April 30, 2010

Study Finds Chocolate Causes Depression. In Other News, These Kinds Of Studies Cause Insanity

axe chocolate man.jpg
all three of us are crying inside


From the Abstract:

Results  Those screening positive for possible depression (CES-D score >16) had higher chocolate consumption (8.4 servings per month) than those not screening positive (5.4 servings per month) (P = .004)



chocolate depression.jpg

Oh god, please,  I need a drink.

The authors are very careful to assure everyone that they don't mean to imply that chocolate causes depression, this is just an association.   Let's not jump to conclusions.


II.

Chocolate lovers 'are more depressive,' say experts-  BBC

The More Chocolate You Eat, the Higher Your Risk of Depression, Study Hints-- ABC News

Chocolate And Depression Go Hand In Hand- CNN.  First sentence:

When Dina Khiry is feeling a bit down, she reaches for chocolate. "I like Reese's peanut butter cups, Hershey's bars, and chocolate cake batter," says the 24-year-old public relations associate. "I feel better in the moment -- and then worse later on, when I realize that I just consumed thousands of calories."
Does anyone understand that there is barely any chocolate in any of those chocolates?  Even the Hershey's Bar, which has the highest of all of them, has 10% chocolate liquor (smashed cacao beans.)  And if the box doesn't say "milk chocolate," then all bets are off.  White chocolate has plenty of cocoa butter, but no chocolate solids.  And no caffeine, theobromine, or flavinoids.  Still counts, though, right?

And see the phrase "cocoa processed with alkali" in the ingredients of "chocolate cake batter"?  Alkalinization (makes it easier to mix) drains the cocoa of the flavinoids.  Is it going to "work" the same?  That's like saying "rum processed with fire" will have the same mood stabilizing effects.  IT DOESN'T.  I'VE TRIED IT.





goodbar and archives.JPGsimulacra





The study, as best as I can tell, did not ask them what kind of chocolate they were eating, it only measured "ounces of chocolate candy."  Is an ounce of chocolate covered cocoa beans the same as an ounce of Hershey's Krackel, which has no cocoa butter (all vegetable oil)? (1) The only thing they have in common is a disdain for fair trade.

Can you imagine if someone did a study about mood and alcohol consumption, and measured it as "ounces of an alcoholic beverage" but didn't specify beer, wine, spirits, or rubbing?  


III.

On the one hand we have no idea how much chocolate was in a serving, if there was any at all.

On the other hand we have "depression."  What's a CES-D

It's a 20 question 0-3 survey that people answer about their mood over the past week.  Think about this. 

The scale doesn't diagnose depression at all; you could have had 30 suicide attempts in the past year and happen to have had some sex this week and come out fine on the inventory; or, you could have been the merriest gal in the whole wide world until your stupid boyfriend dragged you to see Avatar and now you're calling a hotline.  So?

Can you really link a chronic behavior (e.g. eating chocolate) with a static observation of mood over one single week?  I mean, I know you can, but shouldn't there be some kind of law?

IIb.

Each of the 20 questions are scored: 

  • 0 points Rarely or none of the time (< 1 day)
  • 1 point Some or a little of the time (1-2 days)
  • 2 points Occasionally or a moderate amount of the time (3-4 days)
  • 3 points Most or all of the time (5-7 days)
How depressed are you if you answer 1 for each, total=20?  Not very?

Then why, in order to show increased chocolate is associated with increased depression, do they use the binary standard of >16 and <16?

Worse:

The mean CES-D score was 7.7, with a median of 6.0. The CES-D scores ranged from 0 to 45 (maximum possible score, 60). 

So let me rewrite the abstract: "in a study of people who were not depressed, people who were more not depressed last Thursday than others have been eating a little bit less of something they thought may have smelled like chocolate."

III.

You're probably asking why I would bother to pick apart a relatively unimportant study.  That's the reason.  Why is it in one of the most important medical journals? Does it answer any questions?  No.  Does it direct future experiments?  No.  Does it completely confuse an already confused public, who only yesterday were told that just the right amount of mercury in your diet is awesome, only to have scienticians later correct that to silver?

Let's review:

uncontrolled use of the word "chocolate" +

unclear metric for assessing consumption of what little chocolate is in the Peanut Butter Cup+

vague definition of depression offered to a public that already thinks "depression" means something else+

illogical link between chronic behavior and time x +

three reviewers +

one editor +

=

article in Archives of Internal Medicine, and all the free press you could ever want.


But wasn't there anything encouraging about this study?

Of course there was!  Thank GOD, thanks be to GOD-- this study was free of the corrupting poison of Big Pharma.  In your face, Pfizer!  Science can dress up in its sexiest minidress and strut confidently down the dark alley of ignorance and prejudice, unafraid and unmolested because it is protected by the enveloping goodness of the NIH.  You go, girl!


looking for mr goodbar.JPGthis is going to turn out great


-----

(1) Hershey's, et al, petitioned the FDA and EU to allow them to change the definition of "milk chocolate" to allow for the substitution of vegetable oil for cocoa butter.  The FDA said no, but the EU thought it would be awesome idea.

To emphasize: not simply change the ingredients, but to change the definition of the word.


---
http://twitter.com/thelastpsych









Comments

"in a study of people who w... (Below threshold)

April 30, 2010 11:58 AM | Posted by Anonymous: | Reply

"in a study of people who were not depressed, people who were more not depressed last Thursday than others have been eating a little bit less of something they thought may have smelled like chocolate."

LOL. Excellent post!

Vote up Vote down Report this comment Score: 16 (18 votes cast)
BTW does anyone else find t... (Below threshold)

April 30, 2010 11:58 AM | Posted by Anonymous: | Reply

BTW does anyone else find the photo above insanely arousing?

Vote up Vote down Report this comment Score: 4 (12 votes cast)
OK I found out where the pi... (Below threshold)

April 30, 2010 12:05 PM | Posted by Anonymous: | Reply

OK I found out where the picture is from. Very hot.

http://www.youtube.com/watch?v=FgfzdgWgEZ4

I guess this is what I'm missing by not having a TV.

Vote up Vote down Report this comment Score: 2 (8 votes cast)
So true... most of these st... (Below threshold)

April 30, 2010 12:13 PM | Posted by PCD: | Reply

So true... most of these studies are such jokes, which is scary when you realize how many people take them (even slightly) seriously.

Vote up Vote down Report this comment Score: 4 (4 votes cast)
But wait, there's more. I ... (Below threshold)

April 30, 2010 12:33 PM | Posted by Andy: | Reply

But wait, there's more. I just read an article asserting people who eat chocolate have lower blood pressure and cardiovascular risk. So we could contrive that depression is good for your heart.

Vote up Vote down Report this comment Score: 18 (18 votes cast)
TLP yer starting to scare m... (Below threshold)

April 30, 2010 12:48 PM | Posted by Anonymous: | Reply

TLP yer starting to scare me w. yer speech mannerismz.

The image of science walking down a dark alley in a minidress unaffraid of being molested/raped was just enough for me to weigh the pros and cons of even coming back to this blog.

But otherwise, great blog post.

I would not be surprised if there is an association between "depressive symptoms" and "chocolate"... mainly being that some atypical depressives tend to gorge on sugar, and most chocolate candies are actually nothing but sugar and fat with minimal chocolate.

Would be like finding a link between opiate abuse and depression, or alcohol and mania... It's sort of a no brainer.

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The scariest part of Alone'... (Below threshold)

April 30, 2010 2:05 PM | Posted by Jack Coupal: | Reply

The scariest part of Alone's overall "review" of the study is the "3 reviewers + 1 editor".

Our academic scientists say we gotta have anonymous peer review to ensure quality of a study and its conclusions. Maybe those 3 reviewers were from Playboy, Hustler, and Porn.com. That would be appropriate peer review for that study.

The editor then had to sign off on the anonymous (?) reviewers' comments and decide to accept/reject.

Methinks the Archives of Internal Medicine will soon be posting an ad for a new editor.

Vote up Vote down Report this comment Score: 3 (3 votes cast)
I wanna rule the world! All... (Below threshold)

April 30, 2010 2:27 PM | Posted by Alex-5: | Reply

I wanna rule the world! All I gotta do is get some friend with a Ph.D. to publish an article so I can say: "Based on that study,..." followed by any bullshit I want people to belive. :) Who would bother to argue and verify the data in the original article?

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would an actually depressed... (Below threshold)

April 30, 2010 5:25 PM | Posted by Trei: | Reply

would an actually depressed person really know "how depressed" they were "last week"?

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I love you.Serious... (Below threshold)

April 30, 2010 8:53 PM | Posted by Anonymous: | Reply

I love you.

Seriously.

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"That's like saying "rum... (Below threshold)

April 30, 2010 10:03 PM | Posted by popo: | Reply

"That's like saying "rum processed with fire" will have the same mood stabilizing effects. IT DOESN'T. I'VE TRIED IT."

Even when you're not writing for cracked, you're writing for cracked...

Also, I love you too,

Devoted fanbase x x o x

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I'm going to get on the "I ... (Below threshold)

April 30, 2010 10:16 PM | Posted by RC: | Reply

I'm going to get on the "I love you" bandwagon: YOU ROCK ALONE!!!

I do have one question: how much money was used to fund this study, which will undoubtedly bring enormous benefits to tax-paying citizens. *sarcasm*

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I remember back when chocol... (Below threshold)

May 1, 2010 3:13 AM | Posted by Lexi: | Reply

I remember back when chocolate was the love substitute. What do chocolate and love have in common? PEA. Although the PEA in chocolate is not that available, and in pill form has a very short half life . . . for a good time add grapefruit juice, just kidding.

I like my chocolate bars 85% dark.

Also, if people are depressed and eating more chocolate my theory would have been they are eating more chocolate *because* they are depressed, not necessarily because it is chocolate (because it very well may not be) but because it is fat and sugary goodness, which may or may not reward something in our brains which makes us feel good for a second, until reality sets in. Really, what people need to do is come up with a 'reality changing pill' it sounds like Hershey tried. And because depressed people eat more carbs because I've heard it helps them make more serotonin or something, but then the fat accumulation releases other nasty hormones blah blah blah. My turn to lay off the rum.

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Define depression? unhappy?... (Below threshold)

May 1, 2010 7:23 AM | Posted by Anonymous: | Reply

Define depression? unhappy? Antidepressant=Happy pill? But we can't call it a happy pill? By the way the Happy pills mostly don't work .

JAMA. 2010;303(1):47-53.
Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression.
Conclusions The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms.
...
http://clinpsyc.blogspot.com/2008/01/antidepressants-hiding-and-spinning.html
But wait, there's an even better way to suppress data. Suppose that a negative study is submitted to the FDA. There is no commercial value in presenting negative results on a product. Indeed, it makes no sense from a commercial vantage point to submit a clinical trial that shows no advantage for one's drug for publication in a medical journal. While it earns a bit of good PR for being honest, it would of course hurt sales for the drug, which would not please shareholders. From an amoral, purely financial view, there is no reason to publish negative trial results.

On the other hand, there is science. One of the first things that any medical student hopefully learns is that scientists should report all of their results so that other scientists, physicians, the media, and the general public have an up-to-date and comprehensive understanding of all scientific findings. Yes, this may sound naive, but this is how science is supposed to work in an ideal world.

Back to the NEJM study. Were manufacturers of antidepressants playing by the rules of science or the rules of the almighty dollar?

Vote up Vote down Report this comment Score: -1 (3 votes cast)
(Non-serious response)... (Below threshold)

May 1, 2010 7:31 AM | Posted by Anonymous: | Reply

(Non-serious response)

If you ask the shopkeeper for a "sausage", you may get a very different product in Germany that you do in England. It's kind of the same if you ask for "chocolate". (What? There's 70% cocoa in it?)

(More seriously)

The obvious explanation is that (some) depressed people have a craving for carbohydrates.

If some people had a mild cocoa allergy, a week might be long enough to see a difference. [If they're severely allergic, 20 minutes might be enough. But one possible hypothesis would be a common mild cocoa allergy--not severe enough to make them realise they're allergic and stop eating chocolate, but enough to give statistically significant results given a large sample]


It's an interesting theoretical question whether mild ("non-clinical") symptoms act as a proxy for more severe symptoms: if substance X causes non-depressed people to have mild depression-like symptoms without being clinically depressed, can we infer that it will also cause some people to have the more severe symptoms? [As a matter of logic, it doesn't follow in general. But it might be an empirical observation about depression that the mild symptoms are caused by the same things as the severe symptoms]

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This article reporting on i... (Below threshold)

May 1, 2010 7:35 AM | Posted by Jess: | Reply

This article reporting on it is awful
http://psychcentral.com/news/2010/04/27/chocolate-consumption-may-cause-depression/13234.html

It makes it looks like the participants were randomly assigned to eat more or less chocolate.

"The group was divided into three sections to consume varying amounts of chocolate. Each serving averaged about 1 ounce.

One group consumed 5.4 servings, another, averaged 8.4 servings, while the third group consumed 11.8 servings."

Vote up Vote down Report this comment Score: 1 (1 votes cast)
Alone, can you please post ... (Below threshold)

May 1, 2010 7:36 AM | Posted by nwt: | Reply

Alone, can you please post a link containing the EU's reaction to that Hershey's, et al petition? I'd be particularly interested to read up on that, as I'm quite affected..

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I reassert my earlier propo... (Below threshold)

May 1, 2010 1:09 PM | Posted by Quietly Skeptical: | Reply

I reassert my earlier proposition/question: there is no way the person who wrote this is the same person who wrote the Geodon post, and cannot be the same person who wrote the Financial crisis post(s).

Unless we're witnessing sober/drunk/DTs TLP, variously.

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I'm curious about your reas... (Below threshold)

May 1, 2010 4:17 PM | Posted, in reply to Quietly Skeptical's comment, by Lexi: | Reply

I'm curious about your reasoning about why it can't be the same person writing those posts? I wouldn't necessarily disagree, although I am inclined to, but it seems silly to do so without hearing what may be some well thought out points.

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Jeezus. As a fucking chocol... (Below threshold)

May 1, 2010 4:22 PM | Posted by Mae: | Reply

Jeezus. As a fucking chocolate SNOB, I wouldn't even categorize Hershey's as a food product, let alone a "chocolate bar." Sounds to me more like these people are experiencing a sugar high then crash.

Also, that picture creeps me out.

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Jesus Christ, this site sho... (Below threshold)

May 2, 2010 3:42 PM | Posted by Freudwaswrong: | Reply

Jesus Christ, this site should be renamed the cult of narcissism. The author and the readers seem to repeat this mantra to each other as if absolute agreement was rational thought.

Ya'll free thinkers don't see a problem with a conceptual framework that reduces all psycho-social minutia to a simple matter of narcissism? Really now, no doubts about that one?

I'll give you a few more seconds to think that over thrice for good measure....

A logician would call that a circular argument
A psychologist would call you delusional
I just say you're(collectively) talking out of your ass.

I find the authors discussions of cultures role on perceived needs and mental wellness and fascinating and worth merit but my initial excitement has dulled considerably after hearing everything from political theory to OCD being broken down as some kind of narcissism.

I feel like I'm reading an issue of cosmo that says inter-generational relationship are about daddy issues or some other Freudian-pop psychology BS.

You can better.

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This blog is about more tha... (Below threshold)

May 2, 2010 5:58 PM | Posted, in reply to Freudwaswrong's comment, by RC: | Reply

This blog is about more than narcissism, but your insulting, patronizing, and - yes! - NARCISSISTIC comment provides just another example of why the subject matter comes up so frequently.

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Erm, being narcicistic isn'... (Below threshold)

May 3, 2010 12:42 AM | Posted, in reply to RC's comment, by spriteless: | Reply

Erm, being narcicistic isn't a guarantee of a horrible spiral of problems. It is kind of just there, causing people to do things according to a specific framework, and the things one does are more important than why one does them, by far. It is in the sense of self importance, not of being mean. So how is that post narcicistic? S/He says not everything boils down to narcicism, and if everyone here thinks it does than that means we aren't thinking for ourselves, but parroting Last. It is an insult, but not every insult is from narcicism. You can better is neither an insult nor narcicistic.

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This is not the first ridic... (Below threshold)

May 3, 2010 7:27 AM | Posted by Dolores: | Reply

This is not the first ridiculous association-mistaken-for-causation article the Archives have published. Only a month ago they published a similar article titled "Alcohol Consumption, Weight Gain, and Risk of Becoming Overweight in Middle-aged and Older Women" where the authors claim that women who drink more, are less likely to gain weight over a 13-year period. Note: they found an association between baseline alcohol consumption and weight gain.

The question is, what the hell is going on at the editorial office at the Archives? And what morons are they asking to review their papers?

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The reader's comment is nar... (Below threshold)

May 3, 2010 12:43 PM | Posted, in reply to spriteless's comment, by RC: | Reply

The reader's comment is narcissistic because he assumes that any fan of this blog is a mindless individual, incapable of free thought, and resembling a cult member. The author views himself as being the complete opposite - a beacon of light among such idiots.

How can he know that without having individually met each and every one of us? He doesn't need to. He's a narcissist, and so technically none of us exists outside of this online forum. All that really matters is projecting and protecting his chosen identity - a great, noble, and learned individual.

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Aren't you judging him in t... (Below threshold)

May 3, 2010 1:20 PM | Posted, in reply to RC's comment, by DCP: | Reply

Aren't you judging him in the same EXACT way?

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Why assume the worst? He co... (Below threshold)

May 3, 2010 1:22 PM | Posted, in reply to RC's comment, by Anonymous: | Reply

Why assume the worst? He could just be a judgmental but otherwise fairly well-adjusted guy.

I get the feeling that calling someone a narcissist in these comments is a bit like calling someone a fascist elsewhere: a damning accusation, hard to disprove, that quickly derails the conversation.

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Wow, you may have just desc... (Below threshold)

May 3, 2010 2:51 PM | Posted, in reply to Anonymous's comment, by DCP: | Reply

Wow, you may have just described this entire blog and its accompanying comments.

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Sounds like Hershey's would... (Below threshold)

May 3, 2010 3:23 PM | Posted by Sarah G: | Reply

Sounds like Hershey's would make a good placebo for future studies in Chocolate Science. Why doesn't anyone conclude that eating chocolate could simply be self-medicating, rather than causal?

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TLP: consider rum balls. Tw... (Below threshold)

May 3, 2010 3:27 PM | Posted by Sarah G: | Reply

TLP: consider rum balls. Two for one in self-medication!

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"JAMA. 2010;303(1):47-53. A... (Below threshold)

May 3, 2010 4:02 PM | Posted by Anonymous: | Reply

"JAMA. 2010;303(1):47-53. Antidepressant medications represent the best established treatment for major depressive disorder."

Nope, JAMA. Try again. The best established treatment is psychotherapy. Unless you are a physician. The efficacy evidence for talk therapy exists, it goes back to the 1950s, it is not due to placebo, suspected mechanisms have been determined, and all of this matches the entire theoretical model of how depression develops. Predictors of depression can be determined, and based on this, depresssion can be prevented. Quite a causal model. Oh, and they have imaging studies showing that brain structure (some volume in some brain area) and brain activity are different before and after successful talk therapy.

Regarding the CES-D: yes, Alone has pretty much described the proper way to explain the difference between CES-D at 16 or below 16. That is basically how I have phrased what an "elevated score on the CES-D" means when I have published such papers (none yet on chocolate - what a grant!).

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You are!!!!!111!!!!!... (Below threshold)

May 3, 2010 4:02 PM | Posted, in reply to DCP's comment, by kingofpants: | Reply

You are!!!!!111!!!!!

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I agree. TLP himself is us... (Below threshold)

May 3, 2010 5:23 PM | Posted, in reply to Freudwaswrong's comment, by Anonymous: | Reply

I agree. TLP himself is usually very interesting, but sometimes I think tries to explain too much with narcissism. I still read the blog, so I guess it doesn't bother me that much. Some of the comments read like religious acolytes discussing their prophets revelation though. Especially the attempts to 'fit' posts that don't mention narcissism into a 'narcissism is responsible for this' framework and the back and forth narcissism accusations. The first is kind of weird, the second is just aggravatingly stupid. Someone can be wrong or even a jerk without being a narcissist. Likewise having a strong opinion is not the same as narcissism.

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No. Not judging him, judgi... (Below threshold)

May 3, 2010 10:46 PM | Posted, in reply to DCP's comment, by RC: | Reply

No. Not judging him, judging his comment.

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I was merely pointing out t... (Below threshold)

May 3, 2010 11:04 PM | Posted, in reply to Anonymous's comment, by RC: | Reply

I was merely pointing out the irony of an individual criticizing narcissism while displaying narcissistic features. If he were criticizing fascism while displaying fascist features, I would have called him a fascist.

"Narcissist" and "Fascist" are words with real meanings - they don't inherently amount to name-calling or mudslinging when they are used appropriately.

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While I disagree with you, ... (Below threshold)

May 3, 2010 11:09 PM | Posted, in reply to Anonymous's comment, by RC: | Reply

While I disagree with you, I would like to hold your comment as an example of how somebody can make an intelligent dissenting argument NON-NARCISSISTICALLY.

See you guys, it is possible.

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I eat a lot of chocolate. I... (Below threshold)

May 5, 2010 8:17 PM | Posted by KW Norris: | Reply

I eat a lot of chocolate. I try to limit what I read from the established Media. Thanks for the information and all your comments. Regardless of value, they were fun to read. KW

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chocolate sucks... (Below threshold)

May 6, 2010 6:00 PM | Posted by tom: | Reply

chocolate sucks

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The <a href="http://bestfin... (Below threshold)

September 1, 2010 5:15 PM | Posted by TraciMORROW25: | Reply

The home loans suppose to be useful for guys, which would like to organize their organization. By the way, that is comfortable to receive a college loan.

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wow... (Below threshold)

March 4, 2011 12:45 PM | Posted by Anonymous: | Reply

wow

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<a href="http://www.mbtfoot... (Below threshold)

March 24, 2011 3:53 AM | Posted by mbt shoes: | Reply

http://www.mbtfootwearusa.com

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I had always believed that ... (Below threshold)

May 4, 2011 12:12 PM | Posted by John Smith: | Reply

I had always believed that chocolates can stimulate your brain to work and thus making you more alert (the opposite of depression). I would definitely agreed if they had mentioned alcohol as cause for depression since it's a "downer". Well, I think the point of this article is the moderation of consumption of chocolates.

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I notice this was an Americ... (Below threshold)

June 10, 2011 5:38 AM | Posted by chrisboote: | Reply

I notice this was an American study
Ha!
If all I had was American 'chocolate' I'd get depressed as well

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its quite obvious that comm... (Below threshold)

August 8, 2011 3:55 PM | Posted by depressed chocoholic: | Reply

its quite obvious that comments are made from people who are neither depressed or addicted to chocolate.lol... my reason for searching for this topic is that i have been suffering from depression at the age of 40 for the first time and although it occurred after a relationship breakup nearly a year ago, i have no reason now to be depressed as i have a new happy relationship and all else in my life is good,i take antidepressants which help somewhat but i eat large amounts of chocolate and feel driven to eat it, i have noticed that it has awful effects on my moods. other than chocolate i eat a good balanced healthy diet and exercise, so im not just addicted to carbs...also as a trained psychotherapist i can tell you that no amount of talking would make me feel better.lol... so please forgive us depressed chocoholics for hoping that we have found the answer.. i cant be the only one if someone is putting time and money into research.......

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If I ever teach stats to gr... (Below threshold)

January 3, 2014 10:46 AM | Posted by Lori: | Reply

If I ever teach stats to grad students (which would probably only be done from my grave, btw)... can I open with this?

Great post.

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