information-rich guide to improving your mood explains how gut health drives psychological well-being, and how depression and anxiety can be relieved by adjusting your intestinal bacteria. 

Additionally, low daily protein intake can cause low-grade inflammation. Because your son is a young teen who also works out, he needs a bit more protein. No need to go overboard but it might be worthwhile to track his protein intake for a few days.

Magnesium is also sorely lacking in most people’s diets and deficiency can cause anxiety (and many other problems). That’s worth tracking, too, or you could just look up foods high in magnesium to see if he’s eating enough. If not, he could take a good quality, daily supplement.

[El...]

Dd has gone through several periods of time where something similar has happened to her. When she's in a growth spurt now, she eats a big spoon of cream cheese or peanut butter before bed. She's on the lean side, and muscular. She has learned to ask herself if she's hungry when she feels terribly sad and anxious. It's wild to see the way food can bring her back. I had her blood tested, but they found nothing wrong.

[Arcadia]

38 minutes ago, elroisees said:

. I had her blood tested, but they found nothing wrong.

@Junie

Have she been checked for hypoglycemia?

https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

“Hypoglycemia is a condition in which your blood sugar (glucose) level is lower than normal. Glucose is your body's main energy source.

Hypoglycemia is often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don't have diabetes

Hypoglycemia needs immediate treatment when blood sugar levels are low. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia. But your numbers might be different. Ask your doctor.

Treatment involves quickly getting your blood sugar back to normal either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the cause of hypoglycemia.

Symptoms

If blood sugar levels become too low, signs and symptoms can include:

• An irregular or fast heartbeat
• Fatigue
• Pale skin
• Shakiness
• Anxiety
• Sweating
• Hunger
• Irritability
• Tingling or numbness of the lips, tongue or cheek

As hypoglycemia worsens, signs and symptoms can include:

• Confusion, abnormal behavior or both, such as the inability to complete routine tasks
• Visual disturbances, such as blurred vision
• Seizures
• Loss of consciousness“

[Not_a_Number]

That’s fascinating. No, we never had this — DH doesn’t have a normal appetite, and I think the kids lean that way. However, they have EXTREME sensitivity to lack of sleep. Days with an hour of missing sleep would mean ridiculous meltdowns. This was true since they were teeny.

It’s fascinating how the physiological can affect one’s mood and behavior! I’d probably keep talking to him about it so he can self-regulate. This is a good thing to know about yourself!! You can’t consciously improve your mood, but you can know to go get a snack if you feel it coming on.

[Katy]

I think this is common in males.  My DH gets kind of the reverse - he's irritable but doesn't want to stop the project when he's working.  I realized this when we were working on house projects together.  He's often getting insufferable just as I'm getting hungry.  I learned to say, "You can keep working if you want, but I'm getting lunch." I make him some too, and by I'm on my 5th bite he joins me and visibly relaxes in about 2 minutes. It's interesting since he's been working at home because he sometimes decides to skip lunch, and those are always the days when the kid noise drives him crazy.  I started stashing protein bars and nuts in his office.

[Not_a_Number]

Just now, Katy said:

I think this is common in males.  My DH gets kind of the reverse - he's irritable but doesn't want to stop the project when he's working.  I realized this when we were working on house projects together.  He's often getting insufferable just as I'm getting hungry.  I learned to say, "You can keep working if you want, but I'm getting lunch." I make him some too, and by I'm on my 5th bite he joins me and visibly relaxes in about 2 minutes. It's interesting since he's been working at home because he sometimes decides to skip lunch, and those are always the days when the kid noise drives him crazy.  I started stashing protein bars and nuts in his office.

I don't know if it's generically more common in males, but anecdotally, out of DH and his sister, his sister is the one with mood swings associated to food. DH doesn't even notice when he's hungry, and it doesn't make him grumpy, either. 

Now, a low level of caffeine, on the other hand... 

[El...]

1 hour ago, Arcadia said:

@Junie

Have she been checked for hypoglycemia?

https://www.mayoclinic.org/diseases-conditions/hypoglycemia/symptoms-causes/syc-20373685

“Hypoglycemia is a condition in which your blood sugar (glucose) level is lower than normal. Glucose is your body's main energy source.

Hypoglycemia is often related to diabetes treatment. But other drugs and a variety of conditions — many rare — can cause low blood sugar in people who don't have diabetes

Hypoglycemia needs immediate treatment when blood sugar levels are low. For many people, a fasting blood sugar of 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L), or below should serve as an alert for hypoglycemia. But your numbers might be different. Ask your doctor.

Treatment involves quickly getting your blood sugar back to normal either with high-sugar foods or drinks or with medications. Long-term treatment requires identifying and treating the cause of hypoglycemia.

Symptoms

If blood sugar levels become too low, signs and symptoms can include:

• An irregular or fast heartbeat
• Fatigue
• Pale skin
• Shakiness
• Anxiety
• Sweating
• Hunger
• Irritability
• Tingling or numbness of the lips, tongue or cheek

As hypoglycemia worsens, signs and symptoms can include:

• Confusion, abnormal behavior or both, such as the inability to complete routine tasks
• Visual disturbances, such as blurred vision
• Seizures
• Loss of consciousness“

Thank you, yes, that's what they checked. The weird thing is that is only happens a few weeks at a time, during fast growth. It hasn't occurred in 9 months or so.

I think she just needs more calories. She eats a very healthy diet, on her own, and will choose an apple as a snack daily. I push protein.

Blood sugar was absolutely my worry.

[Junie]

My mom used to tell me to eat a piece of cheese.  I guess it was a good mix of carbs and protein because it seemed to help.  I fought it, though.  It took a long time for me to recognize the symptoms before they were over the top.  And once they got to that point I was very... contrary.

[kbutton]

On 10/27/2020 at 11:48 PM, SanDiegoMom said:

There might even be a sensory issue, where he doesn't know he's hungry and mistakes it for something else.  Both he and my oldest have minor sensory issues.  My oldest doesn't feel pain and never gets cold.  Maybe my son never knows he's hungry!

For those who feel they might be in this boat, I have heard great things about this book/curriculum (you can get a lot of stuff, or just the book): https://www.kelly-mahler.com/product/the-interoception-curriculum-a-step-bystep-guide-to-developing-mindful-self-regulation/?gclid=Cj0KCQjwuL_8BRCXARIsAGiC51CROqX-pBO2z2llOtKCHPwX16b-T1gvfgpo4qCp0I8ecpePNEkyMY4aAgrCEALw_wcB

It's on our to-do list.