Cognitive Deficits Revisited: Coca Cola Addiction

Chances are, at some point during the last few days you came across the headlines claiming a link between the consumption of soda, especially diet soda, and an increased risk of depression. The idea itself is not new and has been circulating the media before, but surfaced again this week – even though at a closer inspection there is room for scepticism.
Most of the following text I had written almost a week ago already, but not quite finished the post yet when it suddenly became a hot topic.

Some of the most persistent symptoms of the chronic major depression I suffer from fall into the category of cognitive deficits: word finding problems, temporary inability to access memories, concentration and learning difficulties, generally slowed-down thinking and speaking. There is no doubt that I have improved in all those areas over the past two years, but the progress has not always been linear. The subjectively best I felt in September 2011, when according to the BDI-II my overall depressive symptoms were in the range of 10 points and lower, a score equal of euthymia (non-depressed, reasonably positive moods). That was also the time when I experienced the least cognitive impairment, in all aforementioned categories.
The biggest differences between now and then are that in September 2011, I was not yet back at university, and I had been on a number of short trips that year, providing both recreation and intellectual stimulation. Over the course of just a few short months, my cognitive capacities had improved greatly. In 2012, it was mostly classes, homework, written exams and office appointments instead. As a result, most of the cognitive deficits made a comeback or got worse again. The only exception is access to memories, at least concerning personal history. I remember a lot more now than I did back in May 2011.
It’s a vicious circle: the depression causes cognitive deficits, and I get depressed over those cognitive deficits…

Most days, it is as if I have a cloud in my head; every brain activity appears somewhat hazy. The closest approximation I can give is that feeling when you are just about to fall asleep and your thoughts start drifting, and then you are being forced to rouse yourself and do some task. Except that for me, this sensation can last for hours and is present at any time of the day, without being tied to sleepiness. Brain fog. Mental cotton-balls. A muddy pond in your head.
The only remedy I have for this is drinking Coca Cola – there’s something about the sugar-&-caffeine-rush that clears out the clouds and suddenly makes me more alert, more concentrated, more “intelligent”. Strangely enough, coffee does not nearly have the same effect. Nor do fresh air or anything else I tried. Only cola gets me out of the sedation.

I don’t want to drink coke on a regular base. I am worried about all kinds of negative effects this might have on my health, from diabetes to cavities in my teeth to osteoporosis (the sweeteners in diet coke severely upset my digestion, so that is no option). But more and more, I do crave cola due to the effect it has on my brain and thinking abilities. Nothing else lifts the psychomotor retardation as effectively. None of the blog posts of the last months was written without either a glass of cola standing next to me or having been consumed prior to typing.
I try limiting myself to two glasses a day, one in the early and one in the late afternoon, sometimes coupled with a cup of coffee. The results are about six hours of clarity. But there is no denying that occasionally, I drink more, and that on some days, I already crave cola before breakfast.

As I was going to wrap up this post and googled “cola depression”, I came across another fascinating blog post at Evolutionary Psychiatry, discussing the case study of a woman addicted to coca cola. Until very recently, I was much more worried about the physical consequences of my cola-consumption, and while my own intake is far lower than the quantities mentioned, it does make me wonder about possible influences on my mental health.
There is something of a dilemma: Either I give up Coca Cola and experience even more psychomotor retardation, accepting that the lowered intellectual capacities will depress me even more, and deal with the coke cravings on top of it. Or I will continue drinking soda, but risk possible negative effects for my physical and mental health, in the latter case even increasing the damage my brain has already taken in twenty years of major depression.
Maybe I’m fooling myself into a false sense of security by thinking that two glasses per day are permissible. Maybe I’m fooling myself by thinking that eventually I will get rid of the fatigue and brain fog for good, consequently not needing the cola-boost anymore. Maybe I’m a fool for thinking I will be able to quit the soda eventually. All I know is, right now I will take uncertain and abstract health risks over the certainty of daily psychomotor retardation.

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