Key to Managing Mood Swings: Blood Sugar Regulation


According to Everest Goldstein, PMHNP-BC, APRN, M.Ed, MSN, IFMCP, there’s a significant connection between blood sugar levels and mental health. Blood sugar fluctuations, she said, can negatively affect mood and stress levels.

Goldstein, a functional Psychiatric Nurse Practitioner in Dallas, Texas, explained that blood sugar directly affects cortisol. Spikes or drops in blood sugar can lead to corresponding changes in cortisol levels, which can exacerbate anxiety, disrupt sleep, and contribute to overall stress.

"If we have a jump in blood sugar... we might feel jittery, more anxious, more on edge... and then when that blood sugar comes crashing back down, we might get really tired, our mood might drop and we might get more irritable,” she explained.

Additionally, Goldstien said that unstable blood sugar levels can impair concentration and cause brain fog, often presenting as symptoms similar to attention deficit hyperactivity disorder (ADHD). She explained that this is particularly evident in children with ADHD, autism, mood disorders, or behavioral issues, where stabilizing blood sugar often alleviates these symptoms.

Goldstein's approach to treating blood sugar issues in a mental health setting involves personalized and practical strategies. "The biggest mistake that I've seen some practitioners make, is this one-size-fits-all model that says if blood sugar dysregulation or anxiety, you need to cut out all sugar,” said Goldstein.

Instead, Goldstein assesses her patient's readiness and ability to make changes, ensuring recommendations are feasible and sustainable within their lifestyle. Key components of her treatment plans include:

  • Balanced Meals and Snacks: Goldstein emphasizes the inclusion of protein, healthy fats, and fiber. Protein sources include meats, beans, tofu, and eggs; healthy fats come from avocado, olive oil, salmon, nuts, and seeds; and fiber is primarily from non-starchy vegetables. These components help create a more stable blood sugar response, reducing the likelihood of mood swings and energy crashes. For instance, pairing a banana with almond butter instead of eating the banana alone can prevent a blood sugar spike and keep one fuller longer.
  • Limit Caffeine Consumption: Goldstein advises against consuming coffee on an empty stomach, as caffeine can spike cortisol and blood sugar. Instead, she recommends pairing coffee with a high-protein and fat meal to mitigate this effect.
  • Exercise: Five-to-ten-minute walks after big meals or sugary foods can be extremely helpful, according to Goldstein. She explained that exercise helps muscles shuttle glucose out of the bloodstream and into cells, reducing blood sugar spikes and building long-term resilience.