I don’t know about you, but this time of year is always tough for me. I am sure many of you can relate to a seasonal pattern for highs and lows – bright, sunny, energetic spring and summer almost always brings about the same in me, and so why wouldn’t dull, dreary cold fall and winter do likewise? There are several things that this could be related to. Bipolar disorder is in many ways a disorder of circadian rhythms (our body’s internal clock), and the change in external cues (sunrise and sunset) seems to match our internal cues. The external cues can actually dictate those internal cues, but that is a lengthy discussion and the topic for a future blog entry.There are also a lot of emotionally heavy holidays in the colder months, which tend to be triggers for those with and without mood disorders . Additionally, the colder, darker days also tend to keep us inside more, even here in California. Being cooped up inside all the time causes us to get less exercise, of one of the best natural mood stabilizers.With less energy from the dreary cold, sedentary days, we tend to find ourselves reaching for sugary holiday treats far more often than we would other times of year. I know I am guilty of this if I am not vigilant.  Here are a few reasons I try my best to avoid sugar.

•  Sugar is addictive. Like recreational drugs, sugar releases opioids and dopamine. It also has been shown in studies to affect our brain in ways similar to addictive drugs.  And what about the components of addictive behavior: bingeing, withdrawal, and cravings. You don’t have to be a research professional to see the similarities .
•  Sugar causes inflammation. Inflammation is associated depression. Refined sugar, including white flour, causes a release of inflammatory messengers called cytokines.  Studies have shown a strong correlation between high levels of cytokines and depression.
•  Sugar causes anxiety and irritability. Reactive hypoglycemia can be especially problematic for those with bipolar disorder.  Reactive hypoglycemia, or the “sugar crash,” happens especially after eating high sugar foods.  These foods cause your body to release an excessive amount of insulin to process all the sugar. This leads to a too rapid reduction of blood glucose, or blood sugar levels, causing your body to release adrenaline to compensate.  This is the “fight or flight” chemical that causes the anxiety and irritability. 
•  Sugar lowers your immune response. This is one reason people get sicker in the wintertime.  We tend to eat more refined carbohydrates to get more energy.  We also get less sun, and therefore less Vitamin D, an important element in immune function.  So we are actually reducing our innate ability to fend off a cold with our behaviors. Having a cold gets in the way of daily self-care routines, such as exercise and eating well, both things that are vital for maintaining a healthy mood. 
•  Sugar robs your body of vital nutrients.  Not only are foods that are high in sugar notoriously low in vitamins and minerals, they also end up limiting the number of nutrient dense foods we eat.  All of the biochemical pathways in our body, including those that convert food to energy and produce neurotransmitters like serotonin and dopamine, require these nutrients to work.  Without them, the works get jammed up.  That is why we feel bad after we eat too much sugar. What do we do when we are tired and feeling bad?We eat more sugar because of the dopamine and opioid release it causes.  And that takes us back to number 1. It really is a vicious cycle.

Now I won’t be all doom and gloom.  Who doesn’t want to be able to have a slice of pumpkin pie on Thanksgiving, or their favorite cookies from Mom on Christmas?  Here is what I do to try and indulge without letting it drag me down.

•   Eat sugar with moderation.  Ugh.  I know it is a four-letter word to most people, but moderation is pretty key with sugar intake (or with anything in life really, including excessively healthy behaviors). I am admittedly not very good at moderation. But when I am    reaching for a second or third cookie I try remembering how terrible I felt the last time I had a sugar binge. If that doesn’t work, I think about the 5 things I listed above.  One of those things usually helps me to put on the brakes. 
•   Eat sugar with healthy fats and fiber. Using whole grains instead of refined flours, cooking with gluten free flours with more protein, or including healthy fats from nuts and seeds with the holiday sweets will help slow the absorption of sugar. This helps to minimize  both the cytokine and insulin release associated with inflammation and reactive hypoglycemia.  Fats and fiber also help you to feel full, so try a handful of nuts with your chocolates.
•    Focus on full nutrient dense meals.  Like I said above, too much sugar can take away from the amount of nutrients we get in our daily food intake.  So when I know that there is a favorite dessert coming my way, or a holiday party with the best brownies later that  night, I make sure to have a veggie-dense meal with lean protein beforehand. It’s how I arm myself before the sugar battle. 
•   Let’s not forget that booze is sugar.  Holiday parties often personify the phrase “drink and be merry.”  If you enjoy a drink or two at parties, don’t forget to include them as sugars as well as alcohol.  Beer and wine can be especially high in sugars, as well as many of  the mixers used for cocktails.
  

When I am careful about my sugar intake and focus on these three things, I always feel much better and have more fun at the party. My patients routinely report the same when they have tried these few tactics to help reduce the bad side effects of sugar. I hope they can help some of you. Happy holidays!

Dr. Bahr is a licensed naturopathic doctor in Santa Cruz, CA. For more information about her or naturopathic medicine visit www.DrJenniferBahr.com. For more information on dietary interventions for bipolar disorder, visit her clinic page on nutrition at http://fountainheadclinic.com/nutrition.htm.