Long-Term Loss of Appetite: A Psychiatric Perspective

Q: Long-Term Loss of Appetite: A Psychiatric Perspective

Hello Kakaf： The medications prescribed by the physician have effects on improving low mood, appetite, and sleep. <br>Regarding your symptoms, although you have explained them as thoroughly as possible, the physician cannot conduct an online consultation and needs to clarify and

Long-term loss of appetite and inability to eat?

Hello, doctor.
My symptoms include a long-term lack of appetite, no feeling of hunger, and no desire to eat.
Sometimes, while eating, I experience cold sweats, palpitations, and a sensation of darkness in front of my eyes, along with dizziness.
I also frequently feel nauseous.
My mood and appetite are very low during the day, but they improve somewhat in the evening.
I visited a nearby psychosomatic clinic, and they diagnosed me with autonomic nervous system dysregulation.
The doctor prescribed Sertraline, Clonazepam, Escitalopram, and Levetiracetam.
I have been on medication for over a month, but my symptoms fluctuate.
Each consultation lasts less than five minutes, and the doctor has no plans to change my medication.
I would like to hear your opinion on my symptoms, which have persisted for two years.
I previously consulted gastroenterology, immunology, and neurology at a major hospital, but no significant issues were found.
Thank you for taking the time to provide me with your professional feedback.

Kakafu, 40~49 year old female. Ask Date: 2019/10/22

Dr. Wang Yazhen reply Psychiatry

Hello Kakaf: The medications prescribed by the physician have effects on improving low mood, appetite, and sleep.
Regarding your symptoms, although you have explained them as thoroughly as possible, the physician cannot conduct an online consultation and needs to clarify and understand your symptoms in more depth to make an appropriate diagnosis.
If you feel that the current physician is unable to meet your needs, you may seek a second opinion from another physician.
Thank you!

Reply Date: 2019/10/22

More Info

Long-term loss of appetite can be a complex issue that may stem from various psychological and physiological factors. Given your symptoms, including a lack of hunger, feelings of dizziness, cold sweats, and nausea, it is essential to consider both the psychiatric and medical perspectives in understanding your condition.

From a psychiatric standpoint, loss of appetite can often be associated with mood disorders such as depression or anxiety. These conditions can significantly affect one’s motivation to eat, leading to a decreased appetite. The fact that you experience a low mood during the day but feel somewhat better in the evening could suggest a pattern often seen in depression, where individuals may experience diurnal mood variation. This means that their mood and energy levels fluctuate throughout the day, often improving as the day progresses.

Your symptoms of cold sweats and palpitations during meals could indicate a heightened state of anxiety, which is not uncommon in individuals who are dealing with long-term stress or anxiety disorders. The autonomic nervous system, which regulates bodily functions, can become dysregulated in response to chronic stress, leading to symptoms like those you described. This dysregulation can manifest as gastrointestinal distress, which may further contribute to your loss of appetite.

It is also worth noting that your experience of nausea and dizziness during meals could be linked to a condition known as "food aversion," which can develop when eating becomes associated with negative feelings or physical discomfort. This aversion can create a cycle where the anticipation of discomfort leads to avoidance of food, further exacerbating the loss of appetite.

Regarding your treatment, it is concerning that you feel your consultations are brief and that your medications have not been adjusted despite ongoing symptoms. It is crucial to have a comprehensive treatment plan that addresses both your psychological and physical health. If you feel that your current healthcare provider is not adequately addressing your concerns, it may be beneficial to seek a second opinion or consult with a different psychiatrist or mental health professional who can provide a more thorough evaluation and potentially adjust your treatment plan.

In addition to medication, therapy can be an effective component of treatment for loss of appetite related to psychological issues. Cognitive-behavioral therapy (CBT) is particularly effective in addressing anxiety and depression, helping individuals to develop coping strategies and challenge negative thought patterns that may contribute to their symptoms. Mindfulness practices and stress management techniques can also be beneficial in reducing anxiety and improving overall well-being.

Lastly, it is essential to maintain open communication with your healthcare providers about your symptoms and how they affect your daily life. Keeping a symptom diary can help you track your appetite, mood changes, and any physical symptoms you experience, which can provide valuable information for your treatment team.

In summary, long-term loss of appetite can be a multifaceted issue influenced by psychological, physiological, and environmental factors. It is crucial to address these symptoms holistically, considering both medication and therapeutic interventions, and to ensure that you have a supportive healthcare team that listens to your concerns and adjusts your treatment as necessary. If you continue to experience difficulties, do not hesitate to advocate for yourself and seek additional support.

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