Alcoholism

Alcohol Withdrawal Mood Swings: Might Eating Carbs Help?

Hastening health improvement using nutrition

Posted Mar 28, 2016

My generally genial and placid neighbor was heard complaining about the number of dogs in our building. His comments seem strange, seeing that he once had a dog himself and was often seen petting the dogs of other owners.

“Be tolerant of him," whispered another neighbor. "He just stopped drinking and has the bad mood that goes along with alcohol withdrawal.” My informant had been sober for more than 25 years, as he often told me, so I asked how long the grumpiness and irritability lasts. “Could last up to two years," he replied. "But the anxiety, difficulty focusing, tiredness, insomnia? They usually begin to get better after a couple of months. It has a funny acronym,PAWS...That stands for Post Alcohol Withdrawal Symptoms. Some people have terrific sugar cravings along with it. I sure did, but even though my waistline expanded  from eating cookies and ice cream? It really helped my mood. Maybe I ought to take Fred ( the cranky neighbor) out for some waffles.”

A craving for sweet carbohydrates is not unusual for people during the early months of abstinence from alcohol.  AA meetings traditionally provide doughnuts and other sweetened carbohydrate snacks. Many rehab facilities, as well as on-line self-help sites talk about the perils of replacing an addiction to alcohol with a sugar addiction, because so many people crave sugar. 

Obviously a post-drinking diet of jelly beans, PEEPS ( those yellow and green marshmallow animals) and chocolate kisses is dreadful for one's teeth and weight, and does nothing to meet the very critical need for several vitamins.  Folate, as one example, is very much needed by the recovering alcoholic.  Alcohol, despite its potent effect on the brain, does absolutely nothing to nourish the body, and many alcoholics may be malnourished because they consume up to 50%, if not more, of their daily calories as alcohol.  

The longing for carbohydrates (sugar is a simple carbohydrate) may be driven not by a sweet tooth but by the need to restore a sense of emotional balance, calmness, and tranquility during the turbulent weeks following abstinence.  Many studies have shown how prolonged and excessive alcohol intake effects (not in a good way) several neurotransmitters in the brain. Like a thief who trashes a house, excessive drinking leaves a brain in disorder, and the severe symptoms of acute alcohol withdrawal are testimony to the damage left by the drinking.   

Serotonin is one of the neurotransmitters whose normal activity is affected both by alcohol consumption and its cessation. The many symptoms of PAWS read like the behaviors seen with inactive serotonin: inability to concentrate, anxiety, irritability, lack of motivation, obsessive thoughts, and depression, among others.

Is it possible that the craving for carbohydrates is an attempt by the alcoholic in recovery to increase serotonin activity, and diminish these many unpleasant moods and behaviors? 

Previous research with volunteers whose moods indicated reduced serotonin activity, such as women with premenstrual syndrome and people suffering from winter depression, suggests that the answer might be yes. In both these cases the mood, focus and sleep changes are very similar to those described in PAWS, and reflect diminished serotonin activity.  Extensive research with women who suffer from mild to moderate PMS showed that a small ‘dose‘ of carbohydrates relieves many of the unpleasant symptoms soon after the carbohydrate is digested. Carbohydrate intake seems to have the same effect among those with winter depression.

But it is not necessary or desirable for the recovering alcoholic to eat sugar or sugary, fatty foods like doughnuts, ice cream, chocolate, and cookies in order to smooth out the mood swings. It is critically important that the food choices made by the recovering alcoholic help to restore depleted nutrients.  Many carbohydrate foods which will increase serotonin will do this:

Sweet potatoes, oatmeal, brown rice, beans, whole grain waffles, vitamin fortified breakfast cereals, quinoa, lentils...these are but a few of the many complex carbohydrates that, once digested, will elevate serotonin levels.  Not much is needed. Thirty grams of carbohydrate is enough (which is equivalent to about 1 cup of multi-grain Cheerios).

When carbohydrate is eaten to increase serotonin, it must be eaten with little or no protein, as eating protein prevents serotonin from being made. This should be noted by those promoting high protein, low carbohydrate diets for people in recovery, because such diets will prevent serotonin activity from being restored.  Fat should be limited also because it delays digestion, thus delaying the time it will take until the recovering alcoholic feels some relief from depression, anxiety and lack of concentration.

Many critics of carbohydrate intake point out that even though people feel better after eating sugar, they then ‘crash’ and feel much worse.  What they fail to note is that after three hours of so, serotonin levels may drop again and the feelings experienced before eating the carbohydrate return. It is similar to what happens when a pain reliever wears off; the pain medication doesn’t cause the pain. It temporarily relieves it. No one would suggest not taking a pain medication, such as aspirin, because its effects wear off.  Once the pain disappears, the pain medication is no longer needed. And so when the alcoholic moves through the months following alcohol withdrawal and sees that the emotional discomfort has lessened, he or she may no longer need to use carbohydrates as often to feel better.

Months following alcohol withdrawal are tough, and not recovery is not helped by waves of anxiety, depression, irritability and other negative emotional states. Eating a sweet potato or bowl of rice or oatmeal might take the edge off these mood swings, and help the recovering alcoholic gets through yet another day of sobriety.