Wednesday, May 12, 2010

Self-Medicating Depression With Chocolate

Chocolate, prepared from the seed of the tropical Theobroma cacao tree, contain alkaloids such as theobromine and phenethylamine, which have physiological effects on the body that include elevating serotonin levels in the brain.

Low levels of serotonin are linked to mood disorders and one of the primary action of antidepressants is to raise brain serotonin levels, thereby alleviating the signs and symptoms of depression.

It is therefore not unreasonable to ask the question whether some people who like to eat chocolate are really using it to self-medicate their depression.

This question was now addressed by Natalie Rose and colleagues from the University of California in a paper just published in the Archives of Internal Medicine.

In this paper, the researchers examined the relationship between chocolate consumption and depressed mood in 1018 adults (694 men and 324 women).

Participants who screened positive for possible depression had significantly more chocolate consumption (8.4 servings per month) than those not screening positive (5.4 servings per month) for depression.

In fact, those with the highest depression scores reported even higher chocolate consumption (11.8 servings per month).

Although the authors are very careful in pointing out that this correlation by no means implies causality, it is clearly consistent with the hypothesis that people with mood disorders are more likely to consume chocolate than those with no signs of depression.

This finding certainly corroborates my own, albeit anecdotal, experience that proper management of mood disorders often alleviates chocolate cravings in many of my patients.

As chocolates are one of the densest forms of energy commonly consumed (a single ounce of milk chocolate can contain 150 KCal), using chocolate to treat your depression is certainly a bad idea if you happen to also have a weight problem.

Tip to all clinicians: it may not be a bad idea to screen all patients reporting a particular liking for or excessive consumption of chocolate for an underlying mood disorder.

AMS
Edmonton, Alberta

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Rose N, Koperski S, & Golomb BA (2010). Mood food: chocolate and depressive symptoms in a cross-sectional analysis. Archives of internal medicine, 170 (8), 699-703 PMID: 20421555

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3 Responses to “Self-Medicating Depression With Chocolate”

  1. Colby says:

    “Low levels of serotonin are linked to mood disorders and one of the primary action of antidepressants is to raise brain serotonin levels, thereby alleviating the signs and symptoms of depression.

    It is therefore not unreasonable to ask the question whether some people who like to eat chocolate are really using it to self-medicate their depression.”

    I have read papers that suggest that the serotonin hypothesis of depression is very weak, e.g. http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020392, http://www.journalsleep.org/ViewAbstract.aspx?pid=27726, http://www.nature.com/nrn/journal/v6/n3/full/nrn1629.html among others.

    Therefore if the authors propose this as the mechanism, I would have to question it.

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  2. mavis says:

    11.8 servings of LOVE!

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  3. Drug Rehab Centre - How do you keep up sobriety without going to AA? says:

    [...] Self-Medicating Depression W&#1110t&#1211 Chocolate | Dr. Sharma’s Obesity Notes [...]

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