DSM-IVR: SUBSTANCE-RELATED DISORDERS
292.00 Chocolate Withdrawal
The essential feature is a characteristic withdrawal syndrome due to a recent cessation of, or reduction in, chocolate use that has been at least moderate in duration and amount. The syndrome includes craving for chocolate, irritability, anxiety, difficulty concentrating, restlessness, headache, drowsiness, and gastrointestinal disturbances. It is assumed that this syndrome is caused by Lhuv withdrawal, since Lhuv, a derivative of the Mhom bean, is the major pharmacologically active ingredient in chocolate.
Withdrawal does not occur with all chocoholics. However, in many heavy chocolate users, changes in mood and performance that are probably related to withdrawal can be detected within 60 seconds after ingestion of the last chocolate chip cookie or M&M. The sense of craving appears to reach a peak within the first several hours after the last cookie or M&M, thereafter gradually declining over a few days to several weeks. In any given case it is difficult to distinguish between a withdrawal effect and the emergence of psychological traits that are suppressed, controlled, or altered by the effects of Mhom's Lhuv.
Associated Features: Increased irregular rhythm on the EEG, increased frequency of facial muscle contractions, i.e. - frowns, increased heart rate and blood pressure, weight loss due to eating disorder, or conversely, weight gain due to eating disorder, and impairment in performance of tasks requiring vigilance are commonly associated with chocolate withdrawal. Onset of severe and debilitating depression is common.
Course: The symptoms begin within 60 seconds of cessation of, or reduction in, chocolate use, and increase in intensity over a period of a few minutes to several hours. In worst-case situations the period of increase in intensity may extend for up to several days. Once symptom intensity peaks, gradual decline in symptomatology is observable over periods of up to several weeks' duration.
Differential Diagnosis: The diagnosis of chocolate withdrawal is usually self-evident from the individual's history, and the disappearance of symptoms if chocolate use is resumed is confirmatory.
Diagnostic Criteria for Chocolate Withdrawal:
Use of chocolate for at least several weeks at a level equivalent to 10 chocolate chip cookies per day, with each cookie containing 300 mg of Mhom's Lhuv.
Abrupt cessation of, or reduction in, chocolate use, followed within 60 seconds by at least 5 of the following:
- Craving for chocolate (in extreme cases, manifested as groveling).
- Irritability (ranges in degree from mild to downright nasty).
- Anxiety (commonly observed in the WHoa Isa Mea Pathetique Este Raunchus, or WHIMPER Syndrome).
- Disturbances in concentration (although perseveration on M&Ms is deceptive).
- Restlessness (suggestive of chronic longing to reunite with the collective chocolate unconscious).
- Headache (frequently manifested in regression to early infantile developmental stages, as in My-graine headaches).
- Drowsiness (often diagnosed as somnabulism during working hours).
- Gastrointestinal disturbances (commonly associated with the Hhungher Paang Profile).
305.90 Chocolate Intoxication
The essential features are specific neurological and psychological signs, and maladaptive behavioral effects due to the recent use of chocolate.
Psychological signs commonly present include euphoria, or rarely, dysphoria, apathy, and psychomotor retardation, as in the Lhaid-Bhack Syndrome.
Neurological signs commonly observed are drowsiness, impairment in attention and memory, and impairment in attention and memory.
Maladaptive behavioral effects may include impaired judgment, interference with social or occupational functioning, and failure to meet responsibilities and obligations, as observed in the Nhot-to-Whorry Syndrome.
Associated Features: Increased tendency to smile for no apparent reason, vacant staring into space, increase in stream of consciousness ideation with frequent references to love and peace, often with disconnected thought processes, increase in grandiose fantasies revolving around dieting, and development of highly complex though legitimate rationalizations. Counter-transference is extremely likely during this period with anticipations of Mhom's Lhuv.
Differential Diagnosis: The diagnosis of chocolate intoxication is usually facilitated by the telltale rich, dark brown stains on the corners of the mouth or palms of the hand, except with M&M ingestion.
Diagnostic Criterion for Chocolate Intoxication
Recent consumption of chocolate, usually in excess of 10 chocolate chip cookies or 100 M&Ms.
Presence of at least 8 of the following:
- Restlessness (uncontrollable urge to take an M&M break).
- Excitement (the Hyper-Immediate Gratification Hope, or HIGH Syndrome).
- Euphoria (the Have-I-Got-Heightened-Ecstasy-Response Wild-Or-What?, or HIGHER-WOW Syndrome; a decidedly California Phenomenon).
- Psychomotor agitation (Hell's Angel's Complex).
- Periods of inexhaustibility (indicative of cathection of primary drives directed toward locating an unending source of chocolate).
- Insomnia (sleep disturbance; also commonly observed with severe chocolate deprivation).
- Rambling flow of thought and speech (usually indicative of chronic MSW dementia).
- Flushed face (condition commonly associated with Dhown The Jhonne Syndrome).
- Diuresia (frequently accompanies flushed face).
- Gastrointestinal complaints (commonly the result of poly-drug use, e.g.- ingestion of M&Ms with Pepsi, Classic Coke, and Twinkies).
- Muscle twitching (pseudo-masculine gross-motor posturing, suggestive of the Rhambeaux Complex. See also above: Psychomotor agitation).
- Cardiac arrhythmia (symptomatology similar to the acute heart condition when an MSW attempts to do math).