Chocolate Can Help Beat The Blues

Q. I’ve heard that eating chocolate can help a depressed person feel better. Is that really true? - D.F., Allentown, Pa.

A. If you enjoy chocolate as much as I do, you know just how satisfying the rich, sweet, creamy taste of chocolate can be. According to Hershey’s, the average person consumes about 12 pounds of chocolate per year. And it does seem to make some people feel good - more than just being delicious.

Beyond the texture, taste and smell of chocolate, there may be a biochemical explanation: chocolate can trigger the brain’s production of natural opiates (endorphins) to give us an enhanced sense of pleasure, relaxation and well-being. Runners and joggers can also get this same release of endorphins.

If a person is truly depressed, I wouldn’t recommend treating it with chocolate. True depression needs the care of a doctor and will probably require an anti-depressant medication by prescription. Many folks who are feeling a bit “blue” already seem to know that chocolate makes them feel better, and they “self-prescribe” chocolate. Now we have some insight as to why.

Here’s another possible health benefit from chocolate: protecting the heart against a heart attack. Cocoa contains anti-oxidants known as “procyanids,” which have the potential, at least in theory, to make it more difficult for blood clots to form in a coronary heart blood vessel and can bring about relaxation and dilation of the coronary blood vessels.

All of the research presented at the recent annual meeting of the American Association for the Advancement of Science was supported in part by M&M/ Mars, so the benefits of cocoa findings should be viewed with interest but with caution. After all, chocolate does contain its share of calories, caffeine and fat.

Q. What are the differences between a family practice physician and an internist? Do both qualify as primary care physicians? - W.G., Toney, Ala.

A. In the old days, a doctor graduated medical school, completed one year of training known as an “internship,” and then hung out his “shingle” as a general practitioner - or GP, for short. These GPs often served as the doc of the town, taking care of entire families, from cradle to grave, until retirement day. If there was a medical condition beyond the limits of his expertise, he’d refer you to the specialist. Depending upon the GP’s skills and the availability of doctors in the area, a GP might have performed emergency surgery like an appendectomy or a tonsillectomy. While their formal schooling was limited, these GPs acquired schooling in the field that allowed them to take care of a huge variety of medical conditions.

But here’s the problem that emerged: Medicine was becoming more and more complicated. With medical advances and new treatments occurring at a breakneck pace, it was becoming nearly impossible for a GP to learn in one year all that there was to know about current medical practice.

Two solutions to that problem emerged: the family practitioner and the general internist. Both are training programs that involve at least two years of “residency” training beyond the “internship” year. Both are considered “primary care” docs because they’re the first, or primary, doctor that a person typically will see for treatment of a problem.

Internal medicine is a specialty that takes care of a wide range of medical problems that adults might encounter. They generally don’t see children under 18.

Generally speaking, internal medicine doctors don’t perform major surgery, nor do they deliver babies. They spend a good deal of their training in a hospital setting, so they are quite good at caring for patients who have complicated multiple medical problems.

Family practice as a formal training program is relatively new, with the founding of the American Academy of Family Physicians in 1947. Family practitioners care for patients of all ages. The two more years of training make family practitioners a highly skilled GP. Their training emphasizes learning a little about everything. For management of complicated medical problems, they will typically refer a patient to a specialist.